Re: starting up, need an EMR

[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

[Guest guest]

le,

There are many of us who use Practice Partner. I have been

on it since 2003. Do you go to the forum or have you joined

the User Group listserv? There are many very talented users who could

probably help ease your frustration.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Ben Brewer

Sent: Thursday, January 06, 2011 11:28 PM

To:

Subject: Re: Re: starting up, need an EMR

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

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[Guest guest]

le,

There are many of us who use Practice Partner. I have been

on it since 2003. Do you go to the forum or have you joined

the User Group listserv? There are many very talented users who could

probably help ease your frustration.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Ben Brewer

Sent: Thursday, January 06, 2011 11:28 PM

To:

Subject: Re: Re: starting up, need an EMR

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

CyberDefender has scanned this email for potential threats.

Version 2.0 / Build 4.03.29.01

Get free PC security at http://www.cyberdefender.com

[Guest guest]

OK,So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. J From: [mailto: ] On Behalf Of PrattSent: Friday, January 07, 2011 1:37 AMTo: Subject: Re: starting up, need an EMR 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 trouble 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]

OK,So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. J From: [mailto: ] On Behalf Of PrattSent: Friday, January 07, 2011 1:37 AMTo: Subject: Re: starting up, need an EMR 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 trouble 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]

I agree, it also allows me to practice without any employees, which is a 30-60K

savings a year. You have to look at this as " practice management software " not

electronic charting. The savings have to be put into the equation, as this is

more that a way to do records and the savings are indirect

________________________________________

From:

[ ] On Behalf Of Dr. Brady

[drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM

To:

Subject: RE: starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8 years for me to use

e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff

associated with it done last year (and, of course, the original server,

desktops, other equipment, and networking bought when I first opened). I have

also needed even more IT support this year as I am trying to add the portal and

lab interface, etc. Even if I just pay the upgrade and maintenance fees for the

next 2 years, the cost is still over 600/month. Jim is correct in that the

cost/month drops dramatically when you depreciate expenses, but I have not

looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I

would likely go with that option if I had not just bought a new server. I think

is right that the cost becomes a wash either way, but the difference is

that I would know exactly how much I am going to spend every month. The new

server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just

that alone (even at 6% of collections) would have cost me $114,000 over the past

8 years. Not a bad deal, that means I save >$5000/year and get the very slick,

highly integrated EHR for free. ☺

From:

[mailto: ] On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM

To:

Subject: Re: starting up, need an EMR

Happe-mds is WAY less than $600/mo

On Jan 6, 2011, at 2:41 PM,

> wrote:

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 trouble

Jean

On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@...

<davidcarltonshepherd@...> wrote:

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<http://impcenter.org>

[Guest guest]

I agree, it also allows me to practice without any employees, which is a 30-60K

savings a year. You have to look at this as " practice management software " not

electronic charting. The savings have to be put into the equation, as this is

more that a way to do records and the savings are indirect

________________________________________

From:

[ ] On Behalf Of Dr. Brady

[drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM

To:

Subject: RE: starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8 years for me to use

e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff

associated with it done last year (and, of course, the original server,

desktops, other equipment, and networking bought when I first opened). I have

also needed even more IT support this year as I am trying to add the portal and

lab interface, etc. Even if I just pay the upgrade and maintenance fees for the

next 2 years, the cost is still over 600/month. Jim is correct in that the

cost/month drops dramatically when you depreciate expenses, but I have not

looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I

would likely go with that option if I had not just bought a new server. I think

is right that the cost becomes a wash either way, but the difference is

that I would know exactly how much I am going to spend every month. The new

server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just

that alone (even at 6% of collections) would have cost me $114,000 over the past

8 years. Not a bad deal, that means I save >$5000/year and get the very slick,

highly integrated EHR for free. ☺

From:

[mailto: ] On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM

To:

Subject: Re: starting up, need an EMR

Happe-mds is WAY less than $600/mo

On Jan 6, 2011, at 2:41 PM,

> wrote:

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 trouble

Jean

On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@...

<davidcarltonshepherd@...> wrote:

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<http://impcenter.org>

[Guest guest]

Of course EMRs and the " billing thing " is very individualthere's having   no employees--lower cost/ hassle  vs  maybe loans to  buy the thing to start withThere's  having someone else have the responsibility of answering the billing questions when someone calls

vs  taking control of it to make sure it gets done right there is moneyand there is what suits peopleWhen newbies ask I think we must take both into account, as well as the un ceasing complexity of differing markets( pay scales, type of practice reimbursment etc)

  I have billing outsourced and I re did it all this year , came really close to bringing in it and could not bear the idea of doing it I have no employees  I may pay a biller about what Brady pays/mo for the cost of E-mds but I do not have to DO the work of the billing/posting, wrangling with insurers.Some folks want to do that  and feel it  a better financial  decison

 In the beginning  when no money comes in since billing is a percentage it's a lower costthere are lots of  ways to look at thisLIke to get your teeth into it? or  leave it to someone who  does that and  only that and  therefore is an expert OR   feel like a little practice  willbe ignored by a biller?

