Newbie here

[Guest guest]

Hello everyone,

And thank you for this forum and the opportunity to discuss alternative practice

models.

I'm actually a PA, practicing 25 years and ready to try a minimalist solo

practice. I'm parting ways with the doc I worked with for 13 years. We were a

Medicare opt out, cash only practice and that's how I intend to proceed.

I will be part-time (I have another p/t job) at least to begin with. I expect to

work 16 hours a week and will prob only see 16-20 pts/week. I will be a

consultative practice vs a primary care.

I expect to charge about 30% less than what my patients are now charged at my

current employment. I expect I can generate at least $150/hr and that's before

any extra revenue from labs, or procedures. Anticipating at full schedule to

gross approx $2000 to 2500/week.

I am pretty sure I can find a space for $350/month -- so overhead won't be too

bad in the rent dept.

Where I would most appreciate guidance is wrt EHR systems. I have looked at

PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can

your comment about their pros and cons?

Not sure if any EHR has these features but I'd like a system that allows the

following: patients to make their own appts online and the system messages them

reminders; patients can PAY online with credit cards or paypal BEFORE the visit;

the ability to dictate at least the HPI (or Dragon); generates bills so pts can

file on their own with their insurance; the ability for HIPA safe email

messaging with pts; linkage to Labcorp/Quest so labs are integrated into their

files; tests and referrals reports come back into the EHR system; and the other

typical services.

Does such a system exist? and is it affordable for such a small practice?

With many thanks in advance, Ann

[Guest guest]

What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann>

[Guest guest]

What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann>

[Guest guest]

What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann>

[Guest guest]

THIS is the key point ALL emrs are mediocre AND since we all do not have the SAME one we all spend all our time on our own.Oh we prasie E-MDs  - for $10,000 OH we praise AC and  have to get it to connect to billing and the labs place  OH we praise  LAbquest  interfaces IF we can get it  and on and on and on. Power Med   Office Ally Welford chart notes Pf 

We are nuts. Somewhere along long time ago we missed the  fork in the road that would have taken us to a sensible functional workplace.ONE EMR like it or not grow up docs and deal with i t That is what I understand the dutch and the australains do probably everyone else(I would like t o know)

MU would have been far better to take the 44,000 and pay off docs who invested in emrs and put us all ALL on ONE system Imagine just imagine. if you could talk to ONE kind of tech support and you could  have had labs come ina nd go out and reports to consultants go out and see cts from the  100mi away BIg Hospital etc  Imagine. But now there is no mammogram report  " we are waiitng ot see the old one taken in Calfirnia last year "

 can anyone say Americans are stupid. argh

 

What do you use? 

Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues….

 At lease with Practice Fusion, you are not suffering in your pocket…

 Can you tell me that you are a 100% happy with your emr…you have absolutely no issues?

 Because if you can, then you are very lucky….

 I am not totally happy with Practice Fusion, but they are getting better.  However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow….

 JMHO…. 

From: [mailto: ] On Behalf Of theNeighbors

Sent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here

   You don’t incur any cost until you try to put all the pieces together.  Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming.  Looks like it’s way more expensive than what I use already.

 Now, find someone running a busy practice that finds it meets their needs.  No doubt it demos well.  Add two seconds to every  screen refresh and in a few months it will drive you crazy.  Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF.  Practices grow and switching EMRs is seldom easy. Plan for the long term.

 Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. 

  

From: [mailto: ] On Behalf Of H. Kim

Sent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here

   Anne, 

I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal….

  

From: [mailto: ] On Behalf Of Anne Walch

Sent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here

   Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .

I quickly browsed your site

>> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed.

> > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. >

> I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.

> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?

> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.

> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> 

--      MD          ph    fax

[Guest guest]

THIS is the key point ALL emrs are mediocre AND since we all do not have the SAME one we all spend all our time on our own.Oh we prasie E-MDs  - for $10,000 OH we praise AC and  have to get it to connect to billing and the labs place  OH we praise  LAbquest  interfaces IF we can get it  and on and on and on. Power Med   Office Ally Welford chart notes Pf 

We are nuts. Somewhere along long time ago we missed the  fork in the road that would have taken us to a sensible functional workplace.ONE EMR like it or not grow up docs and deal with i t That is what I understand the dutch and the australains do probably everyone else(I would like t o know)

MU would have been far better to take the 44,000 and pay off docs who invested in emrs and put us all ALL on ONE system Imagine just imagine. if you could talk to ONE kind of tech support and you could  have had labs come ina nd go out and reports to consultants go out and see cts from the  100mi away BIg Hospital etc  Imagine. But now there is no mammogram report  " we are waiitng ot see the old one taken in Calfirnia last year "

 can anyone say Americans are stupid. argh

 

What do you use? 

Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues….

 At lease with Practice Fusion, you are not suffering in your pocket…

 Can you tell me that you are a 100% happy with your emr…you have absolutely no issues?

 Because if you can, then you are very lucky….

 I am not totally happy with Practice Fusion, but they are getting better.  However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow….

 JMHO…. 

From: [mailto: ] On Behalf Of theNeighbors

Sent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here

   You don’t incur any cost until you try to put all the pieces together.  Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming.  Looks like it’s way more expensive than what I use already.

 Now, find someone running a busy practice that finds it meets their needs.  No doubt it demos well.  Add two seconds to every  screen refresh and in a few months it will drive you crazy.  Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF.  Practices grow and switching EMRs is seldom easy. Plan for the long term.

 Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. 

  

From: [mailto: ] On Behalf Of H. Kim

Sent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here

   Anne, 

I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal….

  

From: [mailto: ] On Behalf Of Anne Walch

Sent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here

   Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .

I quickly browsed your site

>> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed.

> > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. >

> I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.

> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?

> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.

> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> 

--      MD          ph    fax

[Guest guest]

THIS is the key point ALL emrs are mediocre AND since we all do not have the SAME one we all spend all our time on our own.Oh we prasie E-MDs  - for $10,000 OH we praise AC and  have to get it to connect to billing and the labs place  OH we praise  LAbquest  interfaces IF we can get it  and on and on and on. Power Med   Office Ally Welford chart notes Pf 

We are nuts. Somewhere along long time ago we missed the  fork in the road that would have taken us to a sensible functional workplace.ONE EMR like it or not grow up docs and deal with i t That is what I understand the dutch and the australains do probably everyone else(I would like t o know)

MU would have been far better to take the 44,000 and pay off docs who invested in emrs and put us all ALL on ONE system Imagine just imagine. if you could talk to ONE kind of tech support and you could  have had labs come ina nd go out and reports to consultants go out and see cts from the  100mi away BIg Hospital etc  Imagine. But now there is no mammogram report  " we are waiitng ot see the old one taken in Calfirnia last year "

 can anyone say Americans are stupid. argh

 

What do you use? 

Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues….

 At lease with Practice Fusion, you are not suffering in your pocket…

 Can you tell me that you are a 100% happy with your emr…you have absolutely no issues?

 Because if you can, then you are very lucky….

 I am not totally happy with Practice Fusion, but they are getting better.  However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow….

 JMHO…. 

From: [mailto: ] On Behalf Of theNeighbors

Sent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here

   You don’t incur any cost until you try to put all the pieces together.  Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming.  Looks like it’s way more expensive than what I use already.

 Now, find someone running a busy practice that finds it meets their needs.  No doubt it demos well.  Add two seconds to every  screen refresh and in a few months it will drive you crazy.  Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF.  Practices grow and switching EMRs is seldom easy. Plan for the long term.

 Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. 

  

From: [mailto: ] On Behalf Of H. Kim

Sent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here

   Anne, 

I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal….

  

From: [mailto: ] On Behalf Of Anne Walch

Sent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here

   Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .

I quickly browsed your site

>> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed.

> > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. >

> I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.

> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?

> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.

> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> 

--      MD          ph    fax

[Guest guest]

I thought all EMRs were above average JThe ads say they are. From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 9:00 AMTo: Subject: Re: Re: Newbie here THIS is the key point ALL emrs are mediocre AND since we all do not have the SAME one we all spend all our time on our own.Oh we prasie E-MDs - for $10,000 OH we praise AC and have to get it to connect to billing and the labs place OH we praise LAbquest interfaces IF we can get it and on and on and on. Power Med Office Ally Welford chart notes Pf We are nuts. Somewhere along long time ago we missed the fork in the road that would have taken us to a sensible functional workplace.ONE EMR like it or not grow up docs and deal with i t That is what I understand the dutch and the australains do probably everyone else(I would like t o know)MU would have been far better to take the 44,000 and pay off docs who invested in emrs and put us all ALL on ONE system Imagine just imagine. if you could talk to ONE kind of tech support and you could have had labs come ina nd go out and reports to consultants go out and see cts from the 100mi away BIg Hospital etc Imagine. But now there is no mammogram report " we are waiitng ot see the old one taken in Calfirnia last year " can anyone say Americans are stupid. argh What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> -- MD ph fax

[Guest guest]

I thought all EMRs were above average JThe ads say they are. From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 9:00 AMTo: Subject: Re: Re: Newbie here THIS is the key point ALL emrs are mediocre AND since we all do not have the SAME one we all spend all our time on our own.Oh we prasie E-MDs - for $10,000 OH we praise AC and have to get it to connect to billing and the labs place OH we praise LAbquest interfaces IF we can get it and on and on and on. Power Med Office Ally Welford chart notes Pf We are nuts. Somewhere along long time ago we missed the fork in the road that would have taken us to a sensible functional workplace.ONE EMR like it or not grow up docs and deal with i t That is what I understand the dutch and the australains do probably everyone else(I would like t o know)MU would have been far better to take the 44,000 and pay off docs who invested in emrs and put us all ALL on ONE system Imagine just imagine. if you could talk to ONE kind of tech support and you could have had labs come ina nd go out and reports to consultants go out and see cts from the 100mi away BIg Hospital etc Imagine. But now there is no mammogram report " we are waiitng ot see the old one taken in Calfirnia last year " can anyone say Americans are stupid. argh What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> -- MD ph fax

[Guest guest]

I thought all EMRs were above average JThe ads say they are. From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 9:00 AMTo: Subject: Re: Re: Newbie here THIS is the key point ALL emrs are mediocre AND since we all do not have the SAME one we all spend all our time on our own.Oh we prasie E-MDs - for $10,000 OH we praise AC and have to get it to connect to billing and the labs place OH we praise LAbquest interfaces IF we can get it and on and on and on. Power Med Office Ally Welford chart notes Pf We are nuts. Somewhere along long time ago we missed the fork in the road that would have taken us to a sensible functional workplace.ONE EMR like it or not grow up docs and deal with i t That is what I understand the dutch and the australains do probably everyone else(I would like t o know)MU would have been far better to take the 44,000 and pay off docs who invested in emrs and put us all ALL on ONE system Imagine just imagine. if you could talk to ONE kind of tech support and you could have had labs come ina nd go out and reports to consultants go out and see cts from the 100mi away BIg Hospital etc Imagine. But now there is no mammogram report " we are waiitng ot see the old one taken in Calfirnia last year " can anyone say Americans are stupid. argh What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> -- MD ph fax

[Guest guest]

Labcorp told me I'm too low volume to do interface.

Quest did mine before they knew my volume and I had to turn it off because it's blocking my all-in-one fax.

To: Cc: Sharon McCoy Sent: Sat, April 2, 2011 4:48:53 PMSubject: Re: Re: Newbie here

What does Labcorp say?

While we are on this topic, yesterday my Quest rep called back very sadly saying that they will not do the interface for me, because my volume is too low. We are not talking they won't pay for it; we are talking they won't do it even if I pay the $500 to Amazing Charts. We've gone back and forth and the higher management of our region at Quest apparently says it costs them more then $500 to set up (not what I hear from AC) and they can't subsidize really low volume practices. So that is sad.

Sharon

Sharon McCoy MD Renaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

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

[Guest guest]

Labcorp told me I'm too low volume to do interface.

Quest did mine before they knew my volume and I had to turn it off because it's blocking my all-in-one fax.

To: Cc: Sharon McCoy Sent: Sat, April 2, 2011 4:48:53 PMSubject: Re: Re: Newbie here

What does Labcorp say?

