Re: Newbie here

[Guest guest]

Hi Ann,

I am starting a solo family medicine clinic. I looked at a few EHRs including eCW and PF. To me PF is easier to use, go live in 5 minutes and with self teaching/learning icons on most screens. It doesn't have many templates as the costly EHRs do. So I guess I need to build my own templates over time. I decided to try PF now. It has billing partnership with a company called Kareo. The cost is low. $69/month from what I learned on the Kareo webnar yesterday. The bills still need to go through a clearing house like Gateway.

I am new to the group. This is the first post. I do want to thank other members with the contributions to the message board. I've learned a lot. Thank you everyone!

Wen

 

[Guest guest]

PF = Practice Fusion?

Re: Newbie here

Hi Ann,

I am starting a solo family medicine clinic. I looked at a few EHRs including eCW and PF. To me PF is easier to use, go live in 5 minutes and with self teaching/learning icons on most screens. It doesn't have many templates as the costly EHRs do. So I guess I need to build my own templates over time. I decided to try PF now. It has billing partnership with a company called Kareo. The cost is low. $69/month from what I learned on the Kareo webnar yesterday. The bills still need to go through a clearing house like Gateway.

I am new to the group. This is the first post. I do want to thank other members with the contributions to the message board. I've learned a lot. Thank you everyone!

Wen

[Guest guest]

Welcome!So where are you?IN a place where a PA can work independently?Jean

 

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

--      MD          ph    fax

[Guest guest]

Welcome to the Listserve Ann. Where are you located in PA? I am in South

Central PA between York and Harrsiburg. You are welcome to check out my

practice if you are nearby.

www.pinchotfamilymed.com

>

> 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]

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-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]

Ann,Look at e-MDs. It has almost all of the functionality except for patients paying through the portal. Even if you don't, I would look only at programs that meet all of the criteria for meaningful use because those companies will be on the forefront of the technologies that you are looking for And should continue to improve to continue to be certified.

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]

E-MDs makes billing a snap. $89/user for the ASP version of e-MDs after you pay the user license to e-MDs. Happy user, no financial ties.

Hi Ann,

I am starting a solo family medicine clinic. I looked at a few EHRs including eCW and PF. To me PF is easier to use, go live in 5 minutes and with self teaching/learning icons on most screens. It doesn't have many templates as the costly EHRs do. So I guess I need to build my own templates over time. I decided to try PF now. It has billing partnership with a company called Kareo. The cost is low. $69/month from what I learned on the Kareo webnar yesterday. The bills still need to go through a clearing house like Gateway.

I am new to the group. This is the first post. I do want to thank other members with the contributions to the message board. I've learned a lot. Thank you everyone!

Wen

[Guest guest]

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-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]

Thanks for your response .Do any of these system allow the pt to pay through the portal?  It seems like a no brainer to me to have that functionality. Or even to have the capability to add that function.  I know there is online services that allow pts to make their own appt and to prepay for them.

If you have time, can you explain your second sentence,,, " only look at programs that meet all of the criteria for meaningful use because.... "     I'm not following you but it seems like a useful piece of information that I should understand.

many thanks!  Anne

 

Ann,Look at e-MDs. It has almost all of the functionality except for patients paying through the portal. Even if you don't, I would look only at programs that meet all of the criteria for meaningful use because those companies will be on the forefront of the technologies that you are looking for And should continue to improve to continue to be certified. 

 

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]

, sorry, what is " ASP " thanks~ Anne

 

E-MDs makes billing a snap. $89/user for the ASP version of e-MDs after you pay the user license to e-MDs. Happy user, no financial ties. 

 

Hi Ann,

I am starting a solo family medicine clinic. I looked at a few EHRs including eCW and PF. To me PF is easier to use, go live in 5 minutes and with self teaching/learning icons on most screens. It doesn't have many templates as the costly EHRs do. So I guess I need to build my own templates over time. I decided to try PF now. It has billing partnership with a company called Kareo. The cost is low. $69/month from what I learned on the Kareo webnar yesterday. The bills still need to go through a clearing house like Gateway.

