CALLING ALL DOCTORS Take 2! EMR Software Opinions Wanted

One of my readers came upon a post that Dr. Jeff did back in July of 2009 called CALLING ALL DOCTORS! EMR Software Opinions Wanted. They loved reading the comments about the various EMR and EHR vendors (I did too) and they thought maybe it was time to call for doctors to offer their opinions and evaluations again. So, here’s some sections of the original post to get you thinking:

This is a SHOUT OUT to all doctors who use EMRs. Which EMRs do you use and how do you like them. Do you love them or hate them? Are you luke warm in your like or dislike? Tell us which EMR you have and how you feel about it. Also tell us what you would do (the mistakes and the good moves) if you were looking into getting an EMR at this time.

Can you comment on the cost and the usability?. Let’s share information so we can help other doctors choose systems that are usable, simple to learn, effective and efficient.

If you don’t have an EMR and are looking into one, what questions would you have for those “who have gone before you”? What advice would you be interested in receiving?

Also, if you’re someone who likes to hear a doctor’s perspective on EMR and EHR, check out this just launched blog called The Wired EMR Doctor where Dr. Koriwchak will be writing about EMR and EHR from a doctor’s perspective. We’ve primed it with 8 or so posts to get him started. I think you’ll enjoy it.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

35 Comments

  • Used Aprima for 12 months now. 12 provider multispecialty practice. 6 providers refused to use it after 6 months, others continuing with various degrees of success and acceptance. Horrendous implementation problems, service atrocious; overall a totally offensive program which takes multiple “clicks” to do what other programs do in just one or two. Completely non-intuitive, ignoring numerous basic computer program conventions.Totally not-ready-for prime time; sure we’ve been doing their beta-testing, at great expense to us, both in actual outlay and in lost revenue.

  • Ali,
    Thanks for sharing your opinion. Are you really doing a “beta test” for Aprima or do you just feel like it’s a beta test for Aprima since you feel the product still lacks so much?

    It’s also worth noting for readers that Allscripts MyWay EMR is built on the same software platform as Aprima. Although, I’ve heard people say that if someone was interested in Allscripts MyWay, then they should just go with Aprima since it’s the original. Interesting to hear about your bad experience with the product.

  • The latter – the product is so deficient that it feels like we’re doing the beta testing – but, you know, I seriously have little doubt that in fact we were, unbeknownst to us, doing beta testing for at least parts of the program.
    As we struggled through learning unnecessarily complex routines to achieve the simplest of tasks (eg, retrieving scanned-in documents while trying to simultaneously input a visit note) the brilliant (I’m sure) computer geek types who came (after months of complaints) to assist us would patiently offer up a tedious route through the minefield but it never seemed to occur to them that perhaps a simpler solution should have been engineered into the product in the first place. And this is when it seemed to me that we were doing their beta-testing, for it seemed we had to explain to them the simplest and most elementary details about how a physician uses a chart, our work patterns, etc – things that, it seems to me, should be the first items that a software company would think about when they started out to design such a program. I would have been embarrassed (and Aprima certainly should have been) to have presented such an unpolished program as if it were fully functional and state-of-the-art. I truly cannot say enough negative things about this wholly horrid program.

  • Ali,
    Thanks for sharing your views. I’m sorry I didn’t respond earlier. I think I broke my system which emails me new comments:-)

    Have you used any EMR software that doesn’t have these issues? The crazy thing is that I bet Aprima has a whole bunch of doctors that help them design their EMR. So, either those doctors don’t have a strong enough voice or possibly they’re so far removed from day to day operations that they create poor designs.

    My only defense for Aprima and other EMR software is that no two doctors practice alike. So, for every EMR software you can find people who love it and people who hate it. That said, some things are universal.

