In need of an EMR for a small solo practice, need recommendations please!

[Ligament]

I've read through the forum and it seems nobody is happy with their EMR. It seems that perhaps Athena and DrChrono are tolerable but not liked. All others seem to be hated.

I'm hoping SOMEBODY on here has an EMR that they like. This is a big time investment for my practice and we want to make a wise decision.

Any advice very much appreciated.

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[Ferrismonk]

I've used several, but a caveat I was never involved in the cost part of it. Here are my notes:

SRS - Did not like. Basically a filing system with dictations
Practice Partner: Ancient interface, but compliant. I don't really care for this one.
Epic - The big guns. Good for hospitals, but bulky for private practice. Had trouble getting IT help because we were small potatoes for them, even when piggybacking on the hospital system.
Cerner - Way too many clicks
Athena - I liked this one the most. End-user friendly, intuitive for office workflow. I've heard it's expensive though.

 

[geauxg8rs]

I've used several, but a caveat I was never involved in the cost part of it. Here are my notes:

SRS - Did not like. Basically a filing system with dictations
Practice Partner: Ancient interface, but compliant. I don't really care for this one.
Epic - The big guns. Good for hospitals, but bulky for private practice. Had trouble getting IT help because we were small potatoes for them, even when piggybacking on the hospital system.
Cerner - Way too many clicks
Athena - I liked this one the most. End-user friendly, intuitive for office workflow. I've heard it's expensive though.

I like athena

 

[Ligament]

I like athena

What do u like about it and what re u paying? Did u consider others? Thanks!

 

[Sushirolls]

Look at charm. Decent price point and won't bleed you dry like others will.

 

[Laryngospasm]

Athena can do a lot of stuff that should help a small practice limit overhead like helping with billing. We used it.. it was expensive but is good and once you get used to it it flows well. Dr. Chrono sucks. Epic is for the big boys. If I recall Athena was costing around 5% of gross.. but I’m not sure.

 

[bedrock]

I've used several, but a caveat I was never involved in the cost part of it. Here are my notes:

SRS - Did not like. Basically a filing system with dictations
Practice Partner: Ancient interface, but compliant. I don't really care for this one.
Epic - The big guns. Good for hospitals, but bulky for private practice. Had trouble getting IT help because we were small potatoes for them, even when piggybacking on the hospital system.
Cerner - Way too many clicks
Athena - I liked this one the most. End-user friendly, intuitive for office workflow. I've heard it's expensive though.

I've read through the forum and it seems nobody is happy with their EMR. It seems that perhaps Athena and DrChrono are tolerable but not liked. All others seem to be hated.

I'm hoping SOMEBODY on here has an EMR that they like. This is a big time investment for my practice and we want to make a wise decision.

Any advice very much appreciated.

Dr Chrono is ok but nothing special. Used for my LA practice. I used Cerner in my first job, it used to be good a decade ago, but now it is click central. Takes forever. Athena isn't bad, but expensive. If you can get an amazing deal, it's worth considering. We've all used EPIC and its great for hospitals, terrible for small PP.

I've been using SRS in my current job the past 6 months. Actually not bad if you pair it with a good dictation service. The patients fill out a bunch of forms and then I dictate the HPI, the MSK/neuro exam, imaging, and then A/P. Our dictation service inputs all the informationn from patient forms into a letter that a doctor/patient can actually read, and then adds my dictated parts to the rest of the note. The notes look great, like they did 20 years ago before notes became useless point and click garbage, and I'm much faster in clinic than I was with Dr. Chrono. Can see 25 patients/day again. No idea how much it costs. My dictation costs are significant, but I easily can see another 4 patients/day which more than covers that expense. Good for a busy practice, not a startup.

 

[Ferrismonk]

I've been using SRS in my current job the past 6 months. Actually not bad if you pair it with a good dictation service. The patients fill out a bunch of forms and then I dictate the HPI, the MSK/neuro exam, imaging, and then A/P. Our dictation service inputs all the informationn from patient forms into a letter that a doctor/patient can actually read, and then adds my dictated parts to the rest of the note. The notes look great, like they did 20 years ago before notes became useless point and click garbage, and I'm much faster in clinic than I was with Dr. Chrono. Can see 25 patients/day again. No idea how much it costs. My dictation costs are significant, but I easily can see another 4 patients/day which more than covers that expense. Good for a busy practice, not a startup.

I hate talking. Would much rather use smartphrases.

 

[callmeanesthesia]

Has anyone ever used Praxis? It’s supposed to be a machine learning type EMR that does not do any templates. Rather, it watches you work and starts predicting your next moves and filling in the chart for you based on past behavior.

Currently we use Aprima and I can’t say I’d recommend it. We are a big client for them and support for getting several frustrating bugs eliminated has been seriously lacking.