I am new to the group. This is the first post. I do want to thank other members with the contributions to the message board. I've learned a lot. Thank you everyone!

Wen

 

[Guest guest]

Anne-I think a bunch of people have forms in connection to websites in fact this is a topic I'm working on this  snowy day on my own website . I will say I can't comment on portals I think you'll find that not too many people have web portals but what some people have done is set things up  with  PayPal so that people click on their website and can pay that way I can think of two websites that I think do that one is Dr. Lynn Ho in RI if you google herand one is Carla's  Montanahealthsolutions I  think   and  Sangeetha Murthy may also--google them, you might try looking at those  websites

I would also encourage you to become a member Our new website is dangerously close to being  up but for now you can become a member  by going to idealhealth.network .org/join because then you could come to phone calls -- once a month to get CME .This is  exactly the stuff  we talk about We have  calls  the first Wednesday of every month noon eastern  and a floating time per second call PLus the  calls a re recorded so  you can listen later..

 I anticipate there will be a panel of working imps oh I do hope you know ideal medical practices providers are called IMPS- there will be  a panel of working imps showing off some techno tools they use for the June call

 I hope that will be of help to you and again welcome I spent some time  in   North Carolina  at UNC  and I liked it  except they said I talked too fast and the  humidity made my hair big Jean

 

Thanks for your response .Do any of these system allow the pt to pay through the portal?  It seems like a no brainer to me to have that functionality. Or even to have the capability to add that function.  I know there is online services that allow pts to make their own appt and to prepay for them.

If you have time, can you explain your second sentence,,, " only look at programs that meet all of the criteria for meaningful use because.... "     I'm not following you but it seems like a useful piece of information that I should understand.

many thanks!  Anne

 

Ann,Look at e-MDs. It has almost all of the functionality except for patients paying through the portal. Even if you don't, I would look only at programs that meet all of the criteria for meaningful use because those companies will be on the forefront of the technologies that you are looking for And should continue to improve to continue to be certified. 

 

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

--      MD          ph    fax

[Guest guest]

Meaningful use or criteria = system qualify to get some incentive from uncle Sam ( Feds).There is a nice web magazine @ www.aafp.org. Go to their website and look for family practice management magazine . The link is on the left side.There are a lot of articles that explain a lot stuff.I'm with , I like emds, I think getting the right emr will save u a lot of headaches.I always remind myself you get what u paid.I consider other products but they don't have what I'm looking for.My 2 cents. AdolfoSent from my iPad

Thanks for your response .Do any of these system allow the pt to pay through the portal? It seems like a no brainer to me to have that functionality. Or even to have the capability to add that function. I know there is online services that allow pts to make their own appt and to prepay for them.

If you have time, can you explain your second sentence,,,"only look at programs that meet all of the criteria for meaningful use because...." I'm not following you but it seems like a useful piece of information that I should understand.

many thanks! Anne

Ann,Look at e-MDs. It has almost all of the functionality except for patients paying through the portal. Even if you don't, I would look only at programs that meet all of the criteria for meaningful use because those companies will be on the forefront of the technologies that you are looking for And should continue to improve to continue to be certified.

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]

thanks so much ,,, great info, great group of people.... I'm very glad I found y'all.   I thought I was a member, but I guess you mean of idealhealth? ,,,, sounds good,,,, will do.... best, Anne

 

Anne-I think a bunch of people have forms in connection to websites in fact this is a topic I'm working on this  snowy day on my own website . I will say I can't comment on portals I think you'll find that not too many people have web portals but what some people have done is set things up  with  PayPal so that people click on their website and can pay that way I can think of two websites that I think do that one is Dr. Lynn Ho in RI if you google herand one is Carla's  Montanahealthsolutions I  think   and  Sangeetha Murthy may also--google them, you might try looking at those  websites

I would also encourage you to become a member Our new website is dangerously close to being  up but for now you can become a member  by going to idealhealth.network .org/join because then you could come to phone calls -- once a month to get CME .This is  exactly the stuff  we talk about We have  calls  the first Wednesday of every month noon eastern  and a floating time per second call PLus the  calls a re recorded so  you can listen later..

