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Best EMR options for pain management?

Discussion in 'Pain Medicine' started by wscott, Feb 19, 2007.

  1. wscott

    wscott Junior Member
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    Please comment on which electronic medical records system your using, have used, or are considering to implement in your practice.

    I saw a really cool sysem at the AAPM&R meeting in Hawaii that was set up like a doctors chart on a electronic notebook. Most of the information could be entered in by drop down menu using a touch screen. You could also enter information by writing on the notebook with your usual handwriting and it converted it to text. Another cool feature was that it automatically calculated the correct E&M code based on the data entered in the note. Prescriptions could be automatically sent via email or fax to the patients pharmacy.

    The thing is, I can't remember the name of the darn company?!?

    It would be great to have a system were the patient can fill out their history in the waiting room by clicking on a notebook with a series of questions and drop down menues. This would allow you to spend more time with the physical exam and decision making.

    Anyone know of some goood systems I should look into?
     
  2. Doctodd

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    i heard good things about eclinical or something like that. Sorry cant help more.

    T
     
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  3. OP
    OP
    wscott

    wscott Junior Member
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    The name if the EMR I was describing above is Catalis.
    Anyone hear of it?
     
  4. ParaVert

    ParaVert Interventional Pain
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    Saw these guys at AAPM. Totally proprietary software, very shakey interaction with other programs. This system requires a big, expensive server. Ballpark estimate for a new solo pain practitioner to get started was >$25,000.

    On the plus side, the company has contracted with a fairly good private pain group in Dallas, TX to write Pain Management templates. This will make them the only EMR with a significantly comprehensive package for a pain practice. Too bad the thing may cost you more than your RF generator, or even your car!
     
  5. C Fiber

    C Fiber Member
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    I am trying out QD Clinical. It's not expensive, but the scheduling program is not as user friendly as I would like it to be. Also the font is small. The EMR portion is pretty nice. But programming your own templates will take some experience. The support is not too bad, if you keep in mind that the CEO is the programmer, receptionist, technical support, and is on-call 24/7. You can't beat the price though.....
     
  6. sunfish

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    I saw Catalis too- very cool. Server not that expensive I think abiut $2,000 to $ 3000. Their web site www.thecatalis.com.
     
  7. algosdoc

    algosdoc algosdoc
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    One must decide what the needs of the clinic, physician, and billers are prior to implementing an EMR. The input method is the most important make or break feature for physicians.

    Input methods: Dragon voice recognition, typing, handwriting recognition, handwriting conversion to an image, templating with dropdowns or by fixed templates, computer intuitive methods such as Praxis. If there is one doc, then the choice may be made up front. If there are several docs, then multiple entry methods are necessary.

    Practice management software: One of the most important features is a scheduling program. The integration of a scheduler is far more desirable than a stand-alone scheduler due to demographic duplication and the need to flip constantly between screens. The best systems have a easy to use but powerful scheduling program.

    Interoffice communication: All the best EMRs have some sort of quick (not cumbersome) method to fire off notes or memos to others in the office or to attach notes/warnings to patient charts

    EMR format: Some EMRs look like spreadsheet programs where as others look like a doctors chart. Many are customizable but some are too customizable to the point this becomes quite taxing. The least flexible programs have a single window for all notes and no soap notes.

    more later
     
  8. Doctodd

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    advantagesoftware.com

    any info?.....i know it says for chiros and podiatry, but can be used for M.D.'s. Free demo for anyone interested....the demo seemed pretty good but i dont know what to look for cuz have never used a product like this.

    T
     
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  9. C Fiber

    C Fiber Member
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    Has anyone heard of E Clinical Works? And eMD?
    BTW,
    Here is an article from Medical Economics on EMR

    http://www.eclinicalworks.com/ecw_website_articles/MedicalEconomics091506.pdf

    E Clinical Works is kind expensive though. $10,000 for 1st provider, $5,000 for 2nd. Training fee of $750 per day of onsite training for 1 week of implementation.

    eMD comes in 2nd place - I have seen this system in action in a 2 FP's practice. They have had it for 2 years without major problems. Everything is paperless!!! It's great! I wonder how well it works for pain management though?
     
