Re: starting up, need an EMR

[Guest guest]

Opening a practice is difficult at the best of times .. and one of the most important things is to maximize your cashflow by minimizing your outgoings.

I'm looking at eMDs, Clearpractice, and AthenaHealth.  Clearpractice is software as a service and is about $600/mo.  I wouldn't need to purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is established (and people seem to love it) but is a bigger initial outlay ($25K for hardware, IT help, backup...). Anyone have any thoughts?

------------------------------------

[Guest guest]

We have been very happy users of e-MDs for

almost 6 years now. It is definitely worth the cost. We are, however,

switching from an in-house server to Tangible Solutions Happe-MDs suite. The

ROI for 5 years is about the same, but we won’t have the hassles of

updating the software or maintaining the server, etc. All you need is an

internet connection, so you can use existing hardware, if you want. I would

recommend also having a FAX gateway, which you can purchase through Tangible

for about $900. You can check them out at www.happe-mds.com

Good luck with your decision, and I’d

be happy to answer any questions you have about e-MDs.

(no financial interest, just

satisfied customers!)

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of dshep0127@...

Sent: Thursday, January 06, 2011

8:22 AM

To:

Subject:

starting up, need an EMR

I'm looking at eMDs, Clearpractice, and AthenaHealth.

Clearpractice is software as a service and is about $600/mo. I wouldn't need to

purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is

established (and people seem to love it) but is a bigger initial outlay ($25K

for hardware, IT help, backup...). Anyone have any thoughts?

[Guest guest]

Look at practice fusion – essentially free emr….. From: [mailto: ] On Behalf Of dshep0127@...Sent: Thursday, January 06, 2011 8:22 AMTo: Subject: starting up, need an EMR I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is software as a service and is about $600/mo. I wouldn't need to purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is established (and people seem to love it) but is a bigger initial outlay ($25K for hardware, IT help, backup...). Anyone have any thoughts?

[Guest guest]

Look at practice fusion – essentially free emr….. From: [mailto: ] On Behalf Of dshep0127@...Sent: Thursday, January 06, 2011 8:22 AMTo: Subject: starting up, need an EMR I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is software as a service and is about $600/mo. I wouldn't need to purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is established (and people seem to love it) but is a bigger initial outlay ($25K for hardware, IT help, backup...). Anyone have any thoughts?

[Guest guest]

I second what Graham is saying. I'm still working on a startup. My plan is to

use PracticeFusion which is free. Some like it () and some don't (Alla).

When I open, I figure I'll have more time than patients and money. When I get

to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing

Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've

used before and LOVE!).

Business startup is about cash flow. It's easier to build a practice when you

aren't sinking. Don't dig a hole so big you can't get out of it.

On the other hand, if you have 500+ patients that will follow you from another

practice, you can expect cash flow will be better so the risk is lower.

Craig

>

> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> > software as a service and is about $600/mo. I wouldn't need to purchase

> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> > established (and people seem to love it) but is a bigger initial outlay

> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >

> >

> >

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

> >

> >

[Guest guest]

Practice fusion isNotTotally free ! Did youCheck hello health.com?Sent from my iPhoneDean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).

When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!).

Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.

On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.

Craig

>

> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> > software as a service and is about $600/mo. I wouldn't need to purchase

> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> > established (and people seem to love it) but is a bigger initial outlay

> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >

> >

> >

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

> >

> >

[Guest guest]

Practice fusion isNotTotally free ! Did youCheck hello health.com?Sent from my iPhoneDean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).

When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!).

Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.

On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.

Craig

>

> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> > software as a service and is about $600/mo. I wouldn't need to purchase

> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> > established (and people seem to love it) but is a bigger initial outlay

> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >

> >

> >

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

> >

> >

[Guest guest]

Can someone please tell me more about Practice Fusion and the REAL costs?

I am so frustrated with Practice Partner that I am ready to dump it after one year in....

Also, are there any other systems beside Relay Health that allow secure messaging with patients??

Thank you all!

Dannielle

To: " " < >Sent: Thu, January 6, 2011 11:50:57 AMSubject: Re: Re: starting up, need an EMR

Practice fusion is

Not

Totally free ! Did you

Check hello health.com?