 Some e people start up on 9,000 for everything(Ok me.   I paid 2500 for the emr ,  and  outsource billing who did all my credentialing for me and  can answer coding  questions and take the  phone calls) Each market and practice and provider is different  we should maybe make it up as a chart for the wiki about pros and cons..

 For newbies listening there are all sorts of pros and cons, and people on t his list serv  tend to be firmly  in one camp or another- which is  good it means  they made the right choice for them , but every indiviual is different

I f  only  I  lived  in a world with only one or two emrs and  they talked to each other and I was paid simply and there WAS no coding and billing ot speak of, ah! Now  THAT  would be the best answer.

 

I agree, it also allows me to practice without any employees, which is a 30-60K savings a year. You have to look at this as " practice management software " not electronic charting. The savings have to be put into the equation, as this is more that a way to do records and the savings are indirect

________________________________________

From: [ ] On Behalf Of Dr. Brady [drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM

To:

Subject: RE: starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. ☺

From: [mailto: ] On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM

To:

Subject: Re: starting up, need an EMR

Happe-mds is WAY less than $600/mo

On Jan 6, 2011, at 2:41 PM, > wrote:

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 trouble

Jean

On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@... <davidcarltonshepherd@...> wrote:

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<http://impcenter.org>

--      MD          ph    fax impcenter.org

[Guest guest]

Of course EMRs and the " billing thing " is very individualthere's having   no employees--lower cost/ hassle  vs  maybe loans to  buy the thing to start withThere's  having someone else have the responsibility of answering the billing questions when someone calls

vs  taking control of it to make sure it gets done right there is moneyand there is what suits peopleWhen newbies ask I think we must take both into account, as well as the un ceasing complexity of differing markets( pay scales, type of practice reimbursment etc)

  I have billing outsourced and I re did it all this year , came really close to bringing in it and could not bear the idea of doing it I have no employees  I may pay a biller about what Brady pays/mo for the cost of E-mds but I do not have to DO the work of the billing/posting, wrangling with insurers.Some folks want to do that  and feel it  a better financial  decison

 In the beginning  when no money comes in since billing is a percentage it's a lower costthere are lots of  ways to look at thisLIke to get your teeth into it? or  leave it to someone who  does that and  only that and  therefore is an expert OR   feel like a little practice  willbe ignored by a biller?

 Some e people start up on 9,000 for everything(Ok me.   I paid 2500 for the emr ,  and  outsource billing who did all my credentialing for me and  can answer coding  questions and take the  phone calls) Each market and practice and provider is different  we should maybe make it up as a chart for the wiki about pros and cons..

 For newbies listening there are all sorts of pros and cons, and people on t his list serv  tend to be firmly  in one camp or another- which is  good it means  they made the right choice for them , but every indiviual is different

I f  only  I  lived  in a world with only one or two emrs and  they talked to each other and I was paid simply and there WAS no coding and billing ot speak of, ah! Now  THAT  would be the best answer.

 

I agree, it also allows me to practice without any employees, which is a 30-60K savings a year. You have to look at this as " practice management software " not electronic charting. The savings have to be put into the equation, as this is more that a way to do records and the savings are indirect

________________________________________

From: [ ] On Behalf Of Dr. Brady [drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM

To:

Subject: RE: starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. ☺

From: [mailto: ] On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM

To:

Subject: Re: starting up, need an EMR

Happe-mds is WAY less than $600/mo

On Jan 6, 2011, at 2:41 PM, > wrote:

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 trouble

Jean

On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@... <davidcarltonshepherd@...> wrote:

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<http://impcenter.org>

--      MD          ph    fax impcenter.org

[Guest guest]

Great points. If I were insurance free (as many on the list serve are), then I’m not sure I would believe e-mds is totally worth the cost. It is still a great ehr for organizing everything, but I think there are probably cheaper programs out there that would serve me just as well for less money. When you add the simplicity of the integrated billing, though, it is worth it for me and I have no regrets. From: [mailto: ] On Behalf Of Sent: Friday, January 07, 2011 9:16 AMTo: Subject: Re: starting up, need an EMR Of course EMRs and the " billing thing " is very individualthere's having no employees--lower cost/ hassle vs maybe loans to buy the thing to start withThere's having someone else have the responsibility of answering the billing questions when someone callsvs taking control of it to make sure it gets done right there is moneyand there is what suits peopleWhen newbies ask I think we must take both into account, as well as the un ceasing complexity of differing markets( pay scales, type of practice reimbursment etc) I have billing outsourced and I re did it all this year , came really close to bringing in it and could not bear the idea of doing it I have no employees I may pay a biller about what Brady pays/mo for the cost of E-mds but I do not have to DO the work of the billing/posting, wrangling with insurers.Some folks want to do that and feel it a better financial decison In the beginning when no money comes in since billing is a percentage it's a lower costthere are lots of ways to look at thisLIke to get your teeth into it? or leave it to someone who does that and only that and therefore is an expert OR feel like a little practice willbe ignored by a biller? Some e people start up on 9,000 for everything(Ok me. I paid 2500 for the emr , and outsource billing who did all my credentialing for me and can answer coding questions and take the phone calls) Each market and practice and provider is different we should maybe make it up as a chart for the wiki about pros and cons.. For newbies listening there are all sorts of pros and cons, and people on t his list serv tend to be firmly in one camp or another- which is good it means they made the right choice for them , but every indiviual is differentI f only I lived in a world with only one or two emrs and they talked to each other and I was paid simply and there WAS no coding and billing ot speak of, ah! Now THAT would be the best answer. I agree, it also allows me to practice without any employees, which is a 30-60K savings a year. You have to look at this as " practice management software " not electronic charting. The savings have to be put into the equation, as this is more that a way to do records and the savings are indirect ________________________________________ From: [ ] On Behalf Of Dr. Brady [drbrady@...] Sent: Friday, January 07, 2011 4:51 AM To: Subject: RE: starting up, need an EMR OK, So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out. Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once. P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. ☺ From: [mailto: ] On Behalf Of Pratt Sent: Friday, January 07, 2011 1:37 AM To: Subject: Re: starting up, need an EMR Happe-mds is WAY less than $600/mo On Jan 6, 2011, at 2:41 PM, > wrote: 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 trouble On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@... <davidcarltonshepherd@...> wrote: 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<http://impcenter.org> -- MD ph fax impcenter.org