  • We have been using Aprima for about two years, a practice of six orthopedic surgeons with varying sub specialties. We are recently going through the upgrade. I can’t imagine that there is a more difficult, cumbersom, and user unfriendly EMR out there! We basically set up the entire orthopedic portion. The initial software seemed to be geared towards primary care, from the physical exam to the end of a patient visit there was nothing pretaining to orthopedics. The support is painfully slow and at times non-existent. The program now after the up grade is very slow and we just upgraded our T-line to a higher speed. Some programs make it possible to view xrays and to view scanned documents simultaineously…not in this case. Nothing is easy or should I repeat user friendly. the blog above described the system very accurately…without repeating everything he/she said. The cost of the program is not all inclulsive they nickle and dime you to death, the purchase, for support time, changes required, and the upgrades are excessive. I am not a geek but I am fairly “techie” and have used other older EMRs that were much more user friendly than Aprima. I would not recommend Aprima as I believe there are much better ones out there and certainly the support is better.

  • Daily rut of life resolves around 128min per spent(x3 providers) watching aPrima’s spinning wheel go round & round. Aprima would be awful for a child’s self esteem and development. Have become very tech savvy and have lots of time to see what a total piece of bat dung was flying in my face the past 18months. Arrogance and ignorance or bliss in aprima land. The only culture they know is screwing over as many dr’s and their practice in there government sponsored turf battle. You’s never meet a real person from aprima. My IT guy has to spend days trying to reach via there email only game. Should be run out of business by incompetence they(THE APRIMA CULTURE OF GREED AND NOT GIVING A RAT’S REAREND ABOUT ANYONE ELSE)

  • M Bryan,
    That was really descriptive. Do you think you could give us a bit more information on why and in what ways?

  • I dont have any prior experience on using emrs but we have recently been searching what information we can find and this site in particular has been very helpful 🙂 We had guys from curemd manhattan branch come over and give us an onsite demo. Their staff is really friendly and the product does seem impressive and affordable. Is there anyone who has had experience with curemd smart cloud?

  • Frank,
    Glad you’ve found the site helpful. What did you find most helpful about the site? I’m always interested to learn what I can do to make the site better and to know what’s working so I can do it more.

    What did you like about curemd and what did you not like about it? I’ve never used it myself.

  • About 3 years of Aprima hell under our belts. We are a surgical practice and have been dissatisfied with Aprima from the outset . Terrible support. Shotty implementation. In order to integrate with other systems, Aprima charges twice what most other companies charge to write interfaces. Agree with all negative comments above. Skip Aprima. Find an EMR in wide use and with robust support.

  • Responding to anonymous blogs is difficult.
    Over the last eight years, thousands of providers have selected and installed Aprima. Is it perfect? No, but we constantly invest in the product, the QA and the customer facing activities. On-going we assess our pricing to insure it is competitive. Ultimately, every customer, whether PM or EHR, knows they can email me, or any member of the management team and we will work to get their issues resolved.
    I invite any poster on this site to do the same.

  • Michael,
    Thanks for stopping by to comment. That’s a great offer. I hope that practice administrator follows up with you. I’ll send them an email to make sure they see your response.

  • Thanks for the offer to email you. Please refer to comment #7. The email support via Aprima is a big part of the problem. We have had an open ticket via email for 4 months! I never get emailed back unless I prod for an update. And if you want to speak to someone, get out your wallet. In addition, if I had to email you every time Aprima unexpectedly crashed for no apparent reason, I would have no time for anything else.

    The thousands of doctors who have signed up for Aprima is not the important stat. The number who have since dropped it is the key. I have personally spoken with three large practices who have dropped Aprima recently. It sounds like a trend.

    I am sorry to have to dump on Aprima. I had such hopes for Imedica when it first came out but Comcast-like support and a long string of unfulfilled promises has forced us to go in another direction. I cant have my docs spending an extra hour of their already busy time every day dealing with the EMR.

    Aprima may work for some practices but read the reviews above, not one is positive. Again, my recommendation is to spend a little extra money an go with a known quantity who has a good reputation for excellent support.

    Michael, as the CEO of Aprima, I appreciate your passion for your product. I would recommend you completely re-tool your PM and EMR so that it is flexible to work with any office workflow. One of my doctors’ biggest frustrations was to have to change their workflow to accommodate Aprima. Good luck in the future.

