Re: Newbie here

[Guest guest]

,We pay for and use all of the updates to our software because we want to use the most current, accurate information available, particularly coding, which CMS updates on a quarterly basis. It definitely wasn't hard or overly time consuming, but our main reasons for switching were:1. Time. I spent about 8 hours per quarter running updates to the software. We could've paid someone to do it, but didn't feel it was worth it at the time. With steve now working Saturdays doing chart review, I'd rather spend those 8 hours (1 Saturday per quarter) with my kids. 2. Up-front cost of a new server. Our server was nearing the end of it's useful life. It was going to be costly to do replace it in one fell swoop, coming off of our worst year financially since 2005. We don't know if we will stay in our current space and ease of portability was also a concern. 3. Steve needed a new tablet, as his old one wouldn't hold a charge by the end of the day. iPad was the least expensive way to go, and was very easy to set up with the ASP, would've required time & $ to get it to work with our existing system. 4. The cost of in-house server vs ASP was essentially a wash over 5 years and we can access info at any time on iPad, cell phone, or Internet connection, making it very easy to work when away from home. We did have remote access before, but never on the phones and definitely more difficult to set up and maintain. 5. Backups. I don't gave to think about it any more. We were backing ip to tape before and would have to remember to change tapes and bring them home. Hard? No. But not as easy as now. Our database has over 2000 patient charts (some that were from a part time provider who is no longer in our suite, but many unactive charts, as we live in an area with high turnover due to corporate relocations). 6. We did not change our program, only where the data is stored and who maintains the server. E-MDs is not going anywhere soon. The ASP has been in business for 10 years. Doubt they are going anywhere soon, either, but our contract stipulates that our data is OURS and we would be able to put it back in house as quickly as we sent it out, on the same program that we have always used. I still get the disks from e-MDs and would be able to get a new server and pull down my data at any time. We did our homework. We didn't go with an ASP when we opened for some of the reasons you worry about. But we have little to no concern in the near future for the safety of our data or our patient information. And while starting from "scratch" in case of major failure would be the worst possible scenario, it is possible to do so. 7. Yes, we have a disaster plan. My brother (in IT and responsible for data migrations and server migration for a major airline and the first-line management person in charge of disaster helped us set it up). In earthquake-prone California, we Are actually better off with our data not stored on site. Our house is 1.5 miles from our office, so damage to both structures in case of major earthquake is definitely likely.Everyone has to make the best decision for their practice and life. And we are very happy with all of the decisions that we have made. No looking back, no regrets, and no fears (just preparedness) of what lays ahead. And we sleep just fine, thank you very much

,

Perhaps this is part of the problem with your program PF. What are the "Problems" with maitaining your database? Once AC is set up especially with the new sequel server version (and yet we are still but a Windows XP Pro P2P network, no major hardware and super software to purchase and up keep licenses or otherwise) it's almost set it and forget it except for making a few back-ups at the end of the day... a five to ten minute process at best with an IMP sized database....

Clearly there is a whole lot more to an EMR than simply price no less ease of learning it, using it, living with it, maintaining it and being able to teach any new user how to use it too.... At such a reasonable buy in price and update and support price, ease of using it, learning it, teaching it and backing it up every night, and.

KEY POINT here.... being able to Keep the program that your data was first created in otherwise it is a useless set of one's and zero's. Would any of you create hundreds of documents in Word or PDF format if you felt that there was a possibility that in 5 or 10 years from now you might not be able to open them up even no less modify them or update them, use them in any meaningful fashion??? Of course you wouldn't. And yet with all these vendors still fighting for final market share no less their very corporate survival and lives it seems to me that doctors are following them almost like lemmings over the cliff with them with those that are in an ASP model.

