I have a wound care-focused private practice. I've used Intellicure, and it is an impressive EMR product. It was founded by Dr. Caroline Fife MD, who is one of the prominent authority figures in the realm of wound care and hyperbaric medicine. She is also a past president of UHMS, Undersea and Hyperbaric Medical Society.

We are also looking into MacPractice. It is an Apple's Mac-based program. It's VERY comprehensive and customizable EMR and billing software. I just saw a demo in my office, and I came away very impressed. If you are sick of PC-based system and high maintenance that go with it, I recommend taking a look at it. You can even use iPhone or probably the Mac tablet (that's due out soon) to do the charting and billing. How cool is that! David Armstrong would go nuts on gadgets like that!

Just my 2 cents. KS.

 

That's the first time I've heard someone say Mac in relation to EMR. That deserves some investigation.

Shari

Re: Mac EMR

There are several of them; MacPractice being the largest and probably the most comprehensive one. The obvious advantage being you don't have to worry about the headaches associated with PCs, ie. virus and running anti-virus, incompatibility with printers and other interfaces.

MacPractice's interface is similar to using iCal, iTune or any other Mac softwares. It was pretty intuitive to me. A sales rep from Apple's business division (there is such a thing) actually came to my office and did a demo for us. 

I was a PC person until several years ago, when Dave Armstrong himself convinced me to switch to Mac. I haven't looked back since. I was using my sister's latest PC (running Vista) over the holidays, and I was amazed how slow and annoying the user experience was... and I was just trying to check my e-mail! 

The options/decisions for EMR are near endless!!!!! However, these many options can have pitfalls. Some being cost, failure to integrate with existing medical software, integrating data of all these various EMR operating systems with each other, etc. Do I use the EMR with my medical software vendor...does it comply with "meaningful use?" There is SAMMY, Traknet DPM- Biomedix, AllScripts, etc..... However, I was just advised in a letter by the hospitals where I am on staff....they are having a presentation on a community EMR system that will be able to integrate with the voluntary staff members. The meeting will take place in late February 2010. I don't know the particulars of this option, however, a large percentage of my patients are from referring physicians that are affiliated with these institutions or use these institutions for their medical care and may allow for better medical care through sharing of medical tests and physician notes. Imagine perhaps not actually having to be at the hospital to write orders, reading consult reports and notes and facilitate with other physicians regarding the care of your patients. One may want to contact their hospital affiliations if there is a community EMR system being used or in the works....just a thought.

Having been running Medinotes for the last 5 years, I can tell you that the basis of having EMR has really made a difference for the practice. The choice for EMR should wholly be practice specific, and whether or not you decide to do the following:

a)  Do I want to e-prescribe (kinda mandatory in 2011)
b)  Do I want to have my own clearinghouse/billing/ledger or outsource it?
c)  How many physicians in the practice?
d)  How easy is the system for practice reports/audits?

Due to Eclipsys buying out Medinotes, I am making the switch to SuiteMed EMO.  It will allow me to have a full fax server, automated checkin procedures, automatic eligibility and benefit checks at time of checkin and have the full ledger available at the front desk to capture $$.

The EMO also will integrate with Ameripath, Quest, Labcorb, etc for labs.  Also, I can embed all my forms and have them all digitally available, which reduces the amount of paper I have to deal with.  

Overall, the decision to go electronic isn't how, but WHEN!

Eric 

I too have been with Medi-Notes, and it has had positives for the practice but the process of generating notes has been very time consuming and my partner and I take home a lot of work to do remotely. This just is not right. If I see more than 25 people in a day, I am guaranteed to be taking home 2-3 hours of work at night. Yes, I do have templates but the response of the system, mini crashes, and shear volume of potential problems and responses makes generating notes very difficult. I have had my system and have used it since late 2006. I just need to know what to do next and how soon do I need to do it. I don't have much money to spare and to invest that when I am not certain which programs will be accepted for government assistance or even if this money even exists is a big concern.

Here's my question on the EMR issue: does anyone use voice recognition software like Dragon Naturally Speaking when dictating?  For those who have tried what was their experience?