Sent from my iPhone Dean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!). Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.Craig > > > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is> > software as a service and is about $600/mo. I wouldn't need to purchase> > hardware, upgrades, worry about backups, or hire IT help. eMDs is> > established (and people seem to love it) but is a bigger initial outlay> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?> >> >> >> >

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

[Guest guest]

Can someone please tell me more about Practice Fusion and the REAL costs?

I am so frustrated with Practice Partner that I am ready to dump it after one year in....

Also, are there any other systems beside Relay Health that allow secure messaging with patients??

Thank you all!

Dannielle

To: " " < >Sent: Thu, January 6, 2011 11:50:57 AMSubject: Re: Re: starting up, need an EMR

Practice fusion is

Not

Totally free ! Did you

Check hello health.com?

Sent from my iPhone Dean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!). Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.Craig > > > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is> > software as a service and is about $600/mo. I wouldn't need to purchase> > hardware, upgrades, worry about backups, or hire IT help. eMDs is> > established (and people seem to love it) but is a bigger initial outlay> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?> >> >> >> >

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

[Guest guest]

Can someone please tell me more about Practice Fusion and the REAL costs?

I am so frustrated with Practice Partner that I am ready to dump it after one year in....

Also, are there any other systems beside Relay Health that allow secure messaging with patients??

Thank you all!

Dannielle

To: " " < >Sent: Thu, January 6, 2011 11:50:57 AMSubject: Re: Re: starting up, need an EMR

Practice fusion is

Not

Totally free ! Did you

Check hello health.com?

Sent from my iPhone Dean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!). Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.Craig > > > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is> > software as a service and is about $600/mo. I wouldn't need to purchase> > hardware, upgrades, worry about backups, or hire IT help. eMDs is> > established (and people seem to love it) but is a bigger initial outlay> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?> >> >> >> >

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

[Guest guest]

600/mo is a ton of money    When you start up, while you do not want to change EMRs later,   do keep cost slow When few patients are coming in  but bills DO come in, taking on large overhead can  casue bad troubleJean

 

I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is software as a service and is about $600/mo. I wouldn't need to purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is established (and people seem to love it) but is a bigger initial outlay ($25K for hardware, IT help, backup...). Anyone have any thoughts?

--      MD          ph    fax impcenter.org

[Guest guest]

600/mo is a ton of money    When you start up, while you do not want to change EMRs later,   do keep cost slow When few patients are coming in  but bills DO come in, taking on large overhead can  casue bad troubleJean

 

I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is software as a service and is about $600/mo. I wouldn't need to purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is established (and people seem to love it) but is a bigger initial outlay ($25K for hardware, IT help, backup...). Anyone have any thoughts?

--      MD          ph    fax impcenter.org

[Guest guest]

600/mo is a ton of money    When you start up, while you do not want to change EMRs later,   do keep cost slow When few patients are coming in  but bills DO come in, taking on large overhead can  casue bad troubleJean

 

I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is software as a service and is about $600/mo. I wouldn't need to purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is established (and people seem to love it) but is a bigger initial outlay ($25K for hardware, IT help, backup...). Anyone have any thoughts?

--      MD          ph    fax impcenter.org

[Guest guest]

Dean will have to explain why he thinks it is not free as I'm not sure what he

means.

Here's their website:

http://www.practicefusion.com/pages/free_ehr.html

The billing is not free:

http://www.practicefusion.com/pages/medical_billing.html

I've played with PF and it seems great for the price. Seto is very happy

with it. However, I believe Alla got frustrated and switched to Amazing Charts

and swears by it. has been very happy with e-MD. I was very happy with

Allscripts but I was seeing 25+ pts/day at the time (non-IMP model) and it

allowed me to see 1 or 2 patients more a day and go home sooner. In that model,

the additional 1-2 patients a day and going hope sooner made it worth the $$$$.

With PF, you can sign on anytime you want (it's a " free " , cloud-based EMR) and

play with it. They have many training videos via U-tube and are willing to

spend several hours with you on the phone for training.

Craig

> >>

> >> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> >> > software as a service and is about $600/mo. I wouldn't need to purchase

> >> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> >> > established (and people seem to love it) but is a bigger initial outlay

> >> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >> >

> >> >

> >> >

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

> >> >

> >> >

[Guest guest]

Dean will have to explain why he thinks it is not free as I'm not sure what he

means.