Ask yourself this: If the ASP based EMR company you sign on with should suddenly close up shop and no longer provide access to the PROGRAM, not your Data but the actual Program, the prioritary Program that your data was collated and created in... What the Heck are you going to do on the day after they close up shop??? Try to log onto a Dead Server that isn't there anymore??? Honestly what will you do??? And who gives a darn if they give some top quality copy of your data.. It is basically USELESS without the darn program it was originally created in... Oh they'll promise you the moon right now during your honeymoon phase, but just wait if and until you chose to leave them or they go under... And all those promises of interoperability have all been proven to be bogus right now and they haven't seemed to be able to be fufilled in the seven years we have been in business so far... Got 10 or 20 thousand dollar to pay some 3rd party

vendor who makes no promises as to how much the can or can not gain you access to above and beyond your basic demographics.... Go to the AC user board where we tore this one apart years ago. There is no guarentees of anything in this world beyond what you can make sure you can provide for yourself. With good Friends like Bert and clean copies of my last working version of AC and licenses and copies of my present operating system I know all of my access to my patients real files and all their data in a completely useable format is fully protected. Because I can do it myself with the modest things I have right now at my very own finger tips.... Can any ASP only customer ever say the same thing??? No they can not.

I know if AC was suddenly swallowed up by any number of corporate blackholes of destruction, I still own and have copies, back-ups with install files to re-install them even on my very own machines even if my harddrives fail... I know what I will do the day after AC closes up, simply log on to my main machine and any of our connected peers and keep right on trucking while considering my mid-term and long-term options, which might include to simply keep on going on with good old reliable AC regardless of whether or not the parent company still out there or not.... I still own copies of the program itself and that is all that matters as my first line disaster plan..... so all of you ASP users out there no less those of you seriously considering being the next in line: What is your first and best disaster plan??? I know know what mine is..... And I can tell you right now, that I can sleep soundly at night with

mine..... Can you????

To: " " < >Sent: Mon, April 4, 2011 7:37:07 PMSubject: Re: Re: Newbie here

Economic and time. Had nothing to do with certification. We simply didn't want to maintain a database any more.

But I was wondering why switched from the local server model to the ASP model now…..economic reasons or certification reasons or both……

From: [mailto: ] On Behalf Of BleiweissSent: Monday, April 04, 2011 10:55 AMTo: Subject: Re: Re: Newbie here

,

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.

[Guest guest]

One, E-MD's seems to be the exception and not the norm for ASP which for you is great. Having access and license to a useable copy of the original program as we BOTH agree is KEY... 9 out of 10 ASP are ASP only. This is only the second one I have heard of doing this proper and as I see it Ethical thing of providing working copies of the program to ASP customers. Years ago I was looking at Altapoint only for PM module and although they personally didn't host, they had a couple of approved vendor third parties that did, and they "Insisted" upon all ASP hosted customers in purchasing at least one working license of the program so they could always have legitimate access to their own data. I found that requirement very refreshing, honest and ethical. So Yes BULLY for you and your choice. And yes in a

disaster prone place true offsight far away back-up is a very sound idea. But even server at the office AC can offer you that too, so ASP not always needed. But again I agree with your basic plan for you and yes you have done your homework... We on the other hand do the mirror RAID 1 on the main machine, and create two back-ups to those modest sized USB drives every night, one stays on site in the office fire and water resistant safe while the other comes home with us every night. And obviously along with the kids my laptop and the drive in that bag are the first things grabbed on the way out the door to run away if we face disaster one day...

It is just my experience that most average doc like customers don't think this way and simply go with the ASP promises which is why they are choosing ASP in the first place, to dump all of those problems back on the vendor who they pay to do it all for them, they just log on and go... Most people the research has consistantly proven don't really think about disaster planning or switching vendors if and until they are just about in the midst of a reason to need to do such. That is when they suddenly realize, OH NO, I'm really caught between a rock and hard place here, now aren't I??? These were studies done a while ago so I can not give you names and publications as much as I really wish I could. The uninformed or cavaler attitude that so many people approach data and program availability to be able to practically access their own data just astounds me sometime... Good for you for being one of the better aware and informed who acted upon what you

were concerned about and aware about in the first place....