[Guest guest]

Great points. If I were insurance free (as many on the list serve are), then I’m not sure I would believe e-mds is totally worth the cost. It is still a great ehr for organizing everything, but I think there are probably cheaper programs out there that would serve me just as well for less money. When you add the simplicity of the integrated billing, though, it is worth it for me and I have no regrets. From: [mailto: ] On Behalf Of Sent: Friday, January 07, 2011 9:16 AMTo: Subject: Re: starting up, need an EMR Of course EMRs and the " billing thing " is very individualthere's having no employees--lower cost/ hassle vs maybe loans to buy the thing to start withThere's having someone else have the responsibility of answering the billing questions when someone callsvs taking control of it to make sure it gets done right there is moneyand there is what suits peopleWhen newbies ask I think we must take both into account, as well as the un ceasing complexity of differing markets( pay scales, type of practice reimbursment etc) I have billing outsourced and I re did it all this year , came really close to bringing in it and could not bear the idea of doing it I have no employees I may pay a biller about what Brady pays/mo for the cost of E-mds but I do not have to DO the work of the billing/posting, wrangling with insurers.Some folks want to do that and feel it a better financial decison In the beginning when no money comes in since billing is a percentage it's a lower costthere are lots of ways to look at thisLIke to get your teeth into it? or leave it to someone who does that and only that and therefore is an expert OR feel like a little practice willbe ignored by a biller? Some e people start up on 9,000 for everything(Ok me. I paid 2500 for the emr , and outsource billing who did all my credentialing for me and can answer coding questions and take the phone calls) Each market and practice and provider is different we should maybe make it up as a chart for the wiki about pros and cons.. For newbies listening there are all sorts of pros and cons, and people on t his list serv tend to be firmly in one camp or another- which is good it means they made the right choice for them , but every indiviual is differentI f only I lived in a world with only one or two emrs and they talked to each other and I was paid simply and there WAS no coding and billing ot speak of, ah! Now THAT would be the best answer. I agree, it also allows me to practice without any employees, which is a 30-60K savings a year. You have to look at this as " practice management software " not electronic charting. The savings have to be put into the equation, as this is more that a way to do records and the savings are indirect ________________________________________ From: [ ] On Behalf Of Dr. Brady [drbrady@...] Sent: Friday, January 07, 2011 4:51 AM To: Subject: RE: starting up, need an EMR OK, So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out. Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once. P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. ☺ From: [mailto: ] On Behalf Of Pratt Sent: Friday, January 07, 2011 1:37 AM To: Subject: Re: starting up, need an EMR Happe-mds is WAY less than $600/mo On Jan 6, 2011, at 2:41 PM, > wrote: 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 trouble On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@... <davidcarltonshepherd@...> wrote: 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<http://impcenter.org> -- MD ph fax impcenter.org

[Guest guest]

I am using Amazing charts and Quick books and it is not easy, but I am growing my practice learning the EMR and will hopefully be integrated by the new program for practice management that was to be out in Jan and now is to be available in the 1st quarter.

Carolyn McCormick MD FAAFP  NC

 

Great points. If I were insurance free (as many on the list serve are), then I’m not sure I would believe e-mds is totally worth the cost. It is still a great ehr for organizing everything, but I think there are probably cheaper programs out there that would serve me just as well for less money. When you add the simplicity of the integrated billing, though, it is worth it for me and I have no regrets.

 

From: [mailto: ] On Behalf Of

Sent: Friday, January 07, 2011 9:16 AMTo: Subject: Re: starting up, need an EMR

   Of course EMRs and the " billing thing " is very individualthere's having   no employees--lower cost/ hassle

 vs  maybe loans to  buy the thing to start withThere's  having someone else have the responsibility of answering the billing questions when someone callsvs  taking control of it to make sure it gets done right

 there is moneyand there is what suits peopleWhen newbies ask I think we must take both into account, as well as the un ceasing complexity of differing markets( pay scales, type of practice reimbursment etc)

  I have billing outsourced and I re did it all this year , came really close to bringing in it and could not bear the idea of doing it I have no employees  I may pay a biller about what Brady pays/mo for the cost of E-mds but I do not have to DO the work of the billing/posting, wrangling with insurers.Some folks want to do that  and feel it  a better financial  decison

 In the beginning  when no money comes in since billing is a percentage it's a lower costthere are lots of  ways to look at thisLIke to get your teeth into it? or  leave it to someone who  does that and  only that and  therefore is an expert OR   feel like a little practice  willbe ignored by a biller?