 I anticipate there will be a panel of working imps oh I do hope you know ideal medical practices providers are called IMPS- there will be  a panel of working imps showing off some techno tools they use for the June call

 I hope that will be of help to you and again welcome I spent some time  in   North Carolina  at UNC  and I liked it  except they said I talked too fast and the  humidity made my hair big Jean

 

Thanks for your response .Do any of these system allow the pt to pay through the portal?  It seems like a no brainer to me to have that functionality. Or even to have the capability to add that function.  I know there is online services that allow pts to make their own appt and to prepay for them.

If you have time, can you explain your second sentence,,, " only look at programs that meet all of the criteria for meaningful use because.... "     I'm not following you but it seems like a useful piece of information that I should understand.

many thanks!  Anne

 

Ann,Look at e-MDs. It has almost all of the functionality except for patients paying through the portal. Even if you don't, I would look only at programs that meet all of the criteria for meaningful use because those companies will be on the forefront of the technologies that you are looking for And should continue to improve to continue to be certified. 

 

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

--      MD          ph    fax

[Guest guest]

Hi Anne,

At this time, I'm not aware of any systems that allow for payment through their portal.  I've been asking e-MDs for this since their portal came out.  But most of the software vendors got sidetracked with Meaningful Use.  This page gives an overview of what Meaningful Use is: http://www.cms.gov/EHRIncentivePrograms/.  If you are a Medicare provider, you can stand to receive up to $44,000 over 5 years if you use a certified program.  also, as a PCP, many states have free or very inexpensive Regional Extension Centers that will help you select &  implement a certified program (often with a nice discount for REC members), and they will help you achieve Meaningful Use.  Here is the link to find the REC closest to you: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__rec_program/1495

 

As an FYI, I know that e-MDs used to at least offer a " part time " provider license for half-time providers.  It's worth asking for from whichever vendor you decide to use.  We joined our REC for $100 and we're getting a $180 discount just on the portal portion of our system, so we've already save $80.  And if they help us achieve MU, then we are way ahead. 

 

this page will give you information about Certifed programs: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204 I worry about programs that aren't certified or close to it.  Since MU started on 1/1/11, any program that isn't on their way at this point to being certified is way behind.  I would worry that any program that isn't certified may not be able to survive and would end up not being supported in a few years time.  I could be wrong, but I personally wouldn't take that risk.

Hope I have scratched the surface for you.  On my way to speak on a panel about this very subject in 20 mins!

 

 

PS:  ASP = Application Service Provider, which basically means that all you need is a computer and an internet connection.  The ASP does your backup and updates to your software so that you don't have the headaches of IT.

 

 

Thanks for your response .Do any of these system allow the pt to pay through the portal?  It seems like a no brainer to me to have that functionality. Or even to have the capability to add that function.  I know there is online services that allow pts to make their own appt and to prepay for them.

If you have time, can you explain your second sentence,,, " only look at programs that meet all of the criteria for meaningful use because.... "     I'm not following you but it seems like a useful piece of information that I should understand.

many thanks!  Anne

[Guest guest]

, Just to be clear 89/user…. Is that 89/user per mo? Per quarter? Per year?User license fees are how much? From: [mailto: ] On Behalf Of PrattSent: Friday, April 01, 2011 7:51 AMTo: Subject: Re: Re: Newbie here E-MDs makes billing a snap. $89/user for the ASP version of e-MDs after you pay the user license to e-MDs. Happy user, no financial ties. Hi Ann,I am starting a solo family medicine clinic. I looked at a few EHRs including eCW and PF. To me PF is easier to use, go live in 5 minutes and with self teaching/learning icons on most screens. It doesn't have many templates as the costly EHRs do. So I guess I need to build my own templates over time. I decided to try PF now. It has billing partnership with a company called Kareo. The cost is low. $69/month from what I learned on the Kareo webnar yesterday. The bills still need to go through a clearing house like Gateway. I am new to the group. This is the first post. I do want to thank other members with the contributions to the message board. I've learned a lot. Thank you everyone!Wen

[Guest guest]

Hi Ann,

PF is Practice Fusion. A web based EHR. They do have patient portal.