 

[Keona]

We just transitioned to Athena. I like it but feel like they were dishonest about some of the things they told us it could do. We asked very specific questions and were assured we would have access to templates people around the country had made (incorrect, you only get access to a standard build and have to create your own from there). This is especially annoying with the Medicare wellness which should be pretty standardized across the country. They also told us telehealth is included in the cost, that was a flat out lie. It’s not. It’s in beta testing and theres an additional cost to use it after it is live. We have an in-house xray and lab and we are almost finished with month two of Athena and it still isn’t integrated!!!!!! (Something we said at very beginning we needed to have, they didn’t even start the process until we went live). They expect you to be able to figure things out for the most part yourself. When we went live we had dedicated phone blocks like 3 separate hours a day where they had someone on a call with us but no actual in person training through Athena and I think that has caused lots of issues that could have likely been sorted out very easily. (Lots of computer online training watching videos which were minimally helpful). We pay them a percentage of revenue I can’t remember how much but it’s a lot of money. It is overall much better than the previous ehr and in a year I may be very happy with it but I’m very unhappy with their transition process and how I’m having to import all the data from our old ehr manually.

 

[Sushirolls]

We just transitioned to Athena. I like it but feel like they were dishonest about some of the things they told us it could do. We asked very specific questions and were assured we would have access to templates people around the country had made (incorrect, you only get access to a standard build and have to create your own from there). This is especially annoying with the Medicare wellness which should be pretty standardized across the country. They also told us telehealth is included in the cost, that was a flat out lie. It’s not. It’s in beta testing and theres an additional cost to use it after it is live. We have an in-house xray and lab and we are almost finished with month two of Athena and it still isn’t integrated!!!!!! (Something we said at very beginning we needed to have, they didn’t even start the process until we went live). They expect you to be able to figure things out for the most part yourself. When we went live we had dedicated phone blocks like 3 separate hours a day where they had someone on a call with us but no actual in person training through Athena and I think that has caused lots of issues that could have likely been sorted out very easily. (Lots of computer online training watching videos which were minimally helpful). We pay them a percentage of revenue I can’t remember how much but it’s a lot of money. It is overall much better than the previous ehr and in a year I may be very happy with it but I’m very unhappy with their transition process and how I’m having to import all the data from our old ehr manually.

Athena takes a percentage of gross. That is ridiculous. Do not sign up for any EMR that locks you into paying a percentage of gross revenue. There are EMRs that have fixed costs. Folks can do better.

 

[Keona]

Athena takes a percentage of gross. That is ridiculous. Do not sign up for any EMR that locks you into paying a percentage of gross revenue. There are EMRs that have fixed costs. Folks can do better.

We had a fixed cost one prior to Athena and that one nickled and dimed you on things. One of the big reasons for Athena was to not have to pay more for escribing, patient portals and telehealth. Azalea was the other strong contender the partners were considering between.

 

[Pain Applicant1]

I've read through the forum and it seems nobody is happy with their EMR. It seems that perhaps Athena and DrChrono are tolerable but not liked. All others seem to be hated.

I'm hoping SOMEBODY on here has an EMR that they like. This is a big time investment for my practice and we want to make a wise decision.

Any advice very much appreciated.

Fact = All EHRs blow
If they all blow why pay more for one than another? Once you get used to any EHR, you learn ways to make it efficient. I use PF for $99/month. Spend time in the beginning and create your templates. I see a f/u every 10 min now and could probably see more if I was inclined to do so. It's able to get the job done.

 

[BobBarker]

Why are you paying for telehealth? Doximity is free, doxy.me is nearly free

 

[NJPAIN]

I just wish there was an EHR that was truly built for this specialty. Any of the ones I have looked at including my current life sentence EHR was built for another specialty (in my case ENT) and morphed into other fields. In that case its great for the original specialty but mediocre for the rest. The more pain docs on one platform the more templates, smart phrases, etc. I would love a monthly cost of $300-350. Currently $745+.

 

[Pain Applicant1]

Why are you paying for telehealth? Doximity is free, doxy.me is nearly free

I use doxy.me. It's free.

 

[Ducttape]

I do not like doxy.me. very dependent on internet connectivity and most of my patients do not have good service. they have better cell phone service so doximity works much better.

FaceTime is still the best, but both parties have to have apple products.

 

[xvaderx]

EPIC/Cerner - Hospital only

Medisoft - First EMR I used, it was "too simple"-- you needed a server in your office etc

EClinical - Currently still have this up, not "unusable" but very redundant with increased work

Modernizing Med - Just implementing this in the past week, supposed to "learn" and use the iPad. As of right now, I feel like I've made a huge mistake, we will see. . . .it was supposed to be tailored for pain and ortho. . . but looks more like it was tailored for ORTHO and pain

 

[chibadriver]

Timely thread. To the OP, what is the nature of your practice? Not sure it matters, but I am transitioning to a free standing orthobiologic clinic after being hospital-based pain service for the past 6 years. Setting all this stuff up is more than I bargained for at times.