 Some e people start up on 9,000 for everything(Ok me.   I paid 2500 for the emr ,  and  outsource billing who did all my credentialing for me and  can answer coding  questions and take the  phone calls) Each market and practice and provider is different  we should maybe make it up as a chart for the wiki about pros and cons..

 For newbies listening there are all sorts of pros and cons, and people on t his list serv  tend to be firmly  in one camp or another- which is  good it means  they made the right choice for them , but every indiviual is different

I f  only  I  lived  in a world with only one or two emrs and  they talked to each other and I was paid simply and there WAS no coding and billing ot speak of, ah! Now  THAT  would be the best answer.

  I agree, it also allows me to practice without any employees, which is a 30-60K savings a year. You have to look at this as " practice management software " not electronic charting. The savings have to be put into the equation, as this is more that a way to do records and the savings are indirect

________________________________________ From: [ ] On Behalf Of Dr. Brady [drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM To: Subject: RE: starting up, need an EMR

OK, So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. ☺

From: [mailto: ] On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM To: Subject: Re: starting up, need an EMR

Happe-mds is WAY less than $600/mo On Jan 6, 2011, at 2:41 PM, > wrote:

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 trouble

On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@... <davidcarltonshepherd@...> wrote:

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<http://impcenter.org>

--      MD          ph    fax

impcenter.org

[Guest guest]

I am using Amazing charts and Quick books and it is not easy, but I am growing my practice learning the EMR and will hopefully be integrated by the new program for practice management that was to be out in Jan and now is to be available in the 1st quarter.

Carolyn McCormick MD FAAFP  NC

 

Great points. If I were insurance free (as many on the list serve are), then I’m not sure I would believe e-mds is totally worth the cost. It is still a great ehr for organizing everything, but I think there are probably cheaper programs out there that would serve me just as well for less money. When you add the simplicity of the integrated billing, though, it is worth it for me and I have no regrets.

 

From: [mailto: ] On Behalf Of

Sent: Friday, January 07, 2011 9:16 AMTo: Subject: Re: starting up, need an EMR

   Of course EMRs and the " billing thing " is very individualthere's having   no employees--lower cost/ hassle

 vs  maybe loans to  buy the thing to start withThere's  having someone else have the responsibility of answering the billing questions when someone callsvs  taking control of it to make sure it gets done right

 there is moneyand there is what suits peopleWhen newbies ask I think we must take both into account, as well as the un ceasing complexity of differing markets( pay scales, type of practice reimbursment etc)

  I have billing outsourced and I re did it all this year , came really close to bringing in it and could not bear the idea of doing it I have no employees  I may pay a biller about what Brady pays/mo for the cost of E-mds but I do not have to DO the work of the billing/posting, wrangling with insurers.Some folks want to do that  and feel it  a better financial  decison

 In the beginning  when no money comes in since billing is a percentage it's a lower costthere are lots of  ways to look at thisLIke to get your teeth into it? or  leave it to someone who  does that and  only that and  therefore is an expert OR   feel like a little practice  willbe ignored by a biller?

 Some e people start up on 9,000 for everything(Ok me.   I paid 2500 for the emr ,  and  outsource billing who did all my credentialing for me and  can answer coding  questions and take the  phone calls) Each market and practice and provider is different  we should maybe make it up as a chart for the wiki about pros and cons..

 For newbies listening there are all sorts of pros and cons, and people on t his list serv  tend to be firmly  in one camp or another- which is  good it means  they made the right choice for them , but every indiviual is different

I f  only  I  lived  in a world with only one or two emrs and  they talked to each other and I was paid simply and there WAS no coding and billing ot speak of, ah! Now  THAT  would be the best answer.

  I agree, it also allows me to practice without any employees, which is a 30-60K savings a year. You have to look at this as " practice management software " not electronic charting. The savings have to be put into the equation, as this is more that a way to do records and the savings are indirect

________________________________________ From: [ ] On Behalf Of Dr. Brady [drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM To: Subject: RE: starting up, need an EMR

OK, So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means I save >$5000/year and get the very slick, highly integrated EHR for free. ☺

From: [mailto: ] On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM To: Subject: Re: starting up, need an EMR

Happe-mds is WAY less than $600/mo On Jan 6, 2011, at 2:41 PM, > wrote:

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 trouble

On Thu, Jan 6, 2011 at 11:22 AM, dshep0127@... <davidcarltonshepherd@...> wrote:

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<http://impcenter.org>

--      MD          ph    fax

impcenter.org

[Guest guest]

If anyone is interested in how much we

spent for Tangible, please contact me off-list. We did not cut any kind

of special deal with them because I just don’t have the time or energy to

quibble over a few dollars per month. All said and done, our startup fees

with Tangible (Happe-MDs) are a LOT less than the cost of a new server.