But seeing that we have a lot of new faces around here who are only now really starting to wrestle with these kind of choices I felt it was important to challenge the basic myths associated with the ASP Only model. Is sounds great if and until you want or need to leave or the company crashes and burns.... as so many have done before any of them.... and we all know it will happen again and again to many others. I never expected Gateway who was so strong in the first few years of the 2000's to be crashing and screwing their "Business Class" customers who we all paid extra for more and better products and access to the belly of the company and their support, but that is exactly what they did. Their brick and mortor stores like the one I purchased my mom's laptop and our first tower at that I loved having the flexibility of a mail order vendor with a brick and mortor place to go and touch and feel and mess around on the machines is exactly what was one

of their first and largest mistakes... Go Know... Companies come and go all the time when you least expect many times no less.... But good for you for really doing some good forethought and planning a few steps out... Own a copy of the actual program that I can load and use is one of my basic must have criteria and I am affraid way too many people just don't get that these days, just like the inappropriate use and sale of our personal data too....

To: " " < >Sent: Mon, April 4, 2011 11:34:22 PMSubject: Re: Re: Newbie here

,

We pay for and use all of the updates to our software because we want to use the most current, accurate information available, particularly coding, which CMS updates on a quarterly basis. It definitely wasn't hard or overly time consuming, but our main reasons for switching were:

1. Time. I spent about 8 hours per quarter running updates to the software. We could've paid someone to do it, but didn't feel it was worth it at the time. With steve now working Saturdays doing chart review, I'd rather spend those 8 hours (1 Saturday per quarter) with my kids.

2. Up-front cost of a new server. Our server was nearing the end of it's useful life. It was going to be costly to do replace it in one fell swoop, coming off of our worst year financially since 2005. We don't know if we will stay in our current space and ease of portability was also a concern. 3. Steve needed a new tablet, as his old one wouldn't hold a charge by the end of the day. iPad was the least expensive way to go, and was very easy to set up with the ASP, would've required time & $ to get it to work with our existing system.

4. The cost of in-house server vs ASP was essentially a wash over 5 years and we can access info at any time on iPad, cell phone, or Internet connection, making it very easy to work when away from home. We did have remote access before, but never on the phones and definitely more difficult to set up and maintain.

5. Backups. I don't gave to think about it any more. We were backing ip to tape before and would have to remember to change tapes and bring them home. Hard? No. But not as easy as now. Our database has over 2000 patient charts (some that were from a part time provider who is no longer in our suite, but many unactive charts, as we live in an area with high turnover due to corporate relocations).

6. We did not change our program, only where the data is stored and who maintains the server. E-MDs is not going anywhere soon. The ASP has been in business for 10 years. Doubt they are going anywhere soon, either, but our contract stipulates that our data is OURS and we would be able to put it back in house as quickly as we sent it out, on the same program that we have always used. I still get the disks from e-MDs and would be able to get a new server and pull down my data at any time. We did our homework. We didn't go with an ASP when we opened for some of the reasons you worry about. But we have little to no concern in the near future for the safety of our data or our patient information. And while starting from "scratch" in case of major failure would be the worst possible scenario, it is possible to do so.

7. Yes, we have a disaster plan. My brother (in IT and responsible for data migrations and server migration for a major airline and the first-line management person in charge of disaster helped us set it up). In earthquake-prone California, we Are actually better off with our data not stored on site. Our house is 1.5 miles from our office, so damage to both structures in case of major earthquake is definitely likely.

Everyone has to make the best decision for their practice and life. And we are very happy with all of the decisions that we have made. No looking back, no regrets, and no fears (just preparedness) of what lays ahead. And we sleep just fine, thank you very much

,

Perhaps this is part of the problem with your program PF. What are the "Problems" with maitaining your database? Once AC is set up especially with the new sequel server version (and yet we are still but a Windows XP Pro P2P network, no major hardware and super software to purchase and up keep licenses or otherwise) it's almost set it and forget it except for making a few back-ups at the end of the day... a five to ten minute process at best with an IMP sized database....

Clearly there is a whole lot more to an EMR than simply price no less ease of learning it, using it, living with it, maintaining it and being able to teach any new user how to use it too.... At such a reasonable buy in price and update and support price, ease of using it, learning it, teaching it and backing it up every night, and.

KEY POINT here.... being able to Keep the program that your data was first created in otherwise it is a useless set of one's and zero's. Would any of you create hundreds of documents in Word or PDF format if you felt that there was a possibility that in 5 or 10 years from now you might not be able to open them up even no less modify them or update them, use them in any meaningful fashion??? Of course you wouldn't. And yet with all these vendors still fighting for final market share no less their very corporate survival and lives it seems to me that doctors are following them almost like lemmings over the cliff with them with those that are in an ASP model.