  • I more than happy to share my experience with EMR’s and after looking at numerous choices, Aprima was the obivous choice. One of the main reasons I chose Aprima was the ability to work off line through replication. It has worked well for me and I am excited to get the upgrade next week. I am a wound specialist and I was surprised how easy it was to set up my templates, update them as I go and capture everything I need.
    In addition, what other company actually has a User conference that the time to help clinicians, actually ask for their input and then make the enhancements to help make the EMR work for them.
    Physicians leaving an EMR is probably more of a reflection of the physicians than Aprima. There are indeed thousands of physicians who has probably bought a system, only to never use it.
    You have to use it to make it work for you! and having experienced other EMR’s and their support, there is no comparison. I can pick up the phone or email a number of support people and get them immediately with any question.
    I am willing to bet that if the PM above would have gone to the user conference, they would have gotten a lot of things resolved.
    Frankly, I am very happy with Aprima. I can use my Samsung Slate 7 tablet with no issues at all. I know and have used some of the other choices are out there, all I can say is good luck.

  • I have read the above comments by numerous medical practices and have not experienced these problems with Aprima. My experience has been favorable. After looking at several EMR’s I decide to go with the hosted product from Aprima to start my vein practice, which I opened in January 2, 2011. I wanted the EMR to be in place when the doors opened. After purchase of the product from Aprima, the salesman I was working with was terminated. After multiple weeks of correcting problems with the contract I learned that there was no way that the product would be operational on opening day. I could’ve left the company at that point, but decided to stay with them knowing that any change would’ve just lengthened the time that i did not have an EMR in the practice. The regional sales manager and project implementation manager for Aprima did everything in their power to get me operational soon after opening day. The scheduling piece of the product was started the second week in January. The EMR portion went into effect 17 February. The practice management piece started 22 March.

    Since then I have been very happy with support and upgrades from Aprima. I have attended the last two user conferences put on by Aprima and have walked away with increased ability to make the EMR work for me.

    If physicians and medical practices are looking for utopia in the EMR world, it doesn’t exist. The product is only as good as the amount of training a person is willing to undergo. Once trained, the individual needs to work with the software and build an EMR that works for them. I have found it very easy to build templates for my procedures, with with macro phases to be used in generating a visit note, and to build office specific documents to be used by the practice.

    Following the last user conference in Dallas August 3 through August 5, I have built a predetermination/preauthorization document for my practice. This document pulls the information from a patient’s visit and concisely places it in a one-page format so that the insurance companies know exactly what the patient’s diagnoses are, a long with the requested procedure (CPT) codes that the individual needs to have done to treat their venous disease. I did this with minimal input from support. The ability to create an EMR that works for me, instead for having tech support do all the work, is the real beauty of the Aprima product.

  • Our large healthcare system just began the implementation of Allscripts Enterprise. I can’t speak to the cost other than it seems extraordinary since I’m an employed doctor, but can speak to its usability. I agree with the comment that the product appears to be in the beta phase, which is a bit scary since we are talking about treating patients. Having said that, it appears most of the products are “not ready for prime time”. The templates are awkward and suffer from “clickarrhea”, it is not in any way, shape or form intuitive and as a family practice doctor it is inconceivable that there is no “out-of-the-box” form for health management that performs as it should (as in your MA or nurse can quickly go through important preventive health questions).

    I wrote several blog posts about the implementation disaster in my blog at familypractice2.blogspot.com. It seems ludicrous that every healthcare system has to go through these consistently difficult implementations. We seem to be reinventing the wheel!

  • Dr. Nieder,
    Thanks for sharing. What a great blog. I’m sure to become a regular reader and will likely to blog posts linking to your content in the future. You provide a real perspective of what most doctors experience with EHR. A mix of personal adaptation with questions on why the EHR was designed the way it was. It’s certainly a mix of both.

  • My Gyn practice is looking at Aprima. We actually have a “middleman” who assures us that their service will ensure a smooth implementation, because they will help us construct appropriate templates, use Dragon to customize notes, etc. Do you think the real reason for discordance in opinions about any given EMR really boils down to the MD’s understanding of the system, coupled with the initial effort spent on design? My concern is that most MD’s just don’t have the time to learn a system first, then decide how to best implement it. I just need a one year sabbatical to set up my templates and perfect my workflow…

  • Dr. Sales,
    I do think that the 2 things you mention are 2 of the biggest issues with EMR implementation. Although, I think that both of those can be helped by choosing an EHR that fits well with your practice. You might be able to dig a hole for a pool with a shovel, but a backhoe can do it much faster. Question is whether the EHR you select is more like a backhoe or a shovel. Plus, remember that sometimes the shovel is better than the backhoe. Each clinic has specific needs.