Here's their website:

http://www.practicefusion.com/pages/free_ehr.html

The billing is not free:

http://www.practicefusion.com/pages/medical_billing.html

I've played with PF and it seems great for the price. Seto is very happy

with it. However, I believe Alla got frustrated and switched to Amazing Charts

and swears by it. has been very happy with e-MD. I was very happy with

Allscripts but I was seeing 25+ pts/day at the time (non-IMP model) and it

allowed me to see 1 or 2 patients more a day and go home sooner. In that model,

the additional 1-2 patients a day and going hope sooner made it worth the $$$$.

With PF, you can sign on anytime you want (it's a " free " , cloud-based EMR) and

play with it. They have many training videos via U-tube and are willing to

spend several hours with you on the phone for training.

Craig

> >>

> >> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> >> > software as a service and is about $600/mo. I wouldn't need to purchase

> >> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> >> > established (and people seem to love it) but is a bigger initial outlay

> >> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >> >

> >> >

> >> >

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

> >> >

> >> >

[Guest guest]

Dean will have to explain why he thinks it is not free as I'm not sure what he

means.

Here's their website:

http://www.practicefusion.com/pages/free_ehr.html

The billing is not free:

http://www.practicefusion.com/pages/medical_billing.html

I've played with PF and it seems great for the price. Seto is very happy

with it. However, I believe Alla got frustrated and switched to Amazing Charts

and swears by it. has been very happy with e-MD. I was very happy with

Allscripts but I was seeing 25+ pts/day at the time (non-IMP model) and it

allowed me to see 1 or 2 patients more a day and go home sooner. In that model,

the additional 1-2 patients a day and going hope sooner made it worth the $$$$.

With PF, you can sign on anytime you want (it's a " free " , cloud-based EMR) and

play with it. They have many training videos via U-tube and are willing to

spend several hours with you on the phone for training.

Craig

> >>

> >> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> >> > software as a service and is about $600/mo. I wouldn't need to purchase

> >> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> >> > established (and people seem to love it) but is a bigger initial outlay

> >> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >> >

> >> >

> >> >

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

> >> >

> >> >

[Guest guest]

First, two facts:1. There is no free lunch. Everything has a cost whether it is money or time or privacy or attention or something else. Google is not free. Those sample weenies they give out at the big box stores are not free. 2. There is no such thing as the perfect EMR, just as there is no such thing as the perfect doctor or the perfect date. That is why Dr. X loves SuperEMR and hates GreatEMR, while Dr. Y loves GreatEMR and hates SuperEMR. It depends on the fit between your needs and your tolerance for the EMRs costs/flaws/limitations. I have been using Practice Fusion for about 15 months so far and am very satisfied with it and with their continuing improvements. I don't know why Dean says it is not totally free, but it truly has not cost me any money, which is not to say there are no costs. The company says it makes money by selling ads that appear on the sides and bottom of the screen (which I ignore), and by selling anonymized data for marketing and research. It more than meets my needs and I am willing to accept these costs in exchange for the use of their EMR. Hopefully we will all feel that way about our respective EMR choices. Practice Fusion may not meet your needs or you may not be willing to accept Practice Fusion's costs and that's okay. There are plenty of other EMR's out there. But it is one of the few EMRs that you can try for free for an unlimited amount of time. It also has an advantage in numbers, as in 50,000 users and 5 million patients making it the 3rd largest EMR behind the VA and Kaiser. Not that it is too big to fail, but I think it is less likely to go bankrupt than an EMR that only has 5000 users. As for Hello Health, I have used both Practice Fusion and Hello Health and comparing them is like comparing apples and oranges. Hello Health is not so much an EMR as it is a practice model. It has a web-based EMR, similar to Practice Fusion, but it is paid for by taking a cut of your encounter fees. Patients need to enter a credit card number in order to use Hello Health, and they are charged whenever they use a service, like e-mail, video visit, or a live office visit. So there is no upfront fee that I had to pay in order to use Hello Health. But without any marketing, very few patients found me through Hello Health. And if they already had insurance, then I was stuck in a dilemma in that my insurance contract requires me to send a claim to insurance, while the Hello Health system already charges the patient for the service if I use the Hello Health EMR to record the visit. I had to keep two separate EMRs while I was in Hello Health. I have since been "deactivated" from Hello Health due to low usage. I think that the best way to use Hello Health successfully is to go all in, that is, accept no insurance plans and require that all patients register through Hello Health. This is essentially a system separate from traditional insurance/Medicare. This may or may not work depending on where you are located.Getting back to 's original question about his listed EMR choices, I am a believer in starting out small and building up your business before adding on costs. Over the years, we have seen several IMP startups fail, almost always because their initial overhead was greater than their income could catch up to. For my own practice, I did not want to spend a lot of money on an EMR system that I would still be paying for if I had to go out of business in 2 years. , if you know you will have a lot of patients as soon as you open your practice, then perhaps you will generate enough income to pay for the more expensive EMRs. There is something to be said for integrated systems, but not everyone can afford one. Just because it is right for someone else doesn't mean it will be right for you. As has been suggested before of the Listserv, download one of the startup Excel spreadsheets (from the Files section of the Yahoo PracticeImprovement1 website - free login required) and calculate your projected income and expenses. If you estimate that you will see 20 patients a day, but it turns out you will need to see 25 patients a day to pay your expenses, then you're going to have to cut back somewhere or rework your numbers. I have no financial interest in any of the above mentioned products. SetoSouth Pasadena, CA