 

[hyperalgesia]

I've used several, but a caveat I was never involved in the cost part of it. Here are my notes:

Cerner - Way too many clicks

I guess Cerner has a good sales department because the entire US DOD and Veterans Affairs is moving all care to Cerner in the next few years.

It might be better than CPRS though, which is nightmare-inducing.

 

[10KHertz]

I use prognosic:bizmatics. Works well, decent support , Indian company primarily. I’m pretty busy solo MD and it meets my needs. Several pain friends also use it , which is important...

 

[NJPAIN]

I use prognosic:bizmatics. Works well, decent support , Indian company primarily. I’m pretty busy solo MD and it meets my needs. Several pain friends also use it , which is important...

I liked PrognoCIS when I looked at it but couldn’t find anyone using it.
What DON’T you like about it?

 

[10KHertz]

I liked PrognoCIS when I looked at it but couldn’t find anyone using it.
What DON’T you like about it?

I know three pain colleagues that use it and we are content.
Their updates cause issues and glitches . Getting a progammer online takes some time. There is a time difference due to techs in India. We have mandated that my IT guy has a heads up after they log into our system for upgrades...
Cost is reasonable and it’s compatible with most billing companies.
Overall I recommend it. I do keep my data in house , so if the internet is down or there is an issue on their platform , I can still work hard...

 

[Ligament]

I know three pain colleagues that use it and we are content.
Their updates cause issues and glitches . Getting a progammer online takes some time. There is a time difference due to techs in India. We have mandated that my IT guy has a heads up after they log into our system for upgrades...
Cost is reasonable and it’s compatible with most billing companies.
Overall I recommend it. I do keep my data in house , so if the internet is down or there is an issue on their platform , I can still work hard...

Prognosis requires you to run your own server?

 

[10KHertz]

Prognosis requires you to run your own server?

You have two options , the typical cloud based data storage and internet-access vs. in-house server option. I choose the later due to keeping patient data in house , as I don’t trust EMR companies in general and possible data ransoms when you leave them ... lol.
Also by having your EMR platform in house, if you lose internet access , you can still work on your charts. Whereas a cloud based system you are handcuffed when internet is down or the cloud EMR server is down .
Both are fine , just preference .
Also add a Datto system for in house , so you can’t be hacked and ransomed by over seas threats ...datto backs up your info, even Hilliard Clinton used datto

 

[OneWord]

Elation seems popular around here.

 

[Got Em]

Fact = All EHRs blow
If they all blow why pay more for one than another? Once you get used to any EHR, you learn ways to make it efficient. I use PF for $99/month. Spend time in the beginning and create your templates. I see a f/u every 10 min now and could probably see more if I was inclined to do so. It's able to get the job done.

I was going to pick Athena, but I'm very interested in practice fusion.

Is it easy for you to eprescribe, view images, sync/schedule appointments online on your own website (Athena has this?), etc?

Who does the billing for you and how much of collections are they charging?

 

[Got Em]

For everyone that has Athena, what percentage of collections are they charging? And how does this compare to other billing companies?

I've heard Athena charges around 6-7% and billing companies usually charge 4-6%. Is this correct?

 

[Pain Applicant1]

I was going to pick Athena, but I'm very interested in practice fusion.

Is it easy for you to eprescribe, view images, sync/schedule appointments online on your own website (Athena has this?), etc?

Easy to eprescribe. I require images. I don't sync practice fusion with my website but the pt's can request appts through PF. Now that you mentioned this, I'll add the link to the scheduling

Who does the billing for you and how much of collections are they charging?

I was going to pick Athena, but I'm very interested in practice fusion.

Is it easy for you to eprescribe, view images, sync/schedule appointments online on your own website (Athena has this?), etc?

Easy to eprescribe. I request images but I think you can link up if you'd like. I don't sync my website but pt's can request appts on PF. Now that you brought it up, I'm going to link an appt request on my website to the PF site.

Who does the billing for you and how much of collections are they charging?
I do the hybrid billing with Athena so we both take care of the different tasks. I can't disclose what I'm paying but if you search around enough you could probably get a pretty good idea. Keep in mind that I contracted with them about 8 years ago.

 

[nvrsumr]

I use Harris caretracker from EMR and PM. 550/month. We do the billing in house but its all thru their program.

 

[10KHertz]

For everyone that has Athena, what percentage of collections are they charging? And how does this compare to other billing companies?

I've heard Athena charges around 6-7% and billing companies usually charge 4-6%. Is this correct?

No.
Depends on your volume. Can get close to 3% if your the bomb...
call ifedora, largest pain collection group and loosely sponsored by ASIPP.
Recommended by me and couple high volume pain guys.

