Re: EMR/practice management f/u

[Guest guest]

Would you mind sharing which systems you reviewed (and your thoughts about

them in whatever detail you have time for)? I am looking for an integrated

package myself and am struggling with the decision.

With respect, I think $17K is ridiculous. On top of this, how much is the

annual support? You don't, technically, ever own a piece of software. Read

the license. If you owned it, you could sell or even give it to someone

else. You only rent it for $17K or, with the help of the bank, for

$825/month. After you've paid off the loan, they will continue to milk you

somehow. What are the support fees, $2000/year? I'm sure there will also be

some reason to charge extra for a special upgraded version, as well, when in

2007 or so our government throws in some new HIPAA-like piece of legislation

that makes the current software obsolete.

I'm sorry if this sounds like I am upset. I am. Not at you, but at software

companies that are ripping us off!

The other thing that is driving me crazy about these companies is that very

few of them are willing to let you have and hold a working demo of their

software. I am considering buying eClinicalWorks (by their subscription

method) but I am only able to evaluate it via a Webex demo. How am I

supposed to know if, by the end of a working day, I am able to keep up with

all of the clicks I will have to do to document visits, unless I am able to

test it in this situation. You wouldn't buy a car based on a video of

someone else showing how it handles!

It seems like several of you on the list are using Alteer, I would like to

know if you all are using it as an EMR as well. When I demo'ed it, it seemed

like it had excellent billing and practice management modules. But I was

very underwhelemed with its EMR. Seemed like it took forever to document a

visit; even the salesman kept making excuses for it and admitted that very

few offices were paperless with it as an EMR. Maybe it has improved since

then.

Is their anyone out there using a different software package? Maybe you

could write in the pros and cons of what you have and if you think it is

worth the money. Specifically, anyone using eClinicalWorks. After demo'ing

about a dozen products, I think this one is probably the strongest, i.e., of

the ones that are priced under $20K per provider. I love the fact that I can

subscribe for $250/mon for the EMR and $400/mon for the whole package. This

includes support. You can purchase it for $7500 or $10000 and then pay

~$2000/year for support if you prefer. The software still sits on your own

server, so if you decide to stop subscribing, all of your data is still

there (the software just knows to not allow you to enter anything new). If

eCW goes out of business, all of a sudden, you still are the steward of your

own data. $400/month, I can do. But it's still hard to know if it will make

me more efficient then something like AmazingCharts (at $500 one time).

Sorry for the rant,

Greg Hinson, MD

EMR/practice management f/u

Graham will receive a packet of info on EMR/practice management

systems I researched along with pricing quotes for the hardware and

software. As a solo practicioner the best deal was Alteer who gave me a 10%

discount just because I was going to go with someone else. Their software

is 17K and you own it. I got a 5.2% loan on $40,000 (it includes my monthly

support for one year etc, I did this because my student loans are locked in

at 8% and I'm putting my income there). My hardware quote was $8000 for

everything (server,workstation,laptop,scannerX2,wireless

connectivity,printer all cables and business software and installation with

3 year warranty). Physician Microsystems was my second choice, but with

their ASP model you never own the software, in 3 years alteer is yours the

way I set it up. So for everything I am paying 825 a month to HPSC bank,

with my $325 rent, 49.95 phone, I am making a good net income.

Feel free to call with any questions...it's overwhelming like any new

language while you're learning

Rothe DO

379 Piney Branch Way

Burnsville, NC 28714

(828)273-2889

[Guest guest]

You can truly own the software. Soapware is a company that has a

great business model for this. Is there support cost for upgrades.

Yes about 300 a year.

I used it for several years. I was stung by medical manager years

ago. It was as Dr. Hinson suggested, ongoing , never ending costs.

There are none with Alteer as far as I know and believe me I asked.

Are there ongoing costs, you bet. Computer storage in the sky is

not cheap and it currently goes for about 300 a month. There is

also a 600 dollar a year cost for the data interchange to get claims

paid. I am still skeptical however that there will not be a time in

the future when they will try to tap us again.

Alteer has allowed 2 physicians in their first month of practice so

far see on average of 50 plus patients daily, minimize staff to 3.5

employees or less , work happy, and work smart. Have we had our

problems? yes and we were both computer literate.

Any computer system has to be programmed once. Alteer is more

template driven. You have to take the time to set up the templates

like you practice medicine. Have we taken the time to get all the

templates set up like we would like? No.

Another problem is there is no place in social history to include

tidbits about the patient like work hx, hobbies, religiousity etc.

I hear the upgrade will be improved in this regard.

Demos are a problem. It was hard to put down the money for a system

that was only shown by a sales person. We were lucky enough to have

a doctor on this list serv take the time to show us how he used

alteer.

We are more than happy to do that for anybody interested.

Brent

> Would you mind sharing which systems you reviewed (and your

thoughts about

> them in whatever detail you have time for)? I am looking for an

integrated

> package myself and am struggling with the decision.