Practice fusion isNotTotally free ! Did youCheck hello health.com?Sent from my iPhoneDean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).

When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!).

Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.

On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.

Craig

>

> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> > software as a service and is about $600/mo. I wouldn't need to purchase

> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> > established (and people seem to love it) but is a bigger initial outlay

> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >

> >

> >

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

> >

> >

[Guest guest]

First, two facts:1. There is no free lunch. Everything has a cost whether it is money or time or privacy or attention or something else. Google is not free. Those sample weenies they give out at the big box stores are not free. 2. There is no such thing as the perfect EMR, just as there is no such thing as the perfect doctor or the perfect date. That is why Dr. X loves SuperEMR and hates GreatEMR, while Dr. Y loves GreatEMR and hates SuperEMR. It depends on the fit between your needs and your tolerance for the EMRs costs/flaws/limitations. I have been using Practice Fusion for about 15 months so far and am very satisfied with it and with their continuing improvements. I don't know why Dean says it is not totally free, but it truly has not cost me any money, which is not to say there are no costs. The company says it makes money by selling ads that appear on the sides and bottom of the screen (which I ignore), and by selling anonymized data for marketing and research. It more than meets my needs and I am willing to accept these costs in exchange for the use of their EMR. Hopefully we will all feel that way about our respective EMR choices. Practice Fusion may not meet your needs or you may not be willing to accept Practice Fusion's costs and that's okay. There are plenty of other EMR's out there. But it is one of the few EMRs that you can try for free for an unlimited amount of time. It also has an advantage in numbers, as in 50,000 users and 5 million patients making it the 3rd largest EMR behind the VA and Kaiser. Not that it is too big to fail, but I think it is less likely to go bankrupt than an EMR that only has 5000 users. As for Hello Health, I have used both Practice Fusion and Hello Health and comparing them is like comparing apples and oranges. Hello Health is not so much an EMR as it is a practice model. It has a web-based EMR, similar to Practice Fusion, but it is paid for by taking a cut of your encounter fees. Patients need to enter a credit card number in order to use Hello Health, and they are charged whenever they use a service, like e-mail, video visit, or a live office visit. So there is no upfront fee that I had to pay in order to use Hello Health. But without any marketing, very few patients found me through Hello Health. And if they already had insurance, then I was stuck in a dilemma in that my insurance contract requires me to send a claim to insurance, while the Hello Health system already charges the patient for the service if I use the Hello Health EMR to record the visit. I had to keep two separate EMRs while I was in Hello Health. I have since been "deactivated" from Hello Health due to low usage. I think that the best way to use Hello Health successfully is to go all in, that is, accept no insurance plans and require that all patients register through Hello Health. This is essentially a system separate from traditional insurance/Medicare. This may or may not work depending on where you are located.Getting back to 's original question about his listed EMR choices, I am a believer in starting out small and building up your business before adding on costs. Over the years, we have seen several IMP startups fail, almost always because their initial overhead was greater than their income could catch up to. For my own practice, I did not want to spend a lot of money on an EMR system that I would still be paying for if I had to go out of business in 2 years. , if you know you will have a lot of patients as soon as you open your practice, then perhaps you will generate enough income to pay for the more expensive EMRs. There is something to be said for integrated systems, but not everyone can afford one. Just because it is right for someone else doesn't mean it will be right for you. As has been suggested before of the Listserv, download one of the startup Excel spreadsheets (from the Files section of the Yahoo PracticeImprovement1 website - free login required) and calculate your projected income and expenses. If you estimate that you will see 20 patients a day, but it turns out you will need to see 25 patients a day to pay your expenses, then you're going to have to cut back somewhere or rework your numbers. I have no financial interest in any of the above mentioned products. SetoSouth Pasadena, CA

Practice fusion isNotTotally free ! Did youCheck hello health.com?Sent from my iPhoneDean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).