  10. drrinoo

    drrinoo Rinoo Shah, MD
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    Anyone have experience with mtbc.com?
    http://www.mtbc.com

    they offer a free emr and 4% billing and 4cents/line dictation
     
  11. jdarren1024

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  12. algosdoc

    algosdoc algosdoc
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    Medisys is an excellent program with pain templates and many extra features such as optional automatic telephone patient appoint reminder. It is easy to use and only modestly expensive compared to most. Overall it is less expensive than eCW or eMD. The downside is the accents of the people working at the California based company are so strong no one in my company, including me, could understand them and we had problems getting them to install the software.
    eMDs and eCW are both decent programs but the eMD requires 2 servers...a bit expensive.
    We continue for now with Amazing Charts partially due to inability to dump the data into a usable format to transfer to other EMRs. The database size is now so large, when dumped to Excel, no Excel program will open it.
    They have made many upgrades but it is typing intensive since the templates are not nested and there are no word choice options within the templates. Dragon does not work on AC due to a glitch in the program that causes the tab to fly over to the weight/height section anytime the word "in" is dictated (program thinks you want to input inches).
    I would strongly caution against using any program that has not been in business more than 6-10 years. An example on another forum was that 17 programs were evaluated in 1987 and 14 of those companies are out of business. When companies go out of business, you are left with a functional program, but is not upgradable as the operating systems change (may work on Windows 2000 but not on XP or Vista, and it is next to impossible to find Windows 2000 operating systems now).
     
  13. Mister Mxyzptlk

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    Not if you have the disk! I love w2k. it is basically xp but without the "phone home" tattletale.
     
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  14. olafa

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    any good EMR reccs for the apple counter part-
     
  15. Mister Mxyzptlk

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    This is the second time this guy has spammed the forum for this software.
     
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  16. powermd

    Physician Lifetime Donor Verified Account 15+ Year Member

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    Does anyone know how templating works in eclinicalworks? I'm pretty sure the practice I'm signing with uses it, and I'm curious how I might integrate my Epic templates from fellowship.

    Epic uses these "smart phrases" that allow you to nest a template anywhere just by typing ".<whateveryoucallit>". The templates themselves have wildcards you can easily tab through to individualize and complete your note, as well as drop down boxes for lists like ROS, etc. It's an efficient and robust system, although the learning curve is steep.
     
  17. PMR 4 MSK

    PMR 4 MSK Large Member
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    You set up your template, give it a name, and then click on a template button, select it and it puts in your phrases or similar. It's pretty simple.
     
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  18. ampaphb

    ampaphb Interventional Spine
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  19. algosdoc

    algosdoc algosdoc
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    Walmart must be desperate. ECW is not being discounted by Walmart: that is their usual price.... It appears their assertion that walmart distribution will result in lower prices is simply a sales pitch. Not everything at Walmart is less expensive.....
     
  20. 2win

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    Thanks algos - I started to use practicefusion, you posted a while ago and it is really good. I compared it with the comercial ones and I found it if not better at least comparable. It is worth to take a look.
     
  21. PainDr

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    I'd like input from anyone regarding pain EMRs. I've looked at AllScripts, Greenway and PrognoCIS. PrognoCIS was the most intuitive, had the most comprehensive templets and seemed to be the most flexible. It was also the cheapest...by far...$2500 vs $10,000 for the other two. The downside is that its a newer, smaller company. Any thoughts?
     
  22. Mister Mxyzptlk

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    November 16, 2009
    Little Benefit Seen, So Far, in Electronic Patient Records
    By STEVE LOHR

    The nation is set to begin an ambitious program, backed by $19 billion in government incentives, to accelerate the adoption of computerized patient records in doctors’ offices and hospitals, replacing ink and paper. There is wide agreement that the conversion will bring better care and lower costs, saving the American health care system up to $100 billion a year by some estimates.

    But a new study comparing 3,000 hospitals at various stages in the adoption of computerized health records has found little difference in the cost and quality of care.

    “The way electronic medical records are used now has not yet had a real impact on the quality or cost of health care,” said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health, who led the research project.

    The research is to be presented on Monday at a conference in Boston. It is a follow-on study to a survey of hospitals’ adoption of electronic health records, published this year and financed by the federal government and the Robert Wood Johnson Foundation.