Ask yourself this: If the ASP based EMR company you sign on with should suddenly close up shop and no longer provide access to the PROGRAM, not your Data but the actual Program, the prioritary Program that your data was collated and created in... What the Heck are you going to do on the day after they close up shop??? Try to log onto a Dead Server that isn't there anymore??? Honestly what will you do??? And who gives a darn if they give some top quality copy of your data.. It is basically USELESS without the darn program it was originally created in... Oh they'll promise you the moon right now during your honeymoon phase, but just wait if and until you chose to leave them or they go under... And all those promises of interoperability have all been proven to be bogus right now and they haven't seemed to be able to be fufilled in the seven years we have been in business so far... Got 10 or 20 thousand dollar to pay some 3rd party

vendor who makes no promises as to how much the can or can not gain you access to above and beyond your basic demographics.... Go to the AC user board where we tore this one apart years ago. There is no guarentees of anything in this world beyond what you can make sure you can provide for yourself. With good Friends like Bert and clean copies of my last working version of AC and licenses and copies of my present operating system I know all of my access to my patients real files and all their data in a completely useable format is fully protected. Because I can do it myself with the modest things I have right now at my very own finger tips.... Can any ASP only customer ever say the same thing??? No they can not.

I know if AC was suddenly swallowed up by any number of corporate blackholes of destruction, I still own and have copies, back-ups with install files to re-install them even on my very own machines even if my harddrives fail... I know what I will do the day after AC closes up, simply log on to my main machine and any of our connected peers and keep right on trucking while considering my mid-term and long-term options, which might include to simply keep on going on with good old reliable AC regardless of whether or not the parent company still out there or not.... I still own copies of the program itself and that is all that matters as my first line disaster plan..... so all of you ASP users out there no less those of you seriously considering being the next in line: What is your first and best disaster plan??? I know know what mine is..... And I can tell you right now, that I can sleep soundly at night with

mine..... Can you????

To: " " < >Sent: Mon, April 4, 2011 7:37:07 PMSubject: Re: Re: Newbie here

Economic and time. Had nothing to do with certification. We simply didn't want to maintain a database any more.

But I was wondering why switched from the local server model to the ASP model now…..economic reasons or certification reasons or both……

From: [mailto: ] On Behalf Of BleiweissSent: Monday, April 04, 2011 10:55 AMTo: Subject: Re: Re: Newbie here

,

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.

[Guest guest]