While we are on this topic, yesterday my Quest rep called back very sadly saying that they will not do the interface for me, because my volume is too low. We are not talking they won't pay for it; we are talking they won't do it even if I pay the $500 to Amazing Charts. We've gone back and forth and the higher management of our region at Quest apparently says it costs them more then $500 to set up (not what I hear from AC) and they can't subsidize really low volume practices. So that is sad.

Sharon

Sharon McCoy MD Renaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

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

[Guest guest]

Labcorp told me I'm too low volume to do interface.

Quest did mine before they knew my volume and I had to turn it off because it's blocking my all-in-one fax.

To: Cc: Sharon McCoy Sent: Sat, April 2, 2011 4:48:53 PMSubject: Re: Re: Newbie here

What does Labcorp say?

While we are on this topic, yesterday my Quest rep called back very sadly saying that they will not do the interface for me, because my volume is too low. We are not talking they won't pay for it; we are talking they won't do it even if I pay the $500 to Amazing Charts. We've gone back and forth and the higher management of our region at Quest apparently says it costs them more then $500 to set up (not what I hear from AC) and they can't subsidize really low volume practices. So that is sad.

Sharon

Sharon McCoy MD Renaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

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

[Guest guest]

It will cost them a whole lot more when you stop sending work their way, other

than those that are contracted by insurance coverage.

Don't ask or beg, demand and threaten!

They are not your friends!

Horvitz, D.O.

stown, NJ

>

> While we are on this topic, yesterday my Quest rep called back very sadly

> saying that they will not do the interface for me, because my volume is too

> low. We are not talking they won't pay for it; we are talking they won't do

> it even if I pay the $500 to Amazing Charts. We've gone back and forth and

> the higher management of our region at Quest apparently says it costs them

> more then $500 to set up (not what I hear from AC) and they can't subsidize

> really low volume practices.

> So that is sad.

> Sharon

>

> Sharon McCoy MD

> Renaissance Family Medicine

> 10 McClintock Court; Irvine, CA 92617

> PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax:

> www.SharonMD.com

>

[Guest guest]

It will cost them a whole lot more when you stop sending work their way, other

than those that are contracted by insurance coverage.

Don't ask or beg, demand and threaten!

They are not your friends!

Horvitz, D.O.

stown, NJ

>

> While we are on this topic, yesterday my Quest rep called back very sadly

> saying that they will not do the interface for me, because my volume is too

> low. We are not talking they won't pay for it; we are talking they won't do

> it even if I pay the $500 to Amazing Charts. We've gone back and forth and

> the higher management of our region at Quest apparently says it costs them

> more then $500 to set up (not what I hear from AC) and they can't subsidize

> really low volume practices.

> So that is sad.

> Sharon

>

> Sharon McCoy MD

> Renaissance Family Medicine

> 10 McClintock Court; Irvine, CA 92617

> PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax:

> www.SharonMD.com

>

[Guest guest]

It will cost them a whole lot more when you stop sending work their way, other

than those that are contracted by insurance coverage.

Don't ask or beg, demand and threaten!

They are not your friends!

Horvitz, D.O.

stown, NJ

>

> While we are on this topic, yesterday my Quest rep called back very sadly

> saying that they will not do the interface for me, because my volume is too

> low. We are not talking they won't pay for it; we are talking they won't do

> it even if I pay the $500 to Amazing Charts. We've gone back and forth and

> the higher management of our region at Quest apparently says it costs them

> more then $500 to set up (not what I hear from AC) and they can't subsidize

> really low volume practices.

> So that is sad.

> Sharon

>

> Sharon McCoy MD

> Renaissance Family Medicine

> 10 McClintock Court; Irvine, CA 92617

> PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax:

> www.SharonMD.com

>

[Guest guest]

Didn't you know that we're all in a "Free Market"???? Isn't Capitalizm Wonderful???? I feel So Freeeee!!!!!!

Ya see class, they're all "Stakeholders".... So is GE, W/A, AZ, Pfizer,, Sanofi, the rest of Big Pharma, the Hospitals, the rs, Greenway, Mccessin,

In the words of Connor as he drops the sunvisor and a set of ignition keys fall down, "Are we learning yet???"