    Dr. Karen Bell, a former senior official in the Department of Health and Human Services and an expert in health technology, said she was not surprised by the research. “Very few hospitals today are effectively using the capabilities of electronic health records,” she observed.

    “There will be no clear answers on the overall payoff from the wider use of electronic health records until we get further along, five years or more,” said Dr. Bell, senior vice president for health information technology services at Masspro, a nonprofit group. “But that doesn’t mean we shouldn’t go forward.”

    The study is an unusual effort to measure the impact of electronic health records nationally. Most of the evidence for gains from the technology, Dr. Jha said, has come from looking at an elite group of large, high-performing health providers that have spent years adapting their practices to the technology. The group usually includes Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic and Intermountain Healthcare, among others.

    But the new study, led by Dr. Jha and Catherine M. DesRoches of Massachusetts General Hospital, suggests that these exceptions mostly point to the long-term potential of electronic health records, properly used.

    The research also underlines the challenge facing the Obama administration as it seeks to accelerate the adoption of electronic health records through 2015, even though only about 20 percent of physicians now use them. And the research shows that installing the technology does not necessarily mean that the hoped-for gains in quality and cost containment will follow quickly.

    Under the administration’s plan, doctors and hospitals will receive incentive payments for “meaningful use” of “certified” records. The standards will not be complete until the end of the year, but they will include requirements for reporting, data-sharing, alerts and decision-support features that get more stringent year by year.

    The new study placed hospitals into three groups: those with full-featured electronic health records, those with more basic ones, and those without computerized records. It then looked at their performance on federally approved quality measures in the care of conditions like congestive heart failure and pneumonia, and in surgical infection prevention.

    In the heart failure category, for example, the hospitals with advanced electronic records met best-practice standards 87.8 percent of the time; those with basic computer records, 86.7 percent; and those without, 85.9 percent. The differences in other categories were similarly slender.

    Reducing the length of hospital stays, according to many experts, should be a big money-saving payoff from electronic health records — as better care aided by technology translates into less time spent in hospitals. For hospitals with full-featured digital records, the average length of stay was 5.5 days; for those with basic computer records, 5.7 days; and those without, 5.7 days.

    The differences, Dr. Jha said, were “really, really marginal.”

    To Dr. Bell, the results of the study suggest that government policies should focus on helping physicians, hospitals and the public health system use the technology more effectively.

    “It’s not going to be easy or quick,” Dr. Bell said, “but the better information at the point of care, the better health care we will have.”
     
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  23. lonelobo

    lonelobo PAIN DOC
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    Started new practice 2 months ago(well took over exisitng) with probably
    500-700 charts. Considering buying practice partner(EMR) as it is compatible
    with currently billing system(PPM)
    For anyone that has converted from paper to EMR, just a few questions.

    How and what exactly did you transfer from paper chart to EMR?
    Did you just start new and keep existing paper charts?

    What kind of time it took to for whole process? Weeks? months?
    Are most using templates? typing? Dragon voice recognition?

    would appreciate any input
     
  24. lobelsteve

    lobelsteve SDN Lifetime Donor
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    I'm using Misys. Just bought by Allscripts. Full featured. The group has 8 different specialties working on the same EMR. Even the radiology reports come off of Merge eFilm and import directly into the EMR. Films do not yet auto-import. Labs do and there is a nice flowsheet for tracking, similar to Powerchart.

    I have a custom template and fortunately, one of the MA's at work is spearheading building all the templates. He gets your basic notes, builds a template, then asks for revisions until it is perfect. I am going live with it this week or next for all charts. A few more weeks and all of my procedure templates will be imported and I will be weaned off of dictation and paper. It will be nice, because I can log in from my iPhone. It is a much improved Misys EMR from 3 years ago.
     
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  25. axm397

    axm397 SDN Moderator
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    we have the old miSYS - our group is looking into upgrading to the new misys/allscripts vs finding another EMR. we'll see.. the old misys is not that great - the templated text is not editable. My volume is relatively low right now so it's ok but once it gets busy (which it hopefully will) - i definitely need something better.
     