,  I basically took the same long term view of disaster planning you took.  While I like my vendor a lot and plan to be together till I retire, I still asked for an ODBC connection to my database so I could always view the data independently with Microsoft Access.  Having the relationship of tables in the database documented means I have options if disaster strikes.  Aside from providing disaster recovery options, the ODBC interface to Microsoft Access provides a report generation capability that has far exceeded my expectations.   Knowing how the database tables work together makes it possible to convert the data if ever needed.   There are parts of the database that would probably never shoe horn nicely into another EMR (like template data) and would need to be saved in a note as text but the essential information is pretty straightforward. Basically, I can export or generate reports on any information in my EMR independently of my EMR software with Microsoft Access.  Hope I never have to move to another EMR but if I had to, I could. Perhaps others will share their plan with us.  Any ASP users with a plan to share? Neighbors, MDHuntsville, Alabama Solo using FlexMedical EMR/Billing since 2/2009 From: [mailto: ] On Behalf Of BleiweissSent: Monday, April 04, 2011 9:57 PMTo: Subject: Re: Re: Newbie here , Perhaps this is part of the problem with your program PF. What are the " Problems " with maitaining your database? Once AC is set up especially with the new sequel server version (and yet we are still but a Windows XP Pro P2P network, no major hardware and super software to purchase and up keep licenses or otherwise) it's almost set it and forget it except for making a few back-ups at the end of the day... a five to ten minute process at best with an IMP sized database.... Clearly there is a whole lot more to an EMR than simply price no less ease of learning it, using it, living with it, maintaining it and being able to teach any new user how to use it too.... At such a reasonable buy in price and update and support price, ease of using it, learning it, teaching it and backing it up every night, and. KEY POINT here.... being able to Keep the program that your data was first created in otherwise it is a useless set of one's and zero's. Would any of you create hundreds of documents in Word or PDF format if you felt that there was a possibility that in 5 or 10 years from now you might not be able to open them up even no less modify them or update them, use them in any meaningful fashion??? Of course you wouldn't. And yet with all these vendors still fighting for final market share no less their very corporate survival and lives it seems to me that doctors are following them almost like lemmings over the cliff with them with those that are in an ASP model. Ask yourself this: If the ASP based EMR company you sign on with should suddenly close up shop and no longer provide access to the PROGRAM, not your Data but the actual Program, the prioritary Program that your data was collated and created in... What the Heck are you going to do on the day after they close up shop??? Try to log onto a Dead Server that isn't there anymore??? Honestly what will you do??? And who gives a darn if they give some top quality copy of your data.. It is basically USELESS without the darn program it was originally created in... Oh they'll promise you the moon right now during your honeymoon phase, but just wait if and until you chose to leave them or they go under... And all those promises of interoperability have all been proven to be bogus right now and they haven't seemed to be able to be fufilled in the seven years we have been in business so far... Got 10 or 20 thousand dollar to pay some 3rd party vendor who makes no promises as to how much the can or can not gain you access to above and beyond your basic demographics.... Go to the AC user board where we tore this one apart years ago. There is no guarentees of anything in this world beyond what you can make sure you can provide for yourself. With good Friends like Bert and clean copies of my last working version of AC and licenses and copies of my present operating system I know all of my access to my patients real files and all their data in a completely useable format is fully protected. Because I can do it myself with the modest things I have right now at my very own finger tips.... Can any ASP only customer ever say the same thing??? No they can not. I know if AC was suddenly swallowed up by any number of corporate blackholes of destruction, I still own and have copies, back-ups with install files to re-install them even on my very own machines even if my harddrives fail... I know what I will do the day after AC closes up, simply log on to my main machine and any of our connected peers and keep right on trucking while considering my mid-term and long-term options, which might include to simply keep on going on with good old reliable AC regardless of whether or not the parent company still out there or not.... I still own copies of the program itself and that is all that matters as my first line disaster plan..... so all of you ASP users out there no less those of you seriously considering being the next in line: What is your first and best disaster plan??? I know know what mine is..... And I can tell you right now, that I can sleep soundly at night with mine..... Can you???? To: " " < >Sent: Mon, April 4, 2011 7:37:07 PMSubject: Re: Re: Newbie here Economic and time. Had nothing to do with certification. We simply didn't want to maintain a database any more. But I was wondering why switched from the local server model to the ASP model now…..economic reasons or certification reasons or both…… From: [mailto: ] On Behalf Of BleiweissSent: Monday, April 04, 2011 10:55 AMTo: Subject: Re: Re: Newbie here , 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

[Guest guest]

Or traditional You Own the Software ones as well. This is perhaps the "Real" long term prep any practice should be thinking about "Before" they choose a program and a version, hosted off-site, hosted yourself on site, ASP 100% and so on.... In the end a baby starts it first wellcare visit with you. Even if that baby never has another visit with you after that first one, you are almost certainly by federal and almost all state laws responsible to be able to produce a viable copy of that baby's chart, notes seven years after he or she reaches the age of Majority.... That means 18+7= 25 years from today you still be to be able to product a viable option to retrieve that patient's chart, notes..... So I ask again all of you sitting on the fence getting read to purchase as well as all of you vets (yes you

too Joanne of the EMR wars, what is your long term strategy and disaster plans????

As Karl Maulden and his huge nose used to say in those American Express travelers' Checks ads;

"What will you do? What will you do???"

To: Sent: Tue, April 5, 2011 7:55:59 AMSubject: RE: Re: Newbie here

, I basically took the same long term view of disaster planning you took. While I like my vendor a lot and plan to be together till I retire, I still asked for an ODBC connection to my database so I could always view the data independently with Microsoft Access. Having the relationship of tables in the database documented means I have options if disaster strikes.