To: Sent: Sun, April 3, 2011 8:55:53 AMSubject: Re: Re: Newbie here

Labcorp told me I'm too low volume to do interface.

Quest did mine before they knew my volume and I had to turn it off because it's blocking my all-in-one fax.

To: Cc: Sharon McCoy Sent: Sat, April 2, 2011 4:48:53 PMSubject: Re: Re: Newbie here

What does Labcorp say?

While we are on this topic, yesterday my Quest rep called back very sadly saying that they will not do the interface for me, because my volume is too low. We are not talking they won't pay for it; we are talking they won't do it even if I pay the $500 to Amazing Charts. We've gone back and forth and the higher management of our region at Quest apparently says it costs them more then $500 to set up (not what I hear from AC) and they can't subsidize really low volume practices. So that is sad.

Sharon

Sharon McCoy MD Renaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

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

[Guest guest]

Didn't you know that we're all in a "Free Market"???? Isn't Capitalizm Wonderful???? I feel So Freeeee!!!!!!

Ya see class, they're all "Stakeholders".... So is GE, W/A, AZ, Pfizer,, Sanofi, the rest of Big Pharma, the Hospitals, the rs, Greenway, Mccessin,

In the words of Connor as he drops the sunvisor and a set of ignition keys fall down, "Are we learning yet???"

To: Sent: Sun, April 3, 2011 8:55:53 AMSubject: Re: Re: Newbie here

Labcorp told me I'm too low volume to do interface.

Quest did mine before they knew my volume and I had to turn it off because it's blocking my all-in-one fax.

To: Cc: Sharon McCoy Sent: Sat, April 2, 2011 4:48:53 PMSubject: Re: Re: Newbie here

What does Labcorp say?

While we are on this topic, yesterday my Quest rep called back very sadly saying that they will not do the interface for me, because my volume is too low. We are not talking they won't pay for it; we are talking they won't do it even if I pay the $500 to Amazing Charts. We've gone back and forth and the higher management of our region at Quest apparently says it costs them more then $500 to set up (not what I hear from AC) and they can't subsidize really low volume practices. So that is sad.

Sharon

Sharon McCoy MD Renaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

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

[Guest guest]

Didn't you know that we're all in a "Free Market"???? Isn't Capitalizm Wonderful???? I feel So Freeeee!!!!!!

Ya see class, they're all "Stakeholders".... So is GE, W/A, AZ, Pfizer,, Sanofi, the rest of Big Pharma, the Hospitals, the rs, Greenway, Mccessin,

In the words of Connor as he drops the sunvisor and a set of ignition keys fall down, "Are we learning yet???"

To: Sent: Sun, April 3, 2011 8:55:53 AMSubject: Re: Re: Newbie here

Labcorp told me I'm too low volume to do interface.

Quest did mine before they knew my volume and I had to turn it off because it's blocking my all-in-one fax.

To: Cc: Sharon McCoy Sent: Sat, April 2, 2011 4:48:53 PMSubject: Re: Re: Newbie here

What does Labcorp say?

While we are on this topic, yesterday my Quest rep called back very sadly saying that they will not do the interface for me, because my volume is too low. We are not talking they won't pay for it; we are talking they won't do it even if I pay the $500 to Amazing Charts. We've gone back and forth and the higher management of our region at Quest apparently says it costs them more then $500 to set up (not what I hear from AC) and they can't subsidize really low volume practices. So that is sad.

