Re: Canadian EMRs

[Guest guest]

Liza,

There are lots of folks on the list who

use affordable EMR’s. We personally use e-MDs and have found it to

be well worth the investment – one that actually allows us to have an

IMP-type practice. Dr. Roy (who currently shares our office space and

whose practice I also manage) just purchased computers and the license for

e-MDs to move to his new location. I think it was about $25K without training

for the hardware and software. However, if you consider that with EMR you

will be saving at least 1 full time employee (if not more), then you have saved

that amount in your first year of practice.

That said, we looked extensively at EMRs

before we decided upon e-MDs. We created criteria for what we wanted in

the EMR, and compared each system to that set of criteria. Each person

needs to evaluate for him/herself what those criteria should be and what

importance they should take. Just some of ours:

How

easy is the billing? (I was starting out to do Steve’s billing

from the get-go, with very little billing experience)

Is

the system easy to use during a face-to-face patient encounter?

Is

there a lot of free-text typing required? (we wanted one that didn’t

have a lot because Steve is a slow typist)

Is

the system user-friendly?

Can

the system be used remotely?

What

are the initial and annual required costs? (e-MDs annual upgrades and

support is about $1800)

We test-drove about 8 different EMR’s

after looking at about 25 different products. Some of them were

discounted right off the bat because they didn’t have easy conversion for

billing, or they were going to require a separate billing program that didn’t

seamlessly integrate, or they were too hard to use during a patient encounter.

We narrowed it down to 3: NextGen (totally unaffordable at about $100K),

e-MDs, and one other that I can’t recall now (it was over 5 years ago!)

but I do remember that it was an ASP module, which my IT brother said to avoid –

that it would be more expensive in the long run.

Keep in mind that every system has some

flaws – you also need to talk to current users and decide for yourself

what is important and what flaws you could or possibly could not live with.

Good luck in your decision!

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of Liza Samson

Sent: Tuesday, June 23, 2009 5:52

PM

To:

Subject:

Canadian EMRs

Trying to start an IMP and looking at EMRs; US companies that

sell the integrated systems often charge in the 15 to 30 K range so not doable

for an IMP unless I want to go into great debt; I looked at the

Canadian EMRs and they have MOIS that is really affordable for IMPs but cannot

sell unless there is a business entity or licensing entity in the US and a

portal; I asked how does one get a portal-- they said usu government and

educational institutions get their own; so Gordon, do you have a portal

that the IMPs can tap into? Just curious how this is all set up; I see lots of

big money going into the EMRs like GE, E Md; are there affordable

options? Just fishing for ideas; here is the link for MOIS which is

a nonprofit IT based in BC and charge around 2000 a year total, prorated to

amount of use.

http://www.canadianemr.ca/index.aspx?type=viewcontent & vid=54 & at=3

[Guest guest]

As always ditto to

________________________________________

From:

[ ] On Behalf Of Pratt

[karen.oaktree@...]

Sent: Tuesday, June 23, 2009 7:19 PM

To:

Subject: RE: Canadian EMRs

Liza,

There are lots of folks on the list who use affordable EMR’s. We personally use

e-MDs and have found it to be well worth the investment – one that actually

allows us to have an IMP-type practice. Dr. Roy (who currently shares our

office space and whose practice I also manage) just purchased computers and the

license for e-MDs to move to his new location. I think it was about $25K

without training for the hardware and software. However, if you consider that

with EMR you will be saving at least 1 full time employee (if not more), then

you have saved that amount in your first year of practice.

That said, we looked extensively at EMRs before we decided upon e-MDs. We

created criteria for what we wanted in the EMR, and compared each system to that

set of criteria. Each person needs to evaluate for him/herself what those

criteria should be and what importance they should take. Just some of ours:

1. How easy is the billing? (I was starting out to do Steve’s billing from

the get-go, with very little billing experience)

2. Is the system easy to use during a face-to-face patient encounter?

3. Is there a lot of free-text typing required? (we wanted one that didn’t

have a lot because Steve is a slow typist)

4. Is the system user-friendly?

5. Can the system be used remotely?

6. What are the initial and annual required costs? (e-MDs annual upgrades and

support is about $1800)

We test-drove about 8 different EMR’s after looking at about 25 different

products. Some of them were discounted right off the bat because they didn’t

have easy conversion for billing, or they were going to require a separate

billing program that didn’t seamlessly integrate, or they were too hard to use

during a patient encounter. We narrowed it down to 3: NextGen (totally

unaffordable at about $100K), e-MDs, and one other that I can’t recall now (it

was over 5 years ago!) but I do remember that it was an ASP module, which my IT

brother said to avoid – that it would be more expensive in the long run.