>

> With respect, I think $17K is ridiculous. On top of this, how much

is the

> annual support? You don't, technically, ever own a piece of

software. Read

> the license. If you owned it, you could sell or even give it to

someone

> else. You only rent it for $17K or, with the help of the bank, for

> $825/month. After you've paid off the loan, they will continue to

milk you

> somehow. What are the support fees, $2000/year? I'm sure there

will also be

> some reason to charge extra for a special upgraded version, as

well, when in

> 2007 or so our government throws in some new HIPAA-like piece of

legislation

> that makes the current software obsolete.

>

> I'm sorry if this sounds like I am upset. I am. Not at you, but at

software

> companies that are ripping us off!

>

> The other thing that is driving me crazy about these companies is

that very

> few of them are willing to let you have and hold a working demo of

their

> software. I am considering buying eClinicalWorks (by their

subscription

> method) but I am only able to evaluate it via a Webex demo. How am

I

> supposed to know if, by the end of a working day, I am able to

keep up with

> all of the clicks I will have to do to document visits, unless I

am able to

> test it in this situation. You wouldn't buy a car based on a video

of

> someone else showing how it handles!

>

> It seems like several of you on the list are using Alteer, I would

like to

> know if you all are using it as an EMR as well. When I demo'ed it,

it seemed

> like it had excellent billing and practice management modules. But

I was

> very underwhelemed with its EMR. Seemed like it took forever to

document a

> visit; even the salesman kept making excuses for it and admitted

that very

> few offices were paperless with it as an EMR. Maybe it has

improved since

> then.

>

> Is their anyone out there using a different software package?

Maybe you

> could write in the pros and cons of what you have and if you think

it is

> worth the money. Specifically, anyone using eClinicalWorks. After

demo'ing

> about a dozen products, I think this one is probably the

strongest, i.e., of

> the ones that are priced under $20K per provider. I love the fact

that I can

> subscribe for $250/mon for the EMR and $400/mon for the whole

package. This

> includes support. You can purchase it for $7500 or $10000 and then

pay

> ~$2000/year for support if you prefer. The software still sits on

your own

> server, so if you decide to stop subscribing, all of your data is

still

> there (the software just knows to not allow you to enter anything

new). If

> eCW goes out of business, all of a sudden, you still are the

steward of your

> own data. $400/month, I can do. But it's still hard to know if it

will make

> me more efficient then something like AmazingCharts (at $500 one

time).

>

> Sorry for the rant,

>

> Greg Hinson, MD

>

>

>

>

> EMR/practice management f/u

>

>

>

> Graham will receive a packet of info on EMR/practice

management

> systems I researched along with pricing quotes for the hardware and

> software. As a solo practicioner the best deal was Alteer who

gave me a 10%

> discount just because I was going to go with someone else. Their

software

> is 17K and you own it. I got a 5.2% loan on $40,000 (it includes

my monthly

> support for one year etc, I did this because my student loans are

locked in

> at 8% and I'm putting my income there). My hardware quote was

$8000 for

> everything (server,workstation,laptop,scannerX2,wireless

> connectivity,printer all cables and business software and

installation with

> 3 year warranty). Physician Microsystems was my second choice,

but with

> their ASP model you never own the software, in 3 years alteer is

yours the

> way I set it up. So for everything I am paying 825 a month to

HPSC bank,

> with my $325 rent, 49.95 phone, I am making a good net income.

>

>

> Feel free to call with any questions...it's overwhelming like any

new

> language while you're learning

>

>

> Rothe DO

> 379 Piney Branch Way

> Burnsville, NC 28714

> (828)273-2889

>

>

>

[Guest guest]

I'm using topsuite by emds. Cost is $7500 per provider (just me)and when you add

licenses ($500/computer), training ($1000/day), one year of upgrades ($1400) and

support ($1800), and set up fee for e-billing ($500), it equates more to $14000.

As I wanted an integrated network with my nurse (only other employee), I needed

a server (with tape drive back-up and 4 back-up hard drives), 2 pcs, scanner,

printer (total hardware-$12000). Add an additional $2500 or so for a networking

guy to put it all together and the total package is right at $30,000. It is very

expensive, but my hope is that I can make the money back by not needing a

medical records person and by doing my own billing. So far, 8 months in, it is

working great. I also like the fact it is not over the internet. Although I have

to carry a tape home with me every night for safekeeping, I don't have to rely

on my internet connection (which proved beneficial when Isabelle blew through).

[Guest guest]

Greetings,

I am still befuddle by trying to find a program that enables me to do my own billing. How are you doing it?

Tim

[Guest guest]

With most of the venders who interface EMR/scheduling and billing they sell the

billing component separately if you want it (Harmony, web-md's practice manager,

physician microsystems, NextGen etc) the AAFP site has a run down too.