  26. lobelsteve

    lobelsteve SDN Lifetime Donor
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    The new Misys is much improved. All text is editable. You can insert into templated text and delete out whatever you want. Makes having the normal template self-populate feature useful. Now it can all be there, then I delete/change the one or two findings and I'm done. I have the nurse and MA do the data entry from my patient questionnaire page and the entire note except for the PE, A/P are done. I can then just tell the MA/nurse what to change on the exam, what Dx codes to click on, and what plan -Rx, imaging, PT, procedure, modality, referral- I head to the next room, the nurse walks in the Rx's and referrals for sig. DONE. Saves 5 min per encounter.
     
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  27. axm397

    axm397 SDN Moderator
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    r u using allscripts pro or enterprise??
     
  28. mid|ine

    mid|ine Interventional Spine
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    Stay FAR away from MicroMD. I have not heard anyone here mention it, but my hospital is slowly rolling this out. Its awful. We are not very far down this road yet, and since mine is the second practice in the hospital employed physicians groups with it I hope we can scrap it.
     
    #28 mid|ine, Nov 24, 2009
    Last edited: Jul 7, 2010
  29. powermd

    Physician Lifetime Donor Verified Account 15+ Year Member

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    My practice has MicroMD. If you don't have it yet, I would avoid it. It's still very much a work in progress. We're working with the company to add features to work out the kinks and improve workflow. But for what this EMR costs, you shouldn't have to do that. It still has problems with little things like text formatting... very lame.

    I miss Epic. It's a monster, but once you learn how to use it, it does everything fairly well. Expen$ive though.
     
  30. mid|ine

    mid|ine Interventional Spine
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    Unfortunately we already have it. Though we are having a high level meeting and if major changes are not made we may well have the opportunity to dump it. I sent you a PM. Would like to discuss with you how you are making it work.
     
  31. paindoc2

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    How much does misys cost? I cannot believe the cost of these programs! The companies seem to pop up, sell their product for outlandish prices and then disappear just as quickly. I'm tempted to just make my own templates in MS Word and have a folder for each patient, backed up on one or two external HDs. Maybe keep paper charts for one week or so to make sure all backup is done. As a start-up, I can't justify 25K or more to store data and "maintain" it.
     
  32. PainDr

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    Well, I've had PrognoCIS for about two weeks. I'm still trying to learn the system. It's more complicated than expected, but very comprehensive, intuitive and flexible. The customer service has been really good...so far. I was pretty apprehensive about getting it because it's a no name company and was sooooo cheap...$2500! But I think it's going to work pretty well. We'll see...
     
  33. portcitypain

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    Just had a demo of AllMeds and then posted on sermo.com to ask questions. Had a very NEGATIVE response from an opthalmalogist (?sp) So far no responses from pain docs. How about WritePad? I have a colleague here in NC who seems to like it.
     
  34. powermd

    Physician Lifetime Donor Verified Account 15+ Year Member

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    Any updates on PrognoCIS or Allmeds?
     
  35. lobelsteve

    lobelsteve SDN Lifetime Donor
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    Misys is going away, but we get free upgrade to Allscripts, which I am told by in house folks is way better. Believe it when I see it, but Misys does suck.
     
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  36. yms01

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    Hi there. Any info from about writepad EMR for pain practices / any new economical EMR's that the gurus think is worth implementing. Will be starting a new practice so need to evaluate now. Thanks much
     
  37. C Fiber

    C Fiber Member
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    Try Springcharts. It links with Medisoft billing software. Not perfect, but very inexpensive. Very easy to use. No mandatory upgrades every year, which helps with your annual budget. We have 10 user license and a small server. We have been fairly happy with it for the last 4 years.
     
  38. traxtar511

    traxtar511 Junior Member
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    My good friend and I (both just started residency) recently set up a high volume interventional pain clinic with some lightweight custom workflow software and a free web-based EMR called practicefusion. Ive been following them for a couple of years. We found the right client for this product and its worked out great.

    The key is to not try to do too much with it and remember your clinic's workflow. We filled in the gaps with custom software, so that it was very close to ideal for the clinic's workflow. PracticeFusion is much better than most of the costly EMRs that we have tried out. All of the data is stored with the company, so it leaves very little maintenance for a small clinic. If anyone wants any info I would be happy to offer some advice.
     