Aside from providing disaster recovery options, the ODBC interface to Microsoft Access provides a report generation capability that has far exceeded my expectations. Knowing how the database tables work together makes it possible to convert the data if ever needed. There are parts of the database that would probably never shoe horn nicely into another EMR (like template data) and would need to be saved in a note as text but the essential information is pretty straightforward.

Basically, I can export or generate reports on any information in my EMR independently of my EMR software with Microsoft Access. Hope I never have to move to another EMR but if I had to, I could.

Perhaps others will share their plan with us. Any ASP users with a plan to share?

Neighbors, MD

Huntsville, Alabama

Solo using FlexMedical EMR/Billing since 2/2009

From: [mailto: ] On Behalf Of BleiweissSent: Monday, April 04, 2011 9:57 PMTo: Subject: Re: Re: Newbie here

,

Perhaps this is part of the problem with your program PF. What are the "Problems" with maitaining your database? Once AC is set up especially with the new sequel server version (and yet we are still but a Windows XP Pro P2P network, no major hardware and super software to purchase and up keep licenses or otherwise) it's almost set it and forget it except for making a few back-ups at the end of the day... a five to ten minute process at best with an IMP sized database....

Clearly there is a whole lot more to an EMR than simply price no less ease of learning it, using it, living with it, maintaining it and being able to teach any new user how to use it too.... At such a reasonable buy in price and update and support price, ease of using it, learning it, teaching it and backing it up every night, and.

KEY POINT here.... being able to Keep the program that your data was first created in otherwise it is a useless set of one's and zero's. Would any of you create hundreds of documents in Word or PDF format if you felt that there was a possibility that in 5 or 10 years from now you might not be able to open them up even no less modify them or update them, use them in any meaningful fashion??? Of course you wouldn't. And yet with all these vendors still fighting for final market share no less their very corporate survival and lives it seems to me that doctors are following them almost like lemmings over the cliff with them with those that are in an ASP model.

Ask yourself this: If the ASP based EMR company you sign on with should suddenly close up shop and no longer provide access to the PROGRAM, not your Data but the actual Program, the prioritary Program that your data was collated and created in... What the Heck are you going to do on the day after they close up shop??? Try to log onto a Dead Server that isn't there anymore??? Honestly what will you do??? And who gives a darn if they give some top quality copy of your data.. It is basically USELESS without the darn program it was originally created in... Oh they'll promise you the moon right now during your honeymoon phase, but just wait if and until you chose to leave them or they go under... And all those promises of interoperability have all been proven to be bogus right now and they haven't seemed to be able to be fufilled in the seven years we have been in business so far... Got 10 or 20 thousand dollar to

pay some 3rd party vendor who makes no promises as to how much the can or can not gain you access to above and beyond your basic demographics.... Go to the AC user board where we tore this one apart years ago. There is no guarentees of anything in this world beyond what you can make sure you can provide for yourself. With good Friends like Bert and clean copies of my last working version of AC and licenses and copies of my present operating system I know all of my access to my patients real files and all their data in a completely useable format is fully protected. Because I can do it myself with the modest things I have right now at my very own finger tips.... Can any ASP only customer ever say the same thing??? No they can not.

I know if AC was suddenly swallowed up by any number of corporate blackholes of destruction, I still own and have copies, back-ups with install files to re-install them even on my very own machines even if my harddrives fail... I know what I will do the day after AC closes up, simply log on to my main machine and any of our connected peers and keep right on trucking while considering my mid-term and long-term options, which might include to simply keep on going on with good old reliable AC regardless of whether or not the parent company still out there or not.... I still own copies of the program itself and that is all that matters as my first line disaster plan..... so all of you ASP users out there no less those of you seriously considering being the next in line: What is your first and best disaster plan??? I know know what mine is..... And I can tell you right now, that I can sleep soundly at

night with mine..... Can you????

To: " " < >Sent: Mon, April 4, 2011 7:37:07 PMSubject: Re: Re: Newbie here

Economic and time. Had nothing to do with certification. We simply didn't want to maintain a database any more.

But I was wondering why switched from the local server model to the ASP model now…..economic reasons or certification reasons or both……

From: [mailto: ] On Behalf Of BleiweissSent: Monday, April 04, 2011 10:55 AMTo: Subject: Re: Re: Newbie here

,

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