Plus we have the flexibility to work from anywhere that we have an internet

connection (while technically we could do this with remote desktop into our

server, it was cumbersome and slow and we tended not to do so). Our

monthly cost for 3 users – not including hardware – will be about

$165 more than what we were paying for just our IT guy. However, when you

take into account that a server is good for about 5 years, at $7000 (it would

have been more for use because of the travel time for our IT guy, who is in Maine), that’s $117/month

just for the hardware. Our estimate for a new server was $9000, so that’s

$150/month. I am more than willing to pay $15/month for someone ELSE to

worry about our backup, plus do all of the updates. I haven’t

updated CPT/ICD-9 codes since November, and we don’t have the new G code

for Medicare Physicals in there yet (did our first one this week). Add to

that that this is a service (similar to your phone), so it is also

tax-deductible, but we don’t have to depreciate anything. If we had

more than 3 users, we would have considered purchasing a new server. But

it just wasn’t worth it for our small office. Plus, we didn’t

want to be tied down to a new server cost if we decided to move or close our

doors or whatever.

And I agree with : e-MDs is

completely worth it’s integration. With Meaningful Use coming up

this year, I suspect that we will see about 85% of the maximum over the next 5

years, which is a total of $37,450, which will more than pay for Happe-MDs.

YMMV,

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ]

On Behalf Of Dr. Brady

Sent: Friday, January 07, 2011

3:51 AM

To:

Subject: RE:

starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8

years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server

and all the IT stuff associated with it done last year (and, of course, the

original server, desktops, other equipment, and networking bought when I first

opened). I have also needed even more IT support this year as I am trying to

add the portal and lab interface, etc. Even if I just pay the upgrade and

maintenance fees for the next 2 years, the cost is still over 600/month. Jim is

correct in that the cost/month drops dramatically when you depreciate expenses,

but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be

through Happe-mds, I would likely go with that option if I had not just bought

a new server. I think is right that the cost becomes a wash either way,

but the difference is that I would know exactly how much I am going to spend

every month. The new server cost me like $7000 last year…tough to come up

with all at once.

P.S. E-mds is still totally worth it to me because I do my own

billing. Just that alone (even at 6% of collections) would have cost me

$114,000 over the past 8 years. Not a bad deal, that means I save

>$5000/year and get the very slick, highly integrated EHR for free. J

From:

[mailto: ] On

Behalf Of Pratt

Sent: Friday, January 07, 2011

1:37 AM

To:

Subject: Re:

starting up, need an EMR

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

trouble

Jean

On Thu, Jan 6,

2011 at 11:22 AM, dshep0127@...

wrote:

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

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

[Guest guest]

If anyone is interested in how much we

spent for Tangible, please contact me off-list. We did not cut any kind

of special deal with them because I just don’t have the time or energy to

quibble over a few dollars per month. All said and done, our startup fees

with Tangible (Happe-MDs) are a LOT less than the cost of a new server.

Plus we have the flexibility to work from anywhere that we have an internet

connection (while technically we could do this with remote desktop into our

server, it was cumbersome and slow and we tended not to do so). Our

monthly cost for 3 users – not including hardware – will be about

$165 more than what we were paying for just our IT guy. However, when you

take into account that a server is good for about 5 years, at $7000 (it would

have been more for use because of the travel time for our IT guy, who is in Maine), that’s $117/month

just for the hardware. Our estimate for a new server was $9000, so that’s

$150/month. I am more than willing to pay $15/month for someone ELSE to

worry about our backup, plus do all of the updates. I haven’t

updated CPT/ICD-9 codes since November, and we don’t have the new G code

for Medicare Physicals in there yet (did our first one this week). Add to

that that this is a service (similar to your phone), so it is also

tax-deductible, but we don’t have to depreciate anything. If we had

more than 3 users, we would have considered purchasing a new server. But

it just wasn’t worth it for our small office. Plus, we didn’t

want to be tied down to a new server cost if we decided to move or close our

doors or whatever.

And I agree with : e-MDs is

completely worth it’s integration. With Meaningful Use coming up

this year, I suspect that we will see about 85% of the maximum over the next 5

years, which is a total of $37,450, which will more than pay for Happe-MDs.

YMMV,

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ]

On Behalf Of Dr. Brady

Sent: Friday, January 07, 2011

3:51 AM

To:

Subject: RE:

starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8

years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server

and all the IT stuff associated with it done last year (and, of course, the

original server, desktops, other equipment, and networking bought when I first

opened). I have also needed even more IT support this year as I am trying to

add the portal and lab interface, etc. Even if I just pay the upgrade and

maintenance fees for the next 2 years, the cost is still over 600/month. Jim is

correct in that the cost/month drops dramatically when you depreciate expenses,

but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be

through Happe-mds, I would likely go with that option if I had not just bought

a new server. I think is right that the cost becomes a wash either way,

but the difference is that I would know exactly how much I am going to spend

every month. The new server cost me like $7000 last year…tough to come up

with all at once.