Keep in mind that every system has some flaws – you also need to talk to current

users and decide for yourself what is important and what flaws you could or

possibly could not live with. Good luck in your decision!

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

________________________________

From:

[mailto: ] On Behalf Of Liza Samson

Sent: Tuesday, June 23, 2009 5:52 PM

To:

Subject: Canadian EMRs

Trying to start an IMP and looking at EMRs; US companies that sell the

integrated systems often charge in the 15 to 30 K range so not doable for an IMP

unless I want to go into great debt; I looked at the Canadian EMRs and they

have MOIS that is really affordable for IMPs but cannot sell unless there is a

business entity or licensing entity in the US and a portal; I asked how does one

get a portal-- they said usu government and educational institutions get their

own; so Gordon, do you have a portal that the IMPs can tap into? Just curious

how this is all set up; I see lots of big money going into the EMRs like GE, E

Md; are there affordable options? Just fishing for ideas; here is the link for

MOIS which is a nonprofit IT based in BC and charge around 2000 a year total,

prorated to amount of use.

http://www.canadianemr.ca/index.aspx?type=viewcontent & vid=54 & at=3

[Guest guest]

Oh dear. So a new IMP start up would need ~$25k right out of the

chute for emr. Ouch.

> As always ditto to

> ________________________________________

> From:

[

> ] On Behalf Of Pratt [karen.oaktree@...]

> Sent: Tuesday, June 23, 2009 7:19 PM

> To:

> Subject: RE: Canadian EMRs

>

> Liza,

>

> There are lots of folks on the list who use affordable EMR’s. We

> personally use e-MDs and have found it to be well worth the

> investment – one that actually allows us to have an IMP-type

> practice. Dr. Roy (who currently shares our office space and whose

> practice I also manage) just purchased computers and the license for

> e-MDs to move to his new location. I think it was about $25K

> without training for the hardware and software. However, if you

> consider that with EMR you will be saving at least 1 full time

> employee (if not more), then you have saved that amount in your

> first year of practice.

>

> That said, we looked extensively at EMRs before we decided upon e-

> MDs. We created criteria for what we wanted in the EMR, and

> compared each system to that set of criteria. Each person needs to

> evaluate for him/herself what those criteria should be and what

> importance they should take. Just some of ours:

>

>

> 1. How easy is the billing? (I was starting out to do Steve’s

> billing from the get-go, with very little billing experience)

> 2. Is the system easy to use during a face-to-face patient encounter?

> 3. Is there a lot of free-text typing required? (we wanted one

> that didn’t have a lot because Steve is a slow typist)

> 4. Is the system user-friendly?

> 5. Can the system be used remotely?

> 6. What are the initial and annual required costs? (e-MDs annual

> upgrades and support is about $1800)

>

> We test-drove about 8 different EMR’s after looking at about 25

> different products. Some of them were discounted right off the bat

> because they didn’t have easy conversion for billing, or they were

> going to require a separate billing program that didn’t seamlessly

> integrate, or they were too hard to use during a patient encounter.

> We narrowed it down to 3: NextGen (totally unaffordable at about

> $100K), e-MDs, and one other that I can’t recall now (it was over 5

> years ago!) but I do remember that it was an ASP module, which my IT

> brother said to avoid – that it would be more expensive in the long

> run.

>

> Keep in mind that every system has some flaws – you also need to

> talk to current users and decide for yourself what is important and

> what flaws you could or possibly could not live with. Good luck in

> your decision!

>

>

>

> Pratt

> Office Manager

> Oak Tree Internal Medicine P.C

> Roy Medical Associates, Inc.