 

[Sushirolls]

Remember, billing is one of the greatest sources of frustration for patients and their dissatisfaction. As a psychiatrist I had sent my billing info to a 3rd party biller. It was more expensive and a time suck for getting the bill details, and following up on the bills, and their errors. It occupied my assistant a lot of time.

By moving to an internal billing where in I submit it electronically thru my EMR to the clearing house and later get the down stream ERA reports automatically uploaded into my EMR I have saved a massive amount of time and money. I went from $600+ per month on billing not including staff time, to $70 a month and 1/2 to 1/3 the amount staff time. My assistant can now focus on quality interactions and the more problematic bills that need more sleuthing, and essentially customer service.

Caution again for all y'all thinking of choosing an EMR that is % based billing with outsourcing to 3rd party billers.

One of my top improvements was making that decision, and the only regret was not doing sooner.

 

[hyperalgesia]

Remember, billing is one of the greatest sources of frustration for patients and their dissatisfaction. As a psychiatrist I had sent my billing info to a 3rd party biller. It was more expensive and a time suck for getting the bill details, and following up on the bills, and their errors. It occupied my assistant a lot of time.

By moving to an internal billing where in I submit it electronically thru my EMR to the clearing house and later get the down stream ERA reports automatically uploaded into my EMR I have saved a massive amount of time and money. I went from $600+ per month on billing not including staff time, to $70 a month and 1/2 to 1/3 the amount staff time. My assistant can now focus on quality interactions and the more problematic bills that need more sleuthing, and essentially customer service.

Caution again for all y'all thinking of choosing an EMR that is % based billing with outsourcing to 3rd party billers.

One of my top improvements was making that decision, and the only regret was not doing sooner.

That's how I did it too. The billing situation is a nightmare and no way around that. But I think it's best to go right into battle and fight with your own troops. One less middleman.

 

[RoloTomassi]

Prognocis, Practice Fusion, Athena.

These keep coming up. Any new experiences? Ligament, chiba: what did you end up going with, happy?

 

[powermd]

My new practice is starting from scratch with Athena. It's been a bear to get set up- there's a million little details. Fortunately a rep from the company holds your hand through the process to make sure it all gets done. I'm also using DocResponse (an add on) for electronic intake, form signing, registration, etc. So far so good on that. There's a button on my website that takes patients straight to online registration where they can do an HPI/ROS, upload their insurance card/DL, sign all the forms.

I'm NOT crazy about the user interface on Athena (or any EHR, really). But I'm especially disappointed in Athena due to it's user-friendly rep. There's a lot that seems counterintuitive to me. You want to do something but it's not at all obvious what to click to get there.

I'm seeing my first patient in the new practice this week, so I'll add some comments as I use the system.

 

[Annie_P]

I think which EHR you choose, first, make out different EHR Software lists, find out which EHR's features are suitable for you, list out pros and cons, and review that EHR. After that, you can choose nest EHR for yourself.

 

[drusso]

Has anyone ever used Praxis? It’s supposed to be a machine learning type EMR that does not do any templates. Rather, it watches you work and starts predicting your next moves and filling in the chart for you based on past behavior.

Currently we use Aprima and I can’t say I’d recommend it. We are a big client for them and support for getting several frustrating bugs eliminated has been seriously lacking.

I looked at Praxis, but didn't like its work flows. I wonder if they've improved it.

 

[drusso]

I've read through the forum and it seems nobody is happy with their EMR. It seems that perhaps Athena and DrChrono are tolerable but not liked. All others seem to be hated.

I'm hoping SOMEBODY on here has an EMR that they like. This is a big time investment for my practice and we want to make a wise decision.

Any advice very much appreciated.

I've looked at this. It looks interesting.

Home

Improve efficiency and treatment outcomes with Modernizing Medicine's specialty-specific EHR systems and healthcare suites built by specialty physicians.

www.modmed.com

 

[myrandom2003]

Can get epic subsidized by a local hospital. For instance, one hospital in my area subsidizes for $300/mo
The other hospital charges $14k upfront implementation and 9k/year per physician with more physicians costing less per year.

 

[Ligament]

Prognocis, Practice Fusion, Athena.

These keep coming up. Any new experiences? Ligament, chiba: what did you end up going with, happy?

I ended up with eclinicalworks, only a few weeks into it after launch. So far, I'm not happy. Tech support is poor with techs that speak barely intelligible english; my staff cannot understand them. I've had multiple staff tell me this. They insist on phone calls for tech support as well; not email, not online ticket system, not email (unless we have a lot of back and forth refusing phone calls). This takes a lot of time from my staff. It is going to take a few months to get a full picture but so far, I'm not pleased with it. Also they do a very poor job of supporting Apple OS. We specifically and