P.S. E-mds is still totally worth it to me because I do my own

billing. Just that alone (even at 6% of collections) would have cost me

$114,000 over the past 8 years. Not a bad deal, that means I save

>$5000/year and get the very slick, highly integrated EHR for free. J

From:

[mailto: ] On

Behalf Of Pratt

Sent: Friday, January 07, 2011

1:37 AM

To:

Subject: Re:

starting up, need an EMR

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

trouble

Jean

On Thu, Jan 6,

2011 at 11:22 AM, dshep0127@...

wrote:

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

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

[Guest guest]

Thank you for all of the posts. I think eMDs would be awesome, but I'm afraid

of the initial cash outlay. All of these points are things I'm struggling with.

I only know of one person using clearpractice which kind of concerns me. They

have a decent portal (which is something I really want) and the rest of the

software is pretty comparable to most other EMRs. The eMD portal is not too

robust yet. I really want the portal and EMR to be integrated for collecting

patient demographics and med history etc...

>

>

>

> 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]

Thank you for all of the posts. I think eMDs would be awesome, but I'm afraid

of the initial cash outlay. All of these points are things I'm struggling with.

I only know of one person using clearpractice which kind of concerns me. They

have a decent portal (which is something I really want) and the rest of the

software is pretty comparable to most other EMRs. The eMD portal is not too

robust yet. I really want the portal and EMR to be integrated for collecting

patient demographics and med history etc...

>

>

>

> 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]

I agree the e-MDs patient portal isn’t

too robust. We have not implemented that portion of it, as the ROI just

isn’t there for our practice. The initial cash outlay to start up

from scratch with Tangible is much less than we paid initially with software,

hardware, licensing fee, etc. for our in-house system. I know that e-MDs

has increased their licensing fees because of the extra programming that they’ve

done to get certified for Meaningful Use. I would not, under any

circumstances, implement an EMR that is not certified for Meaningful Use.

If you go to this website: http://onc-chpl.force.com/ehrcert/EHRProductSearch

you can put in different EMR systems in the middle box and search by name (make

sure to click on the box that says “search”). When it finds

the EMR, then you can click on the name and it will show you all of the MU

criteria that particular EMR is certified to address. Just looking at Clearpractice,

they are not yet certified for all of the ambulatory clinical measures.

You want to make sure that the ambulatory measures that you would report on are

certified with the EMR that you select, or you won’t qualify for the MU $$.

E-MDs is certified for everything. AthenaHealth is not certified at all.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ]

On Behalf Of dshep0127@...

Sent: Friday, January 07, 2011

10:12 AM

To:

Subject:

Re: starting up, need an EMR

Thank you for all of the posts. I think eMDs would be

awesome, but I'm afraid of the initial cash outlay. All of these points are

things I'm struggling with. I only know of one person using clearpractice which

kind of concerns me. They have a decent portal (which is something I really

want) and the rest of the software is pretty comparable to most other EMRs. The

eMD portal is not too robust yet. I really want the portal and EMR to be

integrated for collecting patient demographics and med history etc...

>

>

>

> 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]

I agree the e-MDs patient portal isn’t

too robust. We have not implemented that portion of it, as the ROI just

isn’t there for our practice. The initial cash outlay to start up

from scratch with Tangible is much less than we paid initially with software,

hardware, licensing fee, etc. for our in-house system. I know that e-MDs

has increased their licensing fees because of the extra programming that they’ve

done to get certified for Meaningful Use. I would not, under any

circumstances, implement an EMR that is not certified for Meaningful Use.

If you go to this website: http://onc-chpl.force.com/ehrcert/EHRProductSearch

you can put in different EMR systems in the middle box and search by name (make

sure to click on the box that says “search”). When it finds

the EMR, then you can click on the name and it will show you all of the MU

criteria that particular EMR is certified to address. Just looking at Clearpractice,

they are not yet certified for all of the ambulatory clinical measures.

You want to make sure that the ambulatory measures that you would report on are

certified with the EMR that you select, or you won’t qualify for the MU $$.

E-MDs is certified for everything. AthenaHealth is not certified at all.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ]

On Behalf Of dshep0127@...

Sent: Friday, January 07, 2011

10:12 AM

To:

Subject:

Re: starting up, need an EMR

Thank you for all of the posts. I think eMDs would be

awesome, but I'm afraid of the initial cash outlay. All of these points are

things I'm struggling with. I only know of one person using clearpractice which

kind of concerns me. They have a decent portal (which is something I really

want) and the rest of the software is pretty comparable to most other EMRs. The

eMD portal is not too robust yet. I really want the portal and EMR to be

integrated for collecting patient demographics and med history etc...

>

>

>

> 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]

So I ran the same calculation and our Total costs for 5 years including equipment software and support is $50k so about 10K a year(start up was 31k).

However our depreciation is 30K off the tax bill so our actaul costs are ~$20k or 4K a year.

Estimating saved billing cost @ 6% is $107,000 in savings or 20K a year which is a wash of our costs.

If you include the costs savings in employees I think I still save about 30K/yr.

We buy refurbished servers and computers and they are much less than 7,000. Since running any system has hardware costs, the difference is cost between this and another system is actually the variation in software cost. Our software cost has been 27,000

of which 25,000 is depreciated (this is included in the above.) I do not know what the cost of the others are.