> ________________________________

> From:

[mailto:

> ] On Behalf Of Liza Samson

> Sent: Tuesday, June 23, 2009 5:52 PM

> To:

> Subject: Canadian EMRs

>

>

>

>

> Trying to start an IMP and looking at EMRs; US companies that sell

> the integrated systems often charge in the 15 to 30 K range so not

> doable for an IMP unless I want to go into great debt; I looked at

> the Canadian EMRs and they have MOIS that is really affordable for

> IMPs but cannot sell unless there is a business entity or licensing

> entity in the US and a portal; I asked how does one get a portal--

> they said usu government and educational institutions get their

> own; so Gordon, do you have a portal that the IMPs can tap into?

> Just curious how this is all set up; I see lots of big money going

> into the EMRs like GE, E Md; are there affordable options? Just

> fishing for ideas; here is the link for MOIS which is a nonprofit

> IT based in BC and charge around 2000 a year total, prorated to

> amount of use.

>

> http://www.canadianemr.ca/index.aspx?type=viewcontent & vid=54 & at=3

>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

No, that's the extreme near top end option.

Lots of low cost options if you're willing to explore them starting at

$0/month ( for adverts in your face )

> Oh dear.  So a new IMP start up would need ~$25k right out of the

> chute for emr.  Ouch.

>

>

>> As always ditto to

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

[Guest guest]

I love Amazing Charts..what is it, $500/year? Love it. It has done just about everything I want it to do.

To: Sent: Tuesday, June 23, 2009 10:11:35 PMSubject: Re: Canadian EMRs

No, that's the extreme near top end option.Lots of low cost options if you're willing to explore them starting at$0/month ( for adverts in your face )On Wed, Jun 24, 2009 at 2:03 PM, Kathleen Patton<krpattoncomcast (DOT) net> wrote:> Oh dear. So a new IMP start up would need ~$25k right out of the> chute for emr. Ouch.> >>> As always ditto to -- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.

[Guest guest]

As has been stated, there are two camps on this idea. 

 

Started my IMP in June 2005, paid way more money than I would like to admit for start up.  Here it is June 2009 and I " only " have 8 more payments until I have finally paid off my start up loans. 

 

I was afraid of the billing portion of the IMP idea, so I bought the idea that start up costs were not such a bad thing and that my EMR was taking the place of at least 1.5 employees.  I chose eClincialWorks.  I did like eMD's, but the vendor here was awful and I had to get started, so I ended up with eCW.  The billing portion of eCW was outstanding.  Unfortunately, the rest of the program did not meet my needs. I met its needs.  So, in Jan of 2008, I switched to Amazing Charts (see my old postings on how much fun switching an EMR can be!).  I did use EZClaim when I was billing insurance.  Worked great.  

 

No one system is perfect.  I deeply regret my initial choice of " the bells and whistles " offered by eCW.  If I had it to do again, there is no doubt that AC would have done just fine and I would have quite a bit more money in my personal back account.   

 

Good luck.

 

Durango,CO

I love Amazing Charts..what is it, $500/year?  Love it.  It has done just about everything I want it to do.

To:

Sent: Tuesday, June 23, 2009 10:11:35 PM Subject: Re: Canadian EMRs

No, that's the extreme near top end option.Lots of low cost options if you're willing to explore them starting at$0/month ( for adverts in your face )On Wed, Jun 24, 2009 at 2:03 PM, Kathleen Patton<krpattoncomcast (DOT) net> wrote:

> Oh dear.  So a new IMP start up would need ~$25k right out of the> chute for emr.  Ouch.> >>> As always ditto to -- Graham Chiu

http://www.synapsedirect.comSynapse - the use from anywhere EMR.

[Guest guest]

We started with 0 patients, but we had a

relocation deal with the hospital to help cover expenses.

(e-MDs user)

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From:

[mailto: ] On

Behalf Of Carla Gibson

Sent: Wednesday, June 24, 2009

8:09 AM

To:

Subject: Re:

Canadian EMRs

It is clear that there is a split on this issue re: cheap EMR of

varying degrees of integration and one that is more expensive and more

integrated. I am wondering if those who chose eMDs at their startup had much of

a patient panel at startup or if they were beginning with a clean slate or

nearly so. THough I would have loved to have had an integrated system, I

would have been doomed to failure if I had chosen that route and the associated

cost. I had zero patients (nearly zero) at the beginning. If I had the

luxury of bringing my panel along with me, life would have been much

different.