Sharon

Sharon McCoy MD Renaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

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

[Guest guest]

Interesting, …. Are you noting that you need to go to the ASP model for it be certified?That the local server model was not going to be certified?Just curious…. From: [mailto: ] On Behalf Of PrattSent: Monday, April 04, 2011 7:38 AMTo: Subject: Re: Re: Newbie here There's an entire list of certified EMR's & which version it is that is certified, and if you search the archives, I posted that link a while back. Or go to CMS website and search for yourself. Also, as someone else already pointed out, unless you are a Medicaid provider, today is actually probably the first 90 th day for any Medicare practice. I suspect that there were very few Medicare practices actually ready on 1/1/11 because of the time it takes the EMR vendors to get their certified version out to their users. We got ours mid-Jan but were in the middle of converting from in-house server to ASP and won't go live until 4/15 with the certified version. I'm currently in process of updating our intake form so that we are 100% ready on 4/18 to start with MU. I would suspect that there are very few IMP practices (due to low volume) that will hit the max benefit and get a check in 2011. If you want to wait and see if it is " for real, " then wait until later this year when we've had a chance to implement and attest online and some of us will post to the list and let you know. Ok so we know that e-MDs has been accepted as a certified HER for the Oklahoma practice….. Anyone know of another EMR that has been officially certified and the practice receiving checks? From: [mailto: ] On Behalf Of PrattSent: Sunday, April 03, 2011 7:14 PMTo: Subject: Re: Re: Newbie here Yes. There are plenty of EMR's that are certified. We are upgrading to the certified version on the 15th and will then go 90 days and see if we can achieve MU in the first 90 days of being on the certified version. CMS doesn't mail you a check until you attain the maximum benefit, so since we likely won't reach the maximum in 90 days ( or even the entire year ), I anticipate that we will get our check around this time next year. The first official check went to an e-MDs user in January. Broader question?Does any EMR meet meaningful use? Has anyone started seeing checks yet? From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 5:27 PMTo: Subject: Re: Re: Newbie here Does PF meet all the meaningful use expectataions? What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (63) Recent Activity:

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Interesting, …. Are you noting that you need to go to the ASP model for it be certified?That the local server model was not going to be certified?Just curious…. From: [mailto: ] On Behalf Of PrattSent: Monday, April 04, 2011 7:38 AMTo: Subject: Re: Re: Newbie here There's an entire list of certified EMR's & which version it is that is certified, and if you search the archives, I posted that link a while back. Or go to CMS website and search for yourself. Also, as someone else already pointed out, unless you are a Medicaid provider, today is actually probably the first 90 th day for any Medicare practice. I suspect that there were very few Medicare practices actually ready on 1/1/11 because of the time it takes the EMR vendors to get their certified version out to their users. We got ours mid-Jan but were in the middle of converting from in-house server to ASP and won't go live until 4/15 with the certified version. I'm currently in process of updating our intake form so that we are 100% ready on 4/18 to start with MU. I would suspect that there are very few IMP practices (due to low volume) that will hit the max benefit and get a check in 2011. If you want to wait and see if it is " for real, " then wait until later this year when we've had a chance to implement and attest online and some of us will post to the list and let you know. Ok so we know that e-MDs has been accepted as a certified HER for the Oklahoma practice….. Anyone know of another EMR that has been officially certified and the practice receiving checks? From: [mailto: ] On Behalf Of PrattSent: Sunday, April 03, 2011 7:14 PMTo: Subject: Re: Re: Newbie here Yes. There are plenty of EMR's that are certified. We are upgrading to the certified version on the 15th and will then go 90 days and see if we can achieve MU in the first 90 days of being on the certified version. CMS doesn't mail you a check until you attain the maximum benefit, so since we likely won't reach the maximum in 90 days ( or even the entire year ), I anticipate that we will get our check around this time next year. The first official check went to an e-MDs user in January. Broader question?Does any EMR meet meaningful use? Has anyone started seeing checks yet? From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 5:27 PMTo: Subject: Re: Re: Newbie here Does PF meet all the meaningful use expectataions? What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (63) Recent Activity:

[Guest guest]