From: [ ] On Behalf Of Dr. Brady [drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM

To:

Subject: RE: starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last

year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and

maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes

a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means

I save >$5000/year and get the very slick, highly integrated EHR for free.

J

From: [mailto: ]

On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM

To:

Subject: Re: starting up, need an EMR

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 trouble

Jean

On Thu, Jan 6, 2011 at 11:22 AM,

dshep0127@... wrote:

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]

So I ran the same calculation and our Total costs for 5 years including equipment software and support is $50k so about 10K a year(start up was 31k).

However our depreciation is 30K off the tax bill so our actaul costs are ~$20k or 4K a year.

Estimating saved billing cost @ 6% is $107,000 in savings or 20K a year which is a wash of our costs.

If you include the costs savings in employees I think I still save about 30K/yr.

We buy refurbished servers and computers and they are much less than 7,000. Since running any system has hardware costs, the difference is cost between this and another system is actually the variation in software cost. Our software cost has been 27,000

of which 25,000 is depreciated (this is included in the above.) I do not know what the cost of the others are.

From: [ ] On Behalf Of Dr. Brady [drbrady@...]

Sent: Friday, January 07, 2011 4:51 AM

To:

Subject: RE: starting up, need an EMR

OK,

So I calculated actual costs for everything over the past 8 years for me to use e-mds = 73,500 = 765/month. Now, that includes a new server and all the IT stuff associated with it done last

year (and, of course, the original server, desktops, other equipment, and networking bought when I first opened). I have also needed even more IT support this year as I am trying to add the portal and lab interface, etc. Even if I just pay the upgrade and

maintenance fees for the next 2 years, the cost is still over 600/month. Jim is correct in that the cost/month drops dramatically when you depreciate expenses, but I have not looked at those numbers—this is just what I pay out.

Lots of money. Though I’m not sure what my costs would be through Happe-mds, I would likely go with that option if I had not just bought a new server. I think is right that the cost becomes

a wash either way, but the difference is that I would know exactly how much I am going to spend every month. The new server cost me like $7000 last year…tough to come up with all at once.

P.S. E-mds is still totally worth it to me because I do my own billing. Just that alone (even at 6% of collections) would have cost me $114,000 over the past 8 years. Not a bad deal, that means

I save >$5000/year and get the very slick, highly integrated EHR for free.

J

From: [mailto: ]

On Behalf Of Pratt

Sent: Friday, January 07, 2011 1:37 AM

To:

Subject: Re: starting up, need an EMR

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 trouble

Jean

On Thu, Jan 6, 2011 at 11:22 AM,

dshep0127@... wrote:

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]

I agree the e-MDs patient portal isn’t

too robust.  We have not implemented that portion of it, as the ROI just

isn’t there for our practice.  The initial cash outlay to start up

from scratch with Tangible is much less than we paid initially with software,

hardware, licensing fee, etc. for our in-house system.  I know that e-MDs

has increased their licensing fees because of the extra programming that they’ve

done to get certified for Meaningful Use.  I would not, under any

circumstances, implement an EMR that is not certified for Meaningful Use. 

If you go to this website: http://onc-chpl.force.com/ehrcert/EHRProductSearch

you can put in different EMR systems in the middle box and search by name (make

sure to click on the box that says “search”).  When it finds

the EMR, then you can click on the name and it will show you all of the MU

criteria that particular EMR is certified to address.  Just looking at Clearpractice,

they are not yet certified for all of the ambulatory clinical measures. 

You want to make sure that the ambulatory measures that you would report on are

certified with the EMR that you select, or you won’t qualify for the MU $$. 

E-MDs is certified for everything.  AthenaHealth is not certified at all.

Sorry but that's not true.  Dr Blumenthal recently clarified this ... you have to have access to *ALL* the meaningful use criteria even though you only plan to use only some of them to get meaningful use.  So, either you get a fully certified EMR, or you get one that is partially certified, and have access to another that covers the remaining criteria, even if you're not planning to use them this round.

The rationale is that he wants to make sure that in the coming years you are able to then meet all the other MU criteria.So, in your example, Clearpractice would not work even if they do all the criteria you are planning to use.  Same applies to PracticeFusion and so forth.

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

the type of EMR that you are going to use,will determine part of your success or failure.

It may be expesive but you wont change it if you choose the right one.

I understand that EMD's got good ratings in a couple of practice magament articles. EMR is a big investment do it right from the begining.

If you have an EMR that can multitask,be user friendly and have all your info at your fingertips. You will save a lot of money in overhead.

I used to work in a place that they had Mycis. I think it was a big microsoft word EMR, no way to find out when your last Td vaccine was. You needed to read all the progress notes to find out all you previous care and preventive care. I mentioned to my previous employer,but he did not care (orthopedist).

I know the money is not easy, but think about it, you will ended up paying more money.

Also another factor to keep in mind is: how the EMR would affect you?. Some of them make you go slow and you can not see patients as fast as paper and pen.

Also I would like to have an EMR that help me to keep an eye on the patients: labs warning, pending mamo or colon eval,bone density tests.

Here I am giving my 2 cents and I even dont have a practice yet.

I will make the leap for an IMP, dont know when.