  • We are currently using Allscripts MyWay and are facing the dreaded choice of moving to Allscripts Pro, changing to Aprima, or getting a new system all together. We have had MyWay almost 2 years. Yes, it does have it’s problems – don’t all EMR’s? – but we have been very lucky with our transition to the electronic world. Like another person mentioned, you get out of it what you put into it. If our MD’s had put the effort into setting up their templates in the beginning, it might have been a lot easier for them to grasp in the beginning. But we muddled through and are sailing in mostly calm waters. I am not sure which path to take now…Pro, Aprima, or something else. Has anyone made the move from MyWay to Aprima? Or MyWay to Pro? Any insight would be most apprciated!

  • I have to agree with all the others who do not enjoy working on Aprima. It is very much in the Beta phase still. Simple pleasures of having two folks in a note at once is not possible. Other items like adding insurance information after a Dr. starts a note make it so the patient looks like a self pay patient. One MAJOR Aprima flaw is this inability to have two people in a note at once. (the program starts two notes without the staff knowing) Also, once a note is started it’s started with whatever information is currently in the system. So if for some reason you have to get a patient back quick and the Dr. starts a note before the front desk gets all the information in then once the information is input the note does not reflect the patients full demographics. There are so many flaws within this program it’s not possible to list them. However… Knowing that all EMR’s are not perfect, I would NOT recommend this program! Oh, and Mr. Nissenbaum please send me your email address. I’d be more than happy to give you the list and dates of when our practice has requested fixes/implementation suggestions and how many days we waited for a fix so that you can begin tracking this within your company. It’s a long list and we’re still waiting on many answers.

  • Dear Another Beta Tester:

    My email is mnissenbaum@aprima.com and I look forward to seeing your list and determining what we can do to address your issues. With thousands of providers nationwide using the application it is not, and has not been for a long time, a beta product. Again, I look forward to receiving your issues list.

  • Thank you Michael. Nice to hear back from you so quickly. I’ll start typing and send you a note now.

  • I have to disagree with #24 as that is not our experience at all. It sounds like training and/or workflow issues within the practice. The experience we have is that yes, 2 users can not be in the note at the same time, however, the MD has power to “take over” a locked note. If you are opening the same note as someone else a pop up box comes up letting you know exactly who is in the note. At that point you can retry or cancel or if you are a provider you can take it over so as to not disrupt their flow. You would have to open a new note to get the duplication of notes, the system doesn’t automatically open one.
    Regarding the demographic not being entered prior to note opening, I’m not sure why the demographic information would make a difference in the note section. If the insurance is not entered prior to a note, it’s our experience that again a pop up box comes up letting you know that you have altered information pertaining to a superbill would you like to view? that way you can refile the insurance from one screen.
    I would urge #24 to look at the workflow and maybe seek more training on the system. #16 says it best on that you have to use the EMR correctly to make it work for you.
    We have been using Aprima for several years and still are learning new things to make life easier. Overall it’s a good product and good company that I would recommend.
    Good Luck.

  • It’s actually a great and useful piece of information. I am happy that you just shared this helpful information with us. Please keep us informed like this. Thank you for sharing.