Interesting, …. Are you noting that you need to go to the ASP model for it be certified?That the local server model was not going to be certified?Just curious…. From: [mailto: ] On Behalf Of PrattSent: Monday, April 04, 2011 7:38 AMTo: Subject: Re: Re: Newbie here There's an entire list of certified EMR's & which version it is that is certified, and if you search the archives, I posted that link a while back. Or go to CMS website and search for yourself. Also, as someone else already pointed out, unless you are a Medicaid provider, today is actually probably the first 90 th day for any Medicare practice. I suspect that there were very few Medicare practices actually ready on 1/1/11 because of the time it takes the EMR vendors to get their certified version out to their users. We got ours mid-Jan but were in the middle of converting from in-house server to ASP and won't go live until 4/15 with the certified version. I'm currently in process of updating our intake form so that we are 100% ready on 4/18 to start with MU. I would suspect that there are very few IMP practices (due to low volume) that will hit the max benefit and get a check in 2011. If you want to wait and see if it is " for real, " then wait until later this year when we've had a chance to implement and attest online and some of us will post to the list and let you know. Ok so we know that e-MDs has been accepted as a certified HER for the Oklahoma practice….. Anyone know of another EMR that has been officially certified and the practice receiving checks? From: [mailto: ] On Behalf Of PrattSent: Sunday, April 03, 2011 7:14 PMTo: Subject: Re: Re: Newbie here Yes. There are plenty of EMR's that are certified. We are upgrading to the certified version on the 15th and will then go 90 days and see if we can achieve MU in the first 90 days of being on the certified version. CMS doesn't mail you a check until you attain the maximum benefit, so since we likely won't reach the maximum in 90 days ( or even the entire year ), I anticipate that we will get our check around this time next year. The first official check went to an e-MDs user in January. Broader question?Does any EMR meet meaningful use? Has anyone started seeing checks yet? From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 5:27 PMTo: Subject: Re: Re: Newbie here Does PF meet all the meaningful use expectataions? What do you use? Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues…. At lease with Practice Fusion, you are not suffering in your pocket… Can you tell me that you are a 100% happy with your emr…you have absolutely no issues? Because if you can, then you are very lucky…. I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow…. JMHO…. From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already. Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term. Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for. From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here Anne, I would look at Practice Fusion as an alternative…..I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal…. From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a " supervising physician " .I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care. > > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann> Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (63) Recent Activity:

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,

No offense here but if you read my last post about the "regional Information Exchanges" that is exactly what they are for, to allow PHI in all sorts of places, labs, hospitals, private practices, ASP EMR's, yadda, yadda, to be easily exchanged between other providers and stakeholders.... (I am really learning to hate that word...)... I am 99% certain you are incorrect here otherwise ALL involved would have to be on such a piece of software and such is certainly not the case...

I believe you need to step back and refresh your screen here might we say... There really are more than one way to see this and to skin the cat here as well. Remember all of these laws were designed to be inclusive of most of the larger stakeholders so they could make money off of the present basically Not Reformed system. To cut off the majority of EMR's and their vendors would never have passed under our present system that created these rules and laws....

To: Sent: Mon, April 4, 2011 1:01:14 PMSubject: RE: Re: Newbie here

Interesting, ….

Are you noting that you need to go to the ASP model for it be certified?

That the local server model was not going to be certified?

Just curious….

From: [mailto: ] On Behalf Of PrattSent: Monday, April 04, 2011 7:38 AMTo: Subject: Re: Re: Newbie here

There's an entire list of certified EMR's & which version it is that is certified, and if you search the archives, I posted that link a while back. Or go to CMS website and search for yourself. Also, as someone else already pointed out, unless you are a Medicaid provider, today is actually probably the first 90 th day for any Medicare practice. I suspect that there were very few Medicare practices actually ready on 1/1/11 because of the time it takes the EMR vendors to get their certified version out to their users. We got ours mid-Jan but were in the middle of converting from in-house server to ASP and won't go live until 4/15 with the certified version. I'm currently in process of updating our intake form so that we are 100% ready on 4/18 to start with MU. I would suspect that there are very few IMP practices (due to low volume) that will hit the max benefit and get a check in 2011. If you want to wait and see if it

is "for real," then wait until later this year when we've had a chance to implement and attest online and some of us will post to the list and let you know.

Ok so we know that e-MDs has been accepted as a certified HER for the Oklahoma practice…..

Anyone know of another EMR that has been officially certified and the practice receiving checks?

From: [mailto: ] On Behalf Of PrattSent: Sunday, April 03, 2011 7:14 PMTo: Subject: Re: Re: Newbie here

Yes. There are plenty of EMR's that are certified. We are upgrading to the certified version on the 15th and will then go 90 days and see if we can achieve MU in the first 90 days of being on the certified version. CMS doesn't mail you a check until you attain the maximum benefit, so since we likely won't reach the maximum in 90 days ( or even the entire year ), I anticipate that we will get our check around this time next year. The first official check went to an e-MDs user in January.