Adolfo.

To: Sent: Fri, January 7, 2011 2:02:33 PMSubject: Re: Re: starting up, need an EMR

I agree the e-MDs patient portal isn’t too robust. We have not implemented that portion of it, as the ROI just isn’t there for our practice. The initial cash outlay to start up from scratch with Tangible is much less than we paid initially with software, hardware, licensing fee, etc. for our in-house system. I know that e-MDs has increased their licensing fees because of the extra programming that they’ve done to get certified for Meaningful Use. I would not, under any circumstances, implement an EMR that is not certified for Meaningful Use. If you go to this website: http://onc-chpl.force.com/ehrcert/EHRProductSearch you can put in different EMR systems in the middle box and search by name (make sure to click on the box that says “searchâ€). When it finds the EMR, then you can click on the name

and it will show you all of the MU criteria that particular EMR is certified to address. Just looking at Clearpractice, they are not yet certified for all of the ambulatory clinical measures. You want to make sure that the ambulatory measures that you would report on are certified with the EMR that you select, or you won’t qualify for the MU $$. E-MDs is certified for everything. AthenaHealth is not certified at all.

Sorry but that's not true. Dr Blumenthal recently clarified this ... you have to have access to *ALL* the meaningful use criteria even though you only plan to use only some of them to get meaningful use. So, either you get a fully certified EMR, or you get one that is partially certified, and have access to another that covers the remaining criteria, even if you're not planning to use them this round.

The rationale is that he wants to make sure that in the coming years you are able to then meet all the other MU criteria.

So, in your example, Clearpractice would not work even if they do all the criteria you are planning to use. Same applies to PracticeFusion and so forth.

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

the type of EMR that you are going to use,will determine part of your success or failure.

It may be expesive but you wont change it if you choose the right one.

I understand that EMD's got good ratings in a couple of practice magament articles. EMR is a big investment do it right from the begining.

If you have an EMR that can multitask,be user friendly and have all your info at your fingertips. You will save a lot of money in overhead.

I used to work in a place that they had Mycis. I think it was a big microsoft word EMR, no way to find out when your last Td vaccine was. You needed to read all the progress notes to find out all you previous care and preventive care. I mentioned to my previous employer,but he did not care (orthopedist).

I know the money is not easy, but think about it, you will ended up paying more money.

Also another factor to keep in mind is: how the EMR would affect you?. Some of them make you go slow and you can not see patients as fast as paper and pen.

Also I would like to have an EMR that help me to keep an eye on the patients: labs warning, pending mamo or colon eval,bone density tests.

Here I am giving my 2 cents and I even dont have a practice yet.

I will make the leap for an IMP, dont know when.

Adolfo.

To: Sent: Fri, January 7, 2011 2:02:33 PMSubject: Re: Re: starting up, need an EMR

I agree the e-MDs patient portal isn’t too robust. We have not implemented that portion of it, as the ROI just isn’t there for our practice. The initial cash outlay to start up from scratch with Tangible is much less than we paid initially with software, hardware, licensing fee, etc. for our in-house system. I know that e-MDs has increased their licensing fees because of the extra programming that they’ve done to get certified for Meaningful Use. I would not, under any circumstances, implement an EMR that is not certified for Meaningful Use. If you go to this website: http://onc-chpl.force.com/ehrcert/EHRProductSearch you can put in different EMR systems in the middle box and search by name (make sure to click on the box that says “searchâ€). When it finds the EMR, then you can click on the name

and it will show you all of the MU criteria that particular EMR is certified to address. Just looking at Clearpractice, they are not yet certified for all of the ambulatory clinical measures. You want to make sure that the ambulatory measures that you would report on are certified with the EMR that you select, or you won’t qualify for the MU $$. E-MDs is certified for everything. AthenaHealth is not certified at all.

Sorry but that's not true. Dr Blumenthal recently clarified this ... you have to have access to *ALL* the meaningful use criteria even though you only plan to use only some of them to get meaningful use. So, either you get a fully certified EMR, or you get one that is partially certified, and have access to another that covers the remaining criteria, even if you're not planning to use them this round.

The rationale is that he wants to make sure that in the coming years you are able to then meet all the other MU criteria.

So, in your example, Clearpractice would not work even if they do all the criteria you are planning to use. Same applies to PracticeFusion and so forth.

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

Graham, thanks for that clarification. I’m

so glad that e-MDs is fully certified J

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of Graham Chiu

Sent: Friday, January 07, 2011

11:03 AM

To:

Subject: Re:

Re: starting up, need an EMR

Sorry but that's not true. Dr Blumenthal recently clarified

this ... you have to have access to *ALL* the meaningful use criteria even

though you only plan to use only some of them to get meaningful use. So,

either you get a fully certified EMR, or you get one that is partially

certified, and have access to another that covers the remaining criteria, even

if you're not planning to use them this round.

The rationale is that he wants to make sure that in the coming years

you are able to then meet all the other MU criteria.

So, in your example, Clearpractice would not work even if they do all

the criteria you are planning to use. Same applies to PracticeFusion and

so forth.

--

Graham Chiu

http://www.compkarori.co.nz:8090/

Synapse - the use from anywhere EMR.