Kareo is the billing company. I believe the fee is per month.

Wen

[Guest guest]

Anne,Welcome!I'm in Southern California doing a solo solo (no staff) membership based model out of a home office.Re:  IMP membership.  IdealMedicalPractices is a 501© 3 non-profit that is the " official " organization of the group that meets on this listserve.  So, you are a member of the " " Yahoo group (or you wouldn't be getting these messages), but not of IMP yet.  We are going to be transitioning from the Yahoo listserve to Forums on the website that will enable people to follow only certain message topics (or everything) and make it easier to search archives, etc.  We are working on getting practice tools and other helpful info up on the new website.  These will be behind a " wall " that only members can access.  We are are volunteers currently working without funding (with the exception of the current website development grant) except membership fees.  The fees pay expenses such as the conference calls, etc.

In addition to the monthly calls, we have an annual " camp " that is a great way to learn some practice practice management skills as well as network with other like minded people who are trying to figure out ways to continually improve our practices.  And it's fun.  This year will be outside of Washington, DC in Silver Spring, MD Oct. 14-16.  Registration and more info will be coming soon, but save the date!

 

SharonSharon McCoy MD

IMP Vice-President and Camp Director

IdealMedicalPractices, Inc. a 501©3 non-profit

www.idealhealthnetwork.org

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

[Guest guest]

Hi I can't work independently as a PA anywhere-- I still need a supervising physician who is ultimately responsible. They don't need to be on sitre nor do they need to sign every chart.. We do need to meet every month for the first six months, then every 6 months.

The profession started here in NC in 1965,,,, The NC Med Board provided ways for PA's to practice in areas where docs wouldn't go.best, Anne

 

Welcome!So where are you?IN a place where a PA can work independently?Jean

 

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

--      MD          ph    fax

[Guest guest]

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]

Thank you le for your detailed input --I am also going to have a very small integrative consultative practice, and part-time -- probably only 20 pts/week, 3 weeks out of the month. And cash only -- no insurance (prob half of my pts have no insurance anyhow), I'm opted out of medicare, etc....  I'm pretty sure this will work because it's worked in the current practice I'm employed at, and I will be able to charge less, with less overhead. I think a lot of my pts will follow me over and the lower prices will attract folks who couldn't afford us before.

 I wonder if I even need EMR?   My hope is that EMR would be less work and more efficient and of course less paper.   I don't like the idea of having to hang onto charts for seven years (perahps I'm mistaken). I'd rather not spend so much time running between my copier/fax and charts.  Then again, I get some chronically ill pts with 1-2 " thick past records in tow... I'll have to spend time uploading all those records to EMR -- that could take a ton of time if it is piece by piece,,,,

I suspect I'll open my doors with a paper system, website, online pt scheduling,,, and add EMR after I settle in...Does you pt and appt portal allow pts to schedule, complete intake forms online, pre-pay with a cc or paypal? And have secure email? 

Are those portals part of the Practice Fusion package?  Do you do your scripts digitally? and via Practice Fusion or another vendor?  WHen you say you are adding on secure email, does that mean it is not already part of the Practice Fusion package?

I'd eventually  love a digital feature that would allow my new patients to fill in their intake forms (personal hx, HIPAA, health questionnaires, etc) online so that it is already integrated into the chart before I see them.  At my current NON-EMR practice,,,, it itakes about 15 minutes just collecting, signing their forms when they first come in. .

Btw, nice website ~ Anne

 

I will come out with a big two thumbs up for Practice Fusion! !! I am switching from an expensive (15k) all the bells and whistles emr called Practice Partner.

Two main reasons and then a lot other smaller ones.1. The big emr's havelots of hidden fees....maintenance fees etc....fees to integrate with labs....fees for anything they can think of. It turned out it was over 4 k yearly just to participate.....and that was without he fees I pay to my local IT guy for office hardware issues. This way to expensive for and IMP model with 400 patients.