It might even be interesting to see how it falls out for those after a

few years in practice- those of us who say " cheap " - do we have the

smaller patient panels still?

I'm an AC girl and have loved it. A tremendous value for the

price and I'm still happy with it.

Carla Gibson FNP

Missoula

MT

From:

Egly <kevin_egly>

To:

Sent: Wednesday, June 24, 2009

8:52:52 AM

Subject: Re:

Canadian EMRs

Liza,

and I purchased eMDs in 2004. Costs are

still similar today. Ours was slightly higher than others because we

paid for 1.5 FTE MDs. After looking at expenses at 5 year into

pratice. The EMR and computers with ongoing yearly expense has

been equal or less than our costs of telecommunication, ie cell phone, office

phones, pagers, and yellowpage adds. It is a reasonable expense less

than 1/5 of typical MA or secretary over same time period.

It is without question the one purchase I could not

have done without. We use it everyday all day without fail, not without

occassional headache. Scheduling, reminders, charting, coding, billing AR,

quality.

I can recommend an IT professional to install your

system. He has installed many eMDs systems and often is the go to guy when

eMDs clinics have problems.

Good luck in your choice.

From: Liza Samson <lzsmsngmail (DOT) com>

Subject: [Practiceimprovemen t1] Canadian EMRs

To: Practiceimprovement 1yahoogroups (DOT) com

Date: Tuesday, June 23, 2009, 7:52 PM

Trying to start an IMP and looking at EMRs; US

companies that sell the integrated systems often charge in the 15 to 30 K

range so not doable for an IMP unless I want to go into

great debt; I looked at the Canadian EMRs and they have MOIS that

is really affordable for IMPs but cannot sell unless there is a business

entity or licensing entity in the US and a portal; I asked how does one

get a portal-- they said usu government and educational institutions get

their own; so Gordon, do you have a portal that the IMPs can tap into?

Just curious how this is all set up; I see lots of big money going into the

EMRs like GE, E Md; are there affordable options? Just fishing

for ideas; here is the link for MOIS which is a nonprofit IT based in

BC and charge around 2000 a year total, prorated to amount of use.

http://www.canadian emr.ca/index. aspx?type=

viewcontent & vid=54 & at=3

[Guest guest]

Thank you so much for everyone sharing their experience with EMRs; still undecided but it looks that integrated EMR may come as a package from one company or can be assembled from diff modules to become one integrated system--there is more than one way to do it.  The definition of meaningful use still undefined and who will set the definition still unknown or has that changed already? Again thank you very much;  this thread has been lost as it fanned out into multiple threads.

I believe you can do it either way. Start paper and scan into EMY as panel build buy EMR year two or at 50% capacity, will save cash flow when there is no cash flow, but implementation of EMR talkes time  and you have the time when panel is slow.  If you already have a panel then implementation slows you down. 

 

There is more than one way to solve this problem.

 

 

PS Good luck in your choice.  Make sure you get the EMR with the right price and the right function.

From: Liza Samson <lzsmsngmail (DOT) com>Subject: [Practiceimprovemen t1] Canadian EMRsTo: Practiceimprovement 1yahoogroups (DOT) comDate: Tuesday, June 23, 2009, 7:52 PM

Trying to start an IMP and looking at EMRs;  US companies that sell the integrated systems often charge in the 15 to 30 K range so not doable for an IMP unless I want to go into great debt;  I looked at the Canadian EMRs and they have MOIS that is really affordable for IMPs but cannot sell unless there is a business entity or licensing entity in the US and a portal; I asked how does one get a portal-- they said usu government and educational institutions get their own;  so Gordon, do you have a portal that the IMPs can tap into? Just curious how this is all set up; I see lots of big money going into the EMRs like GE, E Md;  are there affordable options?  Just fishing for ideas; here is the link for MOIS which is  a nonprofit IT based in BC and charge around 2000 a year total, prorated to amount of use. 

 

http://www.canadian emr.ca/index. aspx?type= viewcontent & vid=54 & at=3