Rothe DO

379 Piney Branch Way

Burnsville, NC 28714

(828)273-2889

[Guest guest]

Alteer's newest version has point and click for those who prefer it, and my

sales rep gave a bunch of references to contact...maybe it was sales rep

differences? All of the system really seemed about the same to me in the end.

I chose the internet based version because I didn't want to be responsible for

backup, upgrades are done automatically at their site (the people I did contact

said that was their biggest headache), and living in the mountains if is

difficult getting people out here in a reasonable timeframe, with the ASP model

they can access your software from there and trouble shoot with you...

Sorry this is still in this forum...again I invite people searching to call

rather than write.

Rothe DO

379 Piney Branch Way

Burnsville, NC 28714

(828)273-2889

[Guest guest]

As far as " owning " the software, I just mean that after its paid off (three

years at my rate)I only have to pay support fees. With the other off site

vendors you pay $600+ a month forever. The 5.0 upgrade if included with Alteer,

to be released this spring. If they develop modules they will be extra, but

they are geared toward specialist not FP's. Practice Partner and e-md will send

demo's on disc, it was nice to do it at will, but it was less helpful than going

through it with the sales rep or through web-based demos where I had specific

questions answered. All of the other reps took me through it at least three

times before I made my decision.

It is an overwhelming sum...but that's computor technology not the vendors.

There only high fee is the training. I just look at it for the benefits, I will

save at least that in employees each year, and the efficiency doesn't have a

price tag - I am VERY happy compared to how I was practicing.

Rothe DO

379 Piney Branch Way

Burnsville, NC 28714

(828)273-2889

[Guest guest]

Thanks, for the " EMR packet " . When I'm finished, shall I mail it

back to you or would you prefer I send it on to whomever else from this

list is interested?

Actually, I'm glad you use this forum for this discussion because I find

more information better than none. I also don't think anyone minds

getting mail that may cover previously discussed topics...it's always easy

to skim and delete a message if it doesn't pertain to you. Plus, I

believe the more we talk about this exciting way to practice, the more

polished the idea gets in our application of it. Lately I've noticed a

lull in the conversations... I'll let you guys know how my

house/practice hunting is going soon. Have to go meet my Realestate agent

now!

Thanks agian!

-

>

>

>

>

>

> Alteer's newest version has point and click for those who prefer it, and

> my sales rep gave a bunch of references to contact...maybe it was sales

> rep differences? & nbsp; All of the system really seemed about the same to

> me in the end. & nbsp; I chose the internet based version because I didn't

> want to be responsible for backup, upgrades are done automatically at

> their site (the people I did contact said that was their biggest

> headache), and living in the mountains if is difficult getting people

> out here in a reasonable timeframe, with the ASP model they can access

> your software from there and trouble shoot with you...

>

> Sorry this is still in this forum...again I invite people searching to

> call rather than write. Rothe DO

> 379 Piney Branch Way

> Burnsville, NC 28714

> (828)273-2889

>

>

>

>

>

[Guest guest]

With the topssuite program, its easy. I use the ICD-9 code for the diagnosis and

select the appropriate CPT code while I'm in chart. I then open the billing

section. Hit " posting " and then hit " built invoice. " I then look over the

invoice and save it. At the end of the day, I send all the invoices to McKesson

(the clearinghouse) and wait for the check to come in. The whole process takes

seconds for easy claims, minutes to longer for rejected claims. But overall, its

very doable.

[Guest guest]

With the topssuite program, its easy. I use the ICD-9 code for the diagnosis and

select the appropriate CPT code while I'm in chart. I then open the billing

section. Hit " posting " and then hit " built invoice. " I then look over the

invoice and save it. At the end of the day, I send all the invoices to McKesson

(the clearinghouse) and wait for the check to come in. The whole process takes

seconds for easy claims, minutes to longer for rejected claims. But overall, its

very doable.

[Guest guest]

I'm in Newport News, Va and would love to get together and talk if you can. I am

actually loading the upgrade 5.1 version tonight and we'll see if all the

changes (patient database among them) are as good as they sound. Although we're

still not in the clear financially yet, we seem to be treading water for now

(hopefully February and March will be good to us). Call me at if

you can get together. As in Gordon's model, you can reach me any time through

that number.

[Guest guest]

My quote from alteer was $12,000 more than the e-mds product. In my limited

experience with Alteer, the functionality is similar. The database with pop-up

reminders for each patient depending on disease state (if this is more than just

hype)would set e-mds apart. Also, it depends if you would rather have a

web-based operation or have it all in house. Overall, both seem great. I know my

notes are far better than they ever were when I was hand writing, and the time I

spend creating them is not significantly increased. I am also allowed to bill

higher because the documentation is so complete (Note: I am not overbilling, I

am finally billing correctly). I have no doubts it will pay for itself in 1-2

years.