2. In a small office with only one doc and one staff and less than 1000 pts I find that I really do not need a lot of bells and whistles.  On other thoughts.....although I am committed to using an EMR and have used one since 2000, I do not believe that EMR s make solo doc practices more efficient or save them any money. I think it is a big scam and in the end, as always,  the docs pay and the patients suffer.  Meanwhile insurance companies and now technology companies can profit.  We will barely get our offices all set up with an emt and it will go under as a company etc....then we need a new one.....or maybe there is a security breach and we pay fines...

Ok clearly I am starting to rant!Go with Practice Fusion....ITS FREE! and it has everything you need to get started and run a small practice. The only piece I am adding on is a secure email.Peace and Blessings

DannielleDannielle Harwood, MDwww.MyStudioMD.com RE: Re: Newbie here

 

I thought all EMRs were above average J

The 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 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, gett!

ing 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 c!

ome 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]

Anne,I don't know of any EMRs that currently offer online medical history that automatically poplulate their fields. You may be interested in Instant Medical History though ($50/mo)- it can be set up to take any type of branching history that you want and imports into many EMRs I believe- definitely imports into Amazing Charts.When I first started in 2004, I created a relatively simple system for my own medical record using WordPerfect merge functions. You can do the same with Word but WP was much more elegant to use. Essentially, I set up my history intake form and completed that with the patient in the room- that info then was used to populate the medical history part of each note. It worked well.Now, I have patients fill out a medical history form I created at

jotform.com (free or $45 per year) which has some simple branching logic. That data can be printed to pdf and imported to any EMR or downloaded as a spreadsheet. When you download as a spreadsheet it can then be used to populate fields of a WORD or WP or Open Office form you have created. Once you have the form created, it takes just seconds to download your new patient data and populate your form. I use Amazing Charts and end up cutting and pasting from my Word form into AC. But that is still faster than typing it all in the old way.I find that I like the online form better than my previous paper form. Perhaps I control the content more with my drop down lists and radio buttons that use my language for past history and such. I still have plenty of free text options for them to explain all that they want and to convey their concerns. I did not think people would like the online form that much but they

actually do- many tell me they prefer it over paper. I also think that people were daunted by my 3 page med hx form in the past and online, they don't get the sense of it being "long". If you are not billing insurance and don't need the bells and whistles of an EMR, why not just keep a digital chart with Word-based notes in a folder for each patient? You can scan and import prior records to the same patient folder... just like paper, but digital. And easier to back up, easier to fax to other providers.. easier to access when out of the office.... yada yada.Carla Gibson FNPMissoula, MTTo: Sent: Sat, April 2, 2011 10:01:43 AMSubject: Re: Re: Newbie here

Thank you le for your detailed input --I am also going to have a very small integrative consultative practice, and part-time -- probably only 20 pts/week, 3 weeks out of the month. And cash only -- no insurance (prob half of my pts have no insurance anyhow), I'm opted out of medicare, etc.... I'm pretty sure this will work because it's worked in the current practice I'm employed at, and I will be able to charge less, with less overhead. I think a lot of my pts will follow me over and the lower prices will attract folks who couldn't afford us before.

I wonder if I even need EMR? My hope is that EMR would be less work and more efficient and of course less paper. I don't like the idea of having to hang onto charts for seven years (perahps I'm mistaken). I'd rather not spend so much time running between my copier/fax and charts. Then again, I get some chronically ill pts with 1-2" thick past records in tow... I'll have to spend time uploading all those records to EMR -- that could take a ton of time if it is piece by piece,,,,

I suspect I'll open my doors with a paper system, website, online pt scheduling,,, and add EMR after I settle in...Does you pt and appt portal allow pts to schedule, complete intake forms online, pre-pay with a cc or paypal? And have secure email?

Are those portals part of the Practice Fusion package? Do you do your scripts digitally? and via Practice Fusion or another vendor? WHen you say you are adding on secure email, does that mean it is not already part of the Practice Fusion package?