When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!).

Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.

On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.

Craig

>

> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> > software as a service and is about $600/mo. I wouldn't need to purchase

> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> > established (and people seem to love it) but is a bigger initial outlay

> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >

> >

> >

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

> >

> >

[Guest guest]

First, two facts:1. There is no free lunch. Everything has a cost whether it is money or time or privacy or attention or something else. Google is not free. Those sample weenies they give out at the big box stores are not free. 2. There is no such thing as the perfect EMR, just as there is no such thing as the perfect doctor or the perfect date. That is why Dr. X loves SuperEMR and hates GreatEMR, while Dr. Y loves GreatEMR and hates SuperEMR. It depends on the fit between your needs and your tolerance for the EMRs costs/flaws/limitations. I have been using Practice Fusion for about 15 months so far and am very satisfied with it and with their continuing improvements. I don't know why Dean says it is not totally free, but it truly has not cost me any money, which is not to say there are no costs. The company says it makes money by selling ads that appear on the sides and bottom of the screen (which I ignore), and by selling anonymized data for marketing and research. It more than meets my needs and I am willing to accept these costs in exchange for the use of their EMR. Hopefully we will all feel that way about our respective EMR choices. Practice Fusion may not meet your needs or you may not be willing to accept Practice Fusion's costs and that's okay. There are plenty of other EMR's out there. But it is one of the few EMRs that you can try for free for an unlimited amount of time. It also has an advantage in numbers, as in 50,000 users and 5 million patients making it the 3rd largest EMR behind the VA and Kaiser. Not that it is too big to fail, but I think it is less likely to go bankrupt than an EMR that only has 5000 users. As for Hello Health, I have used both Practice Fusion and Hello Health and comparing them is like comparing apples and oranges. Hello Health is not so much an EMR as it is a practice model. It has a web-based EMR, similar to Practice Fusion, but it is paid for by taking a cut of your encounter fees. Patients need to enter a credit card number in order to use Hello Health, and they are charged whenever they use a service, like e-mail, video visit, or a live office visit. So there is no upfront fee that I had to pay in order to use Hello Health. But without any marketing, very few patients found me through Hello Health. And if they already had insurance, then I was stuck in a dilemma in that my insurance contract requires me to send a claim to insurance, while the Hello Health system already charges the patient for the service if I use the Hello Health EMR to record the visit. I had to keep two separate EMRs while I was in Hello Health. I have since been "deactivated" from Hello Health due to low usage. I think that the best way to use Hello Health successfully is to go all in, that is, accept no insurance plans and require that all patients register through Hello Health. This is essentially a system separate from traditional insurance/Medicare. This may or may not work depending on where you are located.Getting back to 's original question about his listed EMR choices, I am a believer in starting out small and building up your business before adding on costs. Over the years, we have seen several IMP startups fail, almost always because their initial overhead was greater than their income could catch up to. For my own practice, I did not want to spend a lot of money on an EMR system that I would still be paying for if I had to go out of business in 2 years. , if you know you will have a lot of patients as soon as you open your practice, then perhaps you will generate enough income to pay for the more expensive EMRs. There is something to be said for integrated systems, but not everyone can afford one. Just because it is right for someone else doesn't mean it will be right for you. As has been suggested before of the Listserv, download one of the startup Excel spreadsheets (from the Files section of the Yahoo PracticeImprovement1 website - free login required) and calculate your projected income and expenses. If you estimate that you will see 20 patients a day, but it turns out you will need to see 25 patients a day to pay your expenses, then you're going to have to cut back somewhere or rework your numbers. I have no financial interest in any of the above mentioned products. SetoSouth Pasadena, CA

Practice fusion isNotTotally free ! Did youCheck hello health.com?Sent from my iPhoneDean

I second what Graham is saying. I'm still working on a startup. My plan is to use PracticeFusion which is free. Some like it () and some don't (Alla).