Here are the big questions:

1. Is there some sort of promise that this stimulus money is real?

2. The vendors of these EMR products will tell me that I should buy now. How long am I really going to be able to wait to jump in? I do not want to make an expensive mistake. I do not want to make the mistake of getting a product that will slow me down or make me take home a lot of extra work.  I do not want a product that has a difficult learning curve.

3. Is there a master list of EMR products so that I can review each one and decide what is best for my practice?

4. In the worst case scenario is there some way to retrofit my MediNotes so it qualifies for whatever incenitives are out there? 

Shari, 

As  I said earlier, there were many reasons why I am switching my system from Medinotes to SuiteMed.  The basic reasoning is that I have no interest or want to convert to Peak Practice, since it has SO many flaws and bugs and they are not specialzing in any podiatric medicine-based systems.

Eclipsys, who purchased Medinotes, is focusing on primary care and not on podiatry.

Here are a few reasons why I am making the change:

a)  Medinotes will be full convertable of all data including multimedia into SuiteMed.
b)  SuiteMed was offering free conversion of the data
c)  SuiteMed was offering free provider licenses and 24 hours of free web-based training.
d)  Its a fully integratable electronic medical office with use of ENS as their clearinghouse.

You can view it at www.podiatryemo.com

They are installing a practice database on my server for training and will then be putting in the live database after the conversion.  I am looking forward to advancing my practice with this new system.

Plus, SuiteMed is guaranteeing their system will be Recovery Act compliant and will pay for the stimulus to all physicians who have purchased the system if they do not stay compliant with CCHIT program at any time.

And from my understanding, many Medinotes users are making a switch because Eclipsys wants people to convert to Peak Practice, which to my knowledge, is not podiatry friendly nor ready for full-time office use.

I know the cost incursion is tough, but sometimes its worth it financially to be at peace with your ability to have an electronic office that is easier to use.

If you want, I can private message you my sales rep at the reseller to quote your practice and speak with you directly about SuiteMed.

Eric 

That sounds interesting, worth looking into. I would like to know about how much this might cost and to talk to a sales rep about this. Please email me at sharikaminsky@hotmail.com

I feel like I need to qualify my above comments and disclaim the following:

I am not compensated by SuiteMed or Medipro.  Just pissed off about the Medinotes acquisition by Eclipsys and how poorly they have handled their "podiatry" customers and their technical support service.

Thanks for the information. I too understand the aggravation with this product. It took a long time to really get this going and it really has destroyed my free time. I just want the next product to be much better and faster.

I did not read through the whole string of comments but I wanted to add one thing that came up at a charting workshop that I was involved in at the NY conference this last week. It was mentioned that it is very important from a medical-legal standpoint to make sure that your EMR has the "None" option.

I had never even thought about that one. But if you don't have the ability to check a "None" box, and you leave a section empty because nothing is positive (say in a list of review of systems for instance) that can be considered as a part of the exam that was left uncompleted.....as though it was completely ignored.

Good point and one that I had never considered.

Kathleen,

Just to keep you updated:

I reviewed approximately 6 EMR systems before deciding to purchase SuiteMed.  All of the systems I reviewed and tried do include the "NO" or "NONE" option in the subject areas.

A couple of the programs, this may need to be added by the user, but for the most part, if a system is to be CCHIT Certified 2011 for the Medicare Recovery Act qualification, the pertinent negatives are included in the drop down lists or selections.

Eric 

Jerrod,

I've been using voice reognition for 5 years with Dragon.  It is part of a software called TexTalk.  I would find it very difficult to move to a template or database driven system.  And that is most systems.  I've looked at Traknet, Medinformatix, Sammy and a bunch of others.  They are not intuitive to me and extremely time consuming compared to TexTalk.

Marc Katz

I have used it as an Adjuct to my EHR.  It works surprising well right out of the box.  I'm not talking about the more expensive medical version either.  it does NOTwork remotely overa VPN.  that is a very important thing to know

Hi Joel,

TexTalk with Dragon does work through VPN.  There is a copy of the program(TexTalk) on your PC and you VPN into the server. You can then dictate from any location.  Dragon alone does not allow you to do this.  So that is also an advantage of the TexTalk interface.

Marc Katz