Broader question?

Does any EMR meet meaningful use? Has anyone started seeing checks yet?

From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 5:27 PMTo: Subject: Re: Re: Newbie here

Does PF meet all the meaningful use expectataions?

What do you use?

Because I have to tell you that I have been through a whole bunch of models – Nextgen, Cerner, e-MDs, eClinicalworks, Amazing Charts, Medinotes, Alteer, etc… and they all have their issues….

At lease with Practice Fusion, you are not suffering in your pocket…

Can you tell me that you are a 100% happy with your emr…you have absolutely no issues?

Because if you can, then you are very lucky….

I am not totally happy with Practice Fusion, but they are getting better. However, I am totally satisfied with their payment model….and if you have ever used it, you would know that their ad space is minimal and does not significantly interfere with patient flow….

JMHO….

From: [mailto: ] On Behalf Of theNeighborsSent: Friday, April 01, 2011 2:50 PMTo: Subject: RE: Re: Newbie here

You don’t incur any cost until you try to put all the pieces together. Add in premium internet service, billing, getting rid of ads that decrease usable screen space, and add-on that have yet to be priced in – you can bet they are coming. Looks like it’s way more expensive than what I use already.

Now, find someone running a busy practice that finds it meets their needs. No doubt it demos well. Add two seconds to every screen refresh and in a few months it will drive you crazy. Let’s hear from someone that sees 25 to 30 patients a day that’s still happy after a couple of months with PF. Practices grow and switching EMRs is seldom easy. Plan for the long term.

Perhaps someone that previously used an office server base EMR and switched to Practice Fusion will offer the comparative review we are looking for.

From: [mailto: ] On Behalf Of H. KimSent: Friday, April 01, 2011 9:54 AMTo: Subject: RE: Re: Newbie here

Anne,

I would look at Practice Fusion as an alternative…..

I think it is good place to start since it is has a model where you do not incur any costs from the use of their EMR…..go to www.practicefusion.com and check them out…they too along with everyone else it seems are probably working on a patient portal….

From: [mailto: ] On Behalf Of Anne WalchSent: Friday, April 01, 2011 6:29 AMTo: Subject: Re: Re: Newbie here

Hi , I'm a Physician Assistant --PA,,,, I don't live or practice in PA but in NC. Fortunately, physician assistants in NC can incorporate and practice as long as we have a "supervising physician".I quickly browsed your site >> Hello everyone,> And thank you for this forum and the opportunity to discuss alternative practice models.> > I'm actually a PA, practicing 25 years and ready to try a minimalist solo practice. I'm parting ways with the doc I worked with for 13 years. We were a Medicare opt out, cash only practice and that's how I intend to proceed. > > I will be part-tim e (I have another p/t job) at least to begin with. I expect to work 16 hours a week and will prob only see 16-20 pts/week. I will be a consultative practice vs a primary care.

> > I expect to charge about 30% less than what my patients are now charged at my current employment. I expect I can generate at least $150/hr and that's before any extra revenue from labs, or procedures. Anticipating at full schedule to gross approx $2000 to 2500/week.> > I am pretty sure I can find a space for $350/month -- so overhead won't be too bad in the rent dept.> > Where I would most appreciate guidance is wrt EHR systems. I have looked at PracticeFusion and eClinicalWorks a little bit. Has anyone used these and can your comment about their pros and cons?> > Not sure if any EHR has these features but I'd like a system that allows the following: patients to make their own appts online and the system messages them reminders; patients can P AY online with credit cards or paypal BEFORE the visit; the ability to dictate at least the HPI (or Dragon); generates bills so pts can file on their own

with their insurance; the ability for HIPA safe email messaging with pts; linkage to Labcorp/Quest so labs are integrated into their files; tests and referrals reports come back into the EHR system; and the other typical services.> > Does such a system exist? and is it affordable for such a small practice?> > With many thanks in advance, Ann>

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