EMR and billing software

[neuropathic]

Anyone have experience with EMR, whether it is cost-effective for a small practice (1-2 physicians). Is there a big learning curve? Which EMR companies would you recommend? What's the usual cost?

Also, are there any software or comapanies that can help to maximize billing and speed up the payment process?

Thanks.

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[JoanneMehmert]

Anyone have experience with EMR, whether it is cost-effective for a small practice (1-2 physicians). Is there a big learning curve? Which EMR companies would you recommend? What's the usual cost?

Also, are there any software or comapanies that can help to maximize billing and speed up the payment process?

Thanks.

My work revolves more around the documentation, coding billing and reimbursement. I know that electronic records are used in many practices and yes there is a learning curve. I would suggest web searches and talking to peers at pain meetings such as the ASIPP, AAPM etc.. Talk to the vendors at the meetings too. Don't buy anything until you have seen it work and talked to others that use it!!!!

 

[Aether2000]

The least expensive program is Amazing Charts at www.amazingcharts.com
It costs about $1500 for the entire program and the server hardware (Dell) can be off the shelf for under $800. The program is typing intensive but you can quickly develop templates on the fly. It also works with Dragon. We have used it for nearly 2 years now and found it to be a good scheduling program, moderately good EMR, and no integrated office billing program (Amazing Charts has their own billing company that will charge about 5-6% of collections). Our billing company (not Amazing Charts) downloads data from our computers daily electronically therefore the paper transfers are minimal. For the price we are happy with the program considering the next least expensive system is over $9,000 and the majority are between $20,000 and $30,000 for a small office.
I would strongly suggest using a EMR, especially if you are just starting your database as it will save you innumerable headaches and time.
Our transcription costs are zero which saves approximately $15,000 per year.
Other good systems for pain management include EClinical, EMD, Chartnotes, etc. but they are pricey. If you can integrate billing with the EMR database from the beginning, it is a good idea.

 

[paz5559]

The least expensive program is Amazing Charts at www.amazingcharts.com
It costs about $1500 for the entire program and the server hardware (Dell) can be off the shelf for under $800. The program is typing intensive but you can quickly develop templates on the fly. It also works with Dragon. We have used it for nearly 2 years now and found it to be a good scheduling program, moderately good EMR, and no integrated office billing program (Amazing Charts has their own billing company that will charge about 5-6% of collections). Our billing company (not Amazing Charts) downloads data from our computers daily electronically therefore the paper transfers are minimal. For the price we are happy with the program considering the next least expensive system is over $9,000 and the majority are between $20,000 and $30,000 for a small office.
I would strongly suggest using a EMR, especially if you are just starting your database as it will save you innumerable headaches and time.
Our transcription costs are zero which saves approximately $15,000 per year.
Other good systems for pain management include EClinical, EMD, Chartnotes, etc. but they are pricey. If you can integrate billing with the EMR database from the beginning, it is a good idea.

Having seen a few of these products at meetings, my impression has always been that none of the programs are perfect, and each has its own strengths and weaknesses. Given that the field of EMR is still in its infancy, it has always been good policy to not buy version 1.0 of any product, nor to be an early adoptor, but rather, let someone else go through the headaches and workout most of the bugs, and then buy version 2.0 when the first generational upgrade (ie, not version 1.1, likely a mere incremental upgrade) is released.

By way of alternate analogy, EMR is at the stage now where there are too many competeing choices, meaning none of them has a clear competative advantage (the appropriate analogy here would have been NSAID's 10 years ago, when they had 17 different flavors, none of which were dramatically better than any other). I am waiting for the Cox-2 euivalent, which, while it will still not be perfect, will be significantly better than its precursors, and which will have forseeable problems I can potentially manage from the getgo.

 

[member]

Hey Algosdoc and everyone using EMR,

I like the concept of EMR and using Dragon voice recognition software. But what do you do if the primary referrals and mri/ct scan report are in paper. Do you scan them and incorporate them. if so what do you do with your pot patient questionnnaires and exam documentation. How much will you have to invest in data storage for 1000 patients

 

[Aether2000]

We have an 80 gig storage drive which is quite small by todays standards. Our database is used as a recurring entry system that is very hungry for storage space. We have about 2,000 active patients and each entry using amazing charts does not write over the last...which means the database becomes huge (our choice to use it that way, not the preferred way amazing charts suggests). Currently after 2 years of data with monthly visits on each of these 2000 patients has created a database requiring 160Mb which is only a small fraction of the total storage space available.
New patient consults/MRI results can be scanned in as files and embedded into the patient chart.
I am not thrilled with everything about amazingcharts, but given the price that is 1/10 that of the nearest competitor and 1/20 to 1/40 of many of the competitors, it is a no-brainer for a new practice.

 

[member]

New patient consults/MRI results can be scanned in as files and embedded into the patient chart.
I am not thrilled with everything about amazingcharts, but given the price that is 1/10 that of the nearest competitor and 1/20 to 1/40 of many of the competitors, it is a no-brainer for a new practice.

Thank you for your prompt reply as always algosdoc. I had a couple questions. Does amazing charts have a customized pain questionnaire template which you could further customize or do you have to use their generic template. Do you ask patients to fill out questionnaire on paper or do they enter data into a computer . what do you do when you examine a pt. do you fill out on a paper template, the exam and findings and then dictate into amazing charts? is amazing charts good to document medical decision making. what do you do if you do inpatient consults in hospitals.( we do about 1 a week). what are its drawbacks briefly
Thanks again.

 

[Aether2000]

Currently we have patients fill out a questionnaire on the first visit and a different one for the followup visits. We are in the process of computerizing the latter with a light pen to be used on a CRT display in our lobby. Currently we use their written responses and input these manually into our system either by keyboard or voice. The templates are our own and we devised these on the fly which amazing charts permits.
The biggest drawbacks in our practice to this system are: 1. cannot customize the prescription printing capability which is therefore useless for scheduled scripts 2. basic format of a followup visit is the same as the initial H and P rather than a SOAP note or other standard followup format. This is cumbersome and requires either stacking notes on top of one another in the history section as we do, or flipping back and forth between the past visit history and the present (no dual note displays are available). It also has no discrete purchasable billing system...the amazing chart owner has his own billing system that he says he will link directly to amazing charts for 4-6% of collections (we have never tried this).

 

[member]

It also has no discrete purchasable billing system...the amazing chart owner has his own billing system that he says he will link directly to amazing charts for 4-6% of collections (we have never tried this).

Thanks for the info algosdoc. I appreciate it.

 

[paz5559]

Don't forget the VA plans on offering VISTA for free in the not too distant future

 

[PainPhysicians]

We are creating a simple online EMR at painphysicians.org

Individual members are submitting their input so that we can come up with a easy to use system that all can benefit from. Some of the modules are up and running. We invite your input too!

 

[Aether2000]

The second least expensive EMR is found below and there is an on-line demonstration. I especially like the no pressure sales tactics of this company that is unlike almost all other EMR. The others have a high pressure salesman contact you and require spending 1-2 hours on line while he talks you through his demonstration, only to find he only knows about part of the system. In such cases, these high pressure companies want you to spend another hour during an on-line demonstration with yet another person from their company to discuss the other features of the program. The system link below costs $2500 for the software for unlimited users, is Dragon friendly, and has an integrated scheduler.
http://www.edrawer.com/emr/flash/the_chart_viewlet_swf.html

 

[ms123]

If you are looking for a good EMR Software then one can check out EMR Software Solutions by
Cygnet Infotech. This software has different modules and depending on requirements can customize the software.