I'd eventually love a digital feature that would allow my new patients to fill in their intake forms (personal hx, HIPAA, health questionnaires, etc) online so that it is already integrated into the chart before I see them. At my current NON-EMR practice,,,, it itakes about 15 minutes just collecting, signing their forms when they first come in. .

Btw, nice website ~ Anne

I will come out with a big two thumbs up for Practice Fusion! !! I am switching from an expensive (15k) all the bells and whistles emr called Practice Partner.

Two main reasons and then a lot other smaller ones.1. The big emr's havelots of hidden fees....maintenance fees etc....fees to integrate with labs....fees for anything they can think of. It turned out it was over 4 k yearly just to participate.....and that was without he fees I pay to my local IT guy for office hardware issues. This way to expensive for and IMP model with 400 patients.

2. In a small office with only one doc and one staff and less than 1000 pts I find that I really do not need a lot of bells and whistles. On other thoughts.....although I am committed to using an EMR and have used one since 2000, I do not believe that EMR s make solo doc practices more efficient or save them any money. I think it is a big scam and in the end, as always, the docs pay and the patients suffer. Meanwhile insurance companies and now technology companies can profit. We will barely get our offices all set up with an emt and it will go under as a company etc....then we need a new one.....or maybe there is a security breach and we pay fines...

Ok clearly I am starting to rant!Go with Practice Fusion....ITS FREE! and it has everything you need to get started and run a small practice. The only piece I am adding on is a secure email.Peace and Blessings

DannielleDannielle Harwood, MDwww.MyStudioMD.com RE: Re: Newbie here

I thought all EMRs were above average J

The 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 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, gett!

ing 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 c!

ome 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 agree with the opinions about Practice Fusion. I started my solo family medicine clinic this week with one staff. After comparing about 10 EHR, eMD, eCW, Greenway, Amazing Charts, etc, I chose Practice Fusion because of the many good features they provide with min cost even if I want to pay to take off the ad. It's so costly to start a practice, I can't imaging spending another 15-20k on EHR. Plus lots of the those EHR make you wait 6-8 weeks for training before go live. I don't want to use paper chart for 8 weeks then switch. I find Practice Fusion provide almost the same service and work almost immediately. I will give it a try. As far as the billing, PF has partnership with KAREO. The cost is inexpensive per month. I also just signed up to use it. Wen

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, gett!

ing 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 c!

ome 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]

Hi Carla,Thanks SO much for your detailed response and ideas,,, You are more digital savvy than myself (paragraph 3 kind of lost me) but I'm sure I can learn/be tutored..... Some very good ideas.I like your model, your website -- very clear and user friendly. I will be referring back to it --

Do you know Dr. Judy V.? a FP doc?  I was in a Univ practice w/ her back in the late 80's -- I believe she was my Sup.Doc for a spell..... I believe she is still in Missoula..... I am very appreciative of everyone's responses. Fascinating little niche of medical cyber world.... I am even thinking about making that Oct 2011 DC meeting.

thanks again Carla, Anne

 

Anne,I don't know of any EMRs that currently offer online medical history that automatically poplulate their fields. You may be interested in Instant Medical History though ($50/mo)- it can be set up to take any type of branching history that you want and imports into many EMRs I believe- definitely imports into Amazing Charts.

When I first started in 2004, I created a relatively simple system for my own medical record using WordPerfect merge functions. You can do the same with Word but WP was much more elegant to use.  Essentially, I set up my history intake form and completed that with the patient in the room- that info then was used to populate the medical history part of each note.  It worked well.

Now, I have patients fill out a medical history form I created at

jotform.com (free or $45 per year) which has some simple branching logic. That data can be printed to pdf and imported to any EMR or downloaded as a spreadsheet. When you download as a spreadsheet it can then be used to populate fields of a WORD  or WP  or Open Office form you have created.  Once you have the form created, it takes just seconds to download your new patient data and populate your form.  I use Amazing Charts and end up cutting and pasting from my Word form into AC. But that is still faster than typing it all in the old way.