When I open, I figure I'll have more time than patients and money. When I get to 200 patients, I'm going to reassess sticking with PF vs switching to Amazing Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've used before and LOVE!).

Business startup is about cash flow. It's easier to build a practice when you aren't sinking. Don't dig a hole so big you can't get out of it.

On the other hand, if you have 500+ patients that will follow you from another practice, you can expect cash flow will be better so the risk is lower.

Craig

>

> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> > software as a service and is about $600/mo. I wouldn't need to purchase

> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> > established (and people seem to love it) but is a bigger initial outlay

> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >

> >

> >

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

> >

> >

[Guest guest]

I liked ;s response, but....

Switching is expensive, no matter the cost of the programs, time is money and

unless the data is translatable, it will not be free. I will say again that I

believe in the integrated software and do use emds. I spent less than 20K for it

and although there is a yearly cost for upgrades and support, that is it. Why

would you give short shrift to the heart of your practice? Do not forget that

the costs of hardware/software is depreciated as is the loan on the equipment.

We spend about $200/month after depreciation on the cost of emds. We spend

nothing on nurses, billing, Ma's or office managers or collections. Our cash

flow is great.

________________________________________

From:

[ ] On Behalf Of Craig Ross

[rossmd@...]

Sent: Thursday, January 06, 2011 12:46 PM

To:

Subject: Re: starting up, need an EMR

I second what Graham is saying. I'm still working on a startup. My plan is to

use PracticeFusion which is free. Some like it () and some don't (Alla).

When I open, I figure I'll have more time than patients and money. When I get to

200 patients, I'm going to reassess sticking with PF vs switching to Amazing

Charts ($$) (or similar) vs eMD ($$$$) (or similar such as Allscripts which I've

used before and LOVE!).

Business startup is about cash flow. It's easier to build a practice when you

aren't sinking. Don't dig a hole so big you can't get out of it.

On the other hand, if you have 500+ patients that will follow you from another

practice, you can expect cash flow will be better so the risk is lower.

Craig

>

> > I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

> > software as a service and is about $600/mo. I wouldn't need to purchase

> > hardware, upgrades, worry about backups, or hire IT help. eMDs is

> > established (and people seem to love it) but is a bigger initial outlay

> > ($25K for hardware, IT help, backup...). Anyone have any thoughts?

> >

> >

> >

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

> >

> >

[Guest guest]

,

How is the structure of this? Lease, expense, or what.

________________________________________

From:

[ ] On Behalf Of Pratt

[karen.oaktree@...]

Sent: Thursday, January 06, 2011 11:46 AM

To:

Subject: RE: starting up, need an EMR

We have been very happy users of e-MDs for almost 6 years now. It is definitely

worth the cost. We are, however, switching from an in-house server to Tangible

Solutions Happe-MDs suite. The ROI for 5 years is about the same, but we won’t

have the hassles of updating the software or maintaining the server, etc. All

you need is an internet connection, so you can use existing hardware, if you

want. I would recommend also having a FAX gateway, which you can purchase

through Tangible for about $900. You can check them out at

www.happe-mds.com<http://www.happe-mds.com/>

Good luck with your decision, and I’d be happy to answer any questions you have

about e-MDs.

(no financial interest, just satisfied customers!)

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info<http://www.prattmd.info>

________________________________

From:

[mailto: ] On Behalf Of dshep0127@...

Sent: Thursday, January 06, 2011 8:22 AM

To:

Subject: starting up, need an EMR

I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is software

as a service and is about $600/mo. I wouldn't need to purchase hardware,

upgrades, worry about backups, or hire IT help. eMDs is established (and people

seem to love it) but is a bigger initial outlay ($25K for hardware, IT help,

backup...). Anyone have any thoughts?

[Guest guest]

Great post .Another hidden cost to consider is data entry time by the clinician. Getting the data in was a significant cost in personal time and effort when I went from paper to EMR in 2004. If the patient can enter their own demographic data and HPI in the EMR over a portal and save that data entry time it is worth a lot. ClearPractice does that?The ability to communicate securely and easily within the practice and with the patient electronically is a big value. Same thing for getting clean updated data to bill the patient's insurance. I'm intrigued by Phreesia and, the automated check-in software concept. I bought Practice Partner in 2004. If purchasing something as a solo now, I would look hard at the web based modular stuff. I wouldn't go in

debt to purchase a system or commit to high fixed costs. Cash flow is king.le - Dr. Don on the list is super knowledgeable about practice partner EMR. I use it too and could provide some help.Ben

[Guest guest]

Jim,

There's an initial setup fee and then a monthly fee per user. The cost is about

a wash when I calculated in the fees that we were paying our IT guy plus the

cost of a new server if you estimate that the server should be replaced q5

years. But the best thing is that we don't have to worry about backup or

updates.