  39. algosdoc

    algosdoc algosdoc
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    The main problem with web based programs (ASPs) is that if the internet crashes at any point (your computer, your in house wireless, your server, the hospital server, the internet itself, the ASP server), then your EMR is useless. My recommendation is that unless your internet never goes down, to avoid ASPs and use an EMR program and database that is resident on a server in your office, with automated off-site database backup.
     
  40. Ligament

    Ligament Interventional Pain Management
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    How is it you are running a pain clinic as residents?
     
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  41. traxtar511

    traxtar511 Junior Member
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    I was unclear, we organized the IT infrastructure for an existing pain clinic and their new location. We do not actually practice medicine independently. We both had previous experience with workflow and systems consulting, so it was a good opportunity for people interested in pain.

    I agree that service disruptions are an issue, however many dedicated business lines rarely have downtime. Especially compared to the downtime issues with hosting and managing local systems. We felt the benefits outweighed the potential negatives. The value of simplicity in a busy setting can't be overstated.
     
  42. yms01

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    Thanks for all the valuable suggestions. I just downloaded a demo of Springcharts - seems very nice and per C Fiber should work for pain practice. I would still need a billing company that interfaced with the system although with HL-7 bridge it should be doable. I also tried the Practicefusion but their billing partner charges 6.5% and i would need someone facile with software issues to help with setting it up for pain-based practice. Meanwhile as per a suggestion i saw on an earlier post, i am investigating MTBC.com. For $1000 sign-up with flat 5% billing plan, they provide free good EMR and practice management along with many value-added features -- free interactive practice website, free automated patient appointment calls, real time insurance eligibility etc. The concern is that they require you to have transcription service with them (even if you use Dragon etc) which you pay 4c per line. Am waiting to speak to any pain docs that are using MTBC. The company rep promised to e-mail the references. Will update.

    Meanwhile, any leads on economically priced leases for c-arms, tables , RF machines etc.

    Haven't started yet and already sweating with tension about this venture -- whoo!!
     
  43. yms01

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    Also, has anyone used / seen this product - WRITEPAD emr. saw their ad in Pain Physician.
     
  44. hyperalgesia

    hyperalgesia member
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    How much is Springcharts? MTBC.com sounds great except for the transcription service, that is really annoying.

    As for the c-arm, there's a company in Orlando, FL that has a very good rep and that I have dealt with: Amber Diagnostics. They are older machines but are warranted and reasonably priced.
     
  45. carolinapain

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  46. yms01

    2+ Year Member

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    Thanks guys. Meditab has a painsuiteMD (i think) that seems very specific to pain. I have submitted a request for the demo. Hope its not too expensive. Compared to practicefusion and mtbc, streamlineMD is expensive. Let us see.
    BTW thanks hyperalgesia for the amber diagnostics lead. will check them out.
     
  47. yms01

    2+ Year Member

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    Springcharts is also reasonable compared to some but more than mtbc and practicefusion.
    Can't remember, i think maybe $4000 or something like that. You may have to go to the site to confirm that.
     
  48. algosdoc

    algosdoc algosdoc
    10+ Year Member

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    After we paid for Meditab, they missed several appointments to install it on our server (on-line) and were unreachable at the contact telephone. Furthermore, their sales department speaks American English while their tech support/installation speaks an incomprehensible dialect of Indian English. We got our money back and bailed on them...
    It is actually a very nice system....
     
  49. Ligament

    Ligament Interventional Pain Management
    Physician Lifetime Donor Verified Account 10+ Year Member

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    Algos what system are you currently recommending, and also I believe you are doing a lecture on this for ISIS Maui, what is the general consensus there on best EMR for pain practices? Practice fusion is currently looking good to me as it is free and web based, which I personally like.
     
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  50. dc2md

    10+ Year Member

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    What's with this $44,000 all the EMR companies keep talking about? I know it's part of some stimulus money (EMG conversion fund), but do you REALLY get $44,000 to convert to EMRs? Or do they just reimburse you up to $44,000?

    And have you guys been keeping track of EMR costs over the last few years? I'd imagine the companies would jack up their prices after this came out.
     

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