  • After an adequate trial using Aprima, and having had 10 years experience using several EHRs, my opinion is that Aprima rates a 4-5/10…very average, nothing to brag on. Probably would not purchase again.
    Creating a visit note is actually quite easy as is prescribing and ordering…. except for the never-ending spinning wheel as others have noted.
    Indeed, the program is quite customizable providing one has the hundreds of hours necessary to experiment with and build the basic elements of the program one would expect would come with such a product at such a cost such as H&Ps, letters, etc.
    The program is quite robust, and the more robust the program the less intuitive and the less user-friendly. It takes a learning curve just to learn the icons and what they do. Interesting to note that there are no icons for such basic things such as x-ray reports, consults, hospital records, or PFTs. To find these, one must click on one item, then click another, then click another to open the report. Awkward.
    The messaging system seems to be straight out of the 1990s. Once a message is started, one cannot go back to review labs or notes without cancelling out and starting over. One just has to hope to remember all those lab values that needed comments….or make hand written notes which negates the value of electronic messaging.
    Like all other CCHIT certified EHRs, Aprima does everything necessary, just with more angst and irritation.
    All in all, Aprima has a long way to go to make the program easier for providers to use and to customize. As time goes on, only a few vendors will rise to the top and survive such a competitive market. I doubt Aprima will be one of them.

  • Experienced End User-
    I read your comment and while I do not agree with your conclusion, I would welcome a direct email mnissenbaum@aprima.com to discuss your issues and address solutions where possible. A spinning wheel may be a network issue instead of an application issue, especially if you are on Aprima PRM 2011. We are always listening to our users and would be delighted to help make Aprima the last EHR you buy.

  • I’m the superuser for our Aprima system at a small surgical practice. We signed up when it was still iMedica, and I have enhancement requests and bug reports dating back that far as well. In my spare time I develop software, and have spent a lot of time studying user interaction design. Aprima is an abomination from a usability standpoint. It’s cumbersome, heavy-handed, and the tools they provide you to create customized procedure note templates are completely inadequate for anything other than the most basic and simplistic notes.

    There are simple changes that can be made to greatly improve usability that have been ignored for years, while development resources have been squandered on unnecessary items that duplicate functionality with existing products such as instant messaging. You can tell that this is software created by people who have no passion for their product. I don’t have experience with many other EMR’s out there (and I suspect this attitude is widespread in the industry). I would look at everything else out there long and hard before getting trapped with Aprima.

  • My practice has been using Aprima now for almost 5 years. There was an extensive selection process with Aprima being narrowed down to the best choice for our multi-specialty practice. We have had growing pains but some if not most were from lack of our practice staff and providers buy-in when going from paper charts to EMR. Aprima’s EMR is better than most that are out there and the PM side of Aprima is getting better and better and in time it will catch up and be comparable to “big boys” out there. Yes, we like Aprima and we have providers that don’t like ANY EMR and will never like being on EMR regardless of which one.

    Also, even though Aprima is growing fast, they have never made us feel like we are forgotten or hung out to dry. Mike Nissenbaum was correct; you can email him or anyone at Aprima and get a very quick response; if not a phone call from them wanting to help. Please tell me if you can do that with CEO’s of the other companies, I don’t think you can.

    Anyone who is having a hard time with the functionality of Aprima EMR then you are working against it not with it. It truly is not what the negative comments are leading it on to be. I would recommend Aprima without question.

  • My 4 provider group has been on Allscripts Myway since Oct 2010. We changed from the cloud to on site server in Jan 2012 because of the “wheel” and horrible dropped dragon notes. Originally we decided to go the Pro route, but the conversion, after a year and all the training done is still no closer to going live than Feb 2014! We are now speaking to Aprima tomorrow and reviewing their product. I’d love to hear from folks who have gone Myway to Aprima and what good and bad experiences. And Michael I’d love to hear from you…

  • Hi Barbara,

    It sounds like you have the groundwork laid for a successful migration to Aprima. Please review the product tomorrow and reach out to me after you have seen the application. We can do it via client server or hosted, and having close to 600 practices migrated, would love to have join the Aprima family.

    Just in case it does not post, I am at mnissenbaum@aprima.com. Shoot me your contact information when convenient.

    Thanks for your interest and look forward in hearing from you

    MKN

  • Long story short with Aprima: So slow to take to next page that you can go heat your coffee and come back… Crashes so many times a day, TOO MANY steps to get to one screen, and the POOR and SLOW turn around time customer service.

    The management is so unethical that they can charge you unexpected fees with no explanation. The CEO of Dr Administrative solutions is driven by anger and malintended. This has been a horror story for us thanks God, our attorney won over their “agreement”.

    DONT BUY if you want an advice!!

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