> ,

> How is the structure of this? Lease, expense, or what.

> ________________________________________

> From:

[ ] On Behalf Of Pratt

[karen.oaktree@...]

> Sent: Thursday, January 06, 2011 11:46 AM

> To:

> Subject: RE: starting up, need an EMR

>

> We have been very happy users of e-MDs for almost 6 years now. It is

definitely worth the cost. We are, however, switching from an in-house server

to Tangible Solutions Happe-MDs suite. The ROI for 5 years is about the same,

but we won’t have the hassles of updating the software or maintaining the

server, etc. All you need is an internet connection, so you can use existing

hardware, if you want. I would recommend also having a FAX gateway, which you

can purchase through Tangible for about $900. You can check them out at

www.happe-mds.com<http://www.happe-mds.com/>

>

> Good luck with your decision, and I’d be happy to answer any questions you

have about e-MDs.

>

> (no financial interest, just satisfied customers!)

>

> Pratt

> Office Manager

> Oak Tree Internal Medicine P.C

> www.prattmd.info<http://www.prattmd.info>

> ________________________________

> From:

[mailto: ] On Behalf Of dshep0127@...

> Sent: Thursday, January 06, 2011 8:22 AM

> To:

> Subject: starting up, need an EMR

>

>

>

> I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

software as a service and is about $600/mo. I wouldn't need to purchase

hardware, upgrades, worry about backups, or hire IT help. eMDs is established

(and people seem to love it) but is a bigger initial outlay ($25K for hardware,

IT help, backup...). Anyone have any thoughts?

>

>

>

>

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

>

>

[Guest guest]

P.S. The data still belongs to us. We will send them a backup Tuesday nite and

go live on Thursday. There was a 2 year commitment (committing to the monthly

fee), but the data will always belong to us and we can get it back at any time.

> ,

> How is the structure of this? Lease, expense, or what.

> ________________________________________

> From:

[ ] On Behalf Of Pratt

[karen.oaktree@...]

> Sent: Thursday, January 06, 2011 11:46 AM

> To:

> Subject: RE: starting up, need an EMR

>

> We have been very happy users of e-MDs for almost 6 years now. It is

definitely worth the cost. We are, however, switching from an in-house server

to Tangible Solutions Happe-MDs suite. The ROI for 5 years is about the same,

but we won’t have the hassles of updating the software or maintaining the

server, etc. All you need is an internet connection, so you can use existing

hardware, if you want. I would recommend also having a FAX gateway, which you

can purchase through Tangible for about $900. You can check them out at

www.happe-mds.com<http://www.happe-mds.com/>

>

> Good luck with your decision, and I’d be happy to answer any questions you

have about e-MDs.

>

> (no financial interest, just satisfied customers!)

>

> Pratt

> Office Manager

> Oak Tree Internal Medicine P.C

> www.prattmd.info<http://www.prattmd.info>

> ________________________________

> From:

[mailto: ] On Behalf Of dshep0127@...

> Sent: Thursday, January 06, 2011 8:22 AM

> To:

> Subject: starting up, need an EMR

>

>

>

> I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is

software as a service and is about $600/mo. I wouldn't need to purchase

hardware, upgrades, worry about backups, or hire IT help. eMDs is established

(and people seem to love it) but is a bigger initial outlay ($25K for hardware,

IT help, backup...). Anyone have any thoughts?

>

>

>

>

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

>

>

[Guest guest]

Happe-mds is WAY less than $600/mo

600/mo is a ton of money When you start up, while you do not want to change EMRs later, do keep cost slow When few patients are coming in but bills DO come in, taking on large overhead can casue bad troubleJean

I'm looking at eMDs, Clearpractice, and AthenaHealth. Clearpractice is software as a service and is about $600/mo. I wouldn't need to purchase hardware, upgrades, worry about backups, or hire IT help. eMDs is established (and people seem to love it) but is a bigger initial outlay ($25K for hardware, IT help, backup...). Anyone have any thoughts?

-- MD ph fax impcenter.org