I find that I like the online form better than my previous paper form.  Perhaps I control the content more with my drop down lists and radio buttons that use my language for past history and such.  I still have plenty of free text options for them to explain all that they want and to convey their concerns.  I did not think people would like the online form that much but they

actually do- many tell me they prefer it over paper.  I also think that people were daunted by my 3 page med hx form in the past and online, they don't get the sense of it being " long " .  If you are not billing insurance and don't need the bells and whistles of an EMR, why not just keep a digital chart with Word-based notes in a folder for each patient? You can scan and import prior records to the same patient folder... just like paper, but digital.  And easier to back up, easier to fax to other providers.. easier to access when out of the office.... yada yada.

Carla Gibson FNPMissoula, MT

To:

Sent: Sat, April 2, 2011 10:01:43 AMSubject: Re: Re: Newbie here

 

Thank you le for your detailed input --I am also going to have a very small integrative consultative practice, and part-time -- probably only 20 pts/week, 3 weeks out of the month. And cash only -- no insurance (prob half of my pts have no insurance anyhow), I'm opted out of medicare, etc....  I'm pretty sure this will work because it's worked in the current practice I'm employed at, and I will be able to charge less, with less overhead. I think a lot of my pts will follow me over and the lower prices will attract folks who couldn't afford us before.

 I wonder if I even need EMR?   My hope is that EMR would be less work and more efficient and of course less paper.   I don't like the idea of having to hang onto charts for seven years (perahps I'm mistaken). I'd rather not spend so much time running between my copier/fax and charts.  Then again, I get some chronically ill pts with 1-2 " thick past records in tow... I'll have to spend time uploading all those records to EMR -- that could take a ton of time if it is piece by piece,,,,

I suspect I'll open my doors with a paper system, website, online pt scheduling,,, and add EMR after I settle in...Does you pt and appt portal allow pts to schedule, complete intake forms online, pre-pay with a cc or paypal? And have secure email? 

Are those portals part of the Practice Fusion package?  Do you do your scripts digitally? and via Practice Fusion or another vendor?  WHen you say you are adding on secure email, does that mean it is not already part of the Practice Fusion package?

I'd eventually  love a digital feature that would allow my new patients to fill in their intake forms (personal hx, HIPAA, health questionnaires, etc) online so that it is already integrated into the chart before I see them.  At my current NON-EMR practice,,,, it itakes about 15 minutes just collecting, signing their forms when they first come in. .

Btw, nice website ~ Anne

 

I will come out with a big two thumbs up for Practice Fusion! !! I am switching from an expensive (15k) all the bells and whistles emr called Practice Partner.

Two main reasons and then a lot other smaller ones.1. The big emr's havelots of hidden fees....maintenance fees etc....fees to integrate with labs....fees for anything they can think of. It turned out it was over 4 k yearly just to participate.....and that was without he fees I pay to my local IT guy for office hardware issues. This way to expensive for and IMP model with 400 patients.

2. In a small office with only one doc and one staff and less than 1000 pts I find that I really do not need a lot of bells and whistles.  On other thoughts.....although I am committed to using an EMR and have used one since 2000, I do not believe that EMR s make solo doc practices more efficient or save them any money. I think it is a big scam and in the end, as always,  the docs pay and the patients suffer.  Meanwhile insurance companies and now technology companies can profit.  We will barely get our offices all set up with an emt and it will go under as a company etc....then we need a new one.....or maybe there is a security breach and we pay fines...

Ok clearly I am starting to rant!Go with Practice Fusion....ITS FREE! and it has everything you need to get started and run a small practice. The only piece I am adding on is a secure email.Peace and Blessings

DannielleDannielle Harwood, MDwww.MyStudioMD.com RE: Re: Newbie here

 

I thought all EMRs were above average J

The 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 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, gett!

ing 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 c!

ome 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]

Unfortunately, that is the cost or benefit of free enterprise… From: [mailto: ] On Behalf Of Sent: Saturday, April 02, 2011 7:00 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]

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.SharonSharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax: 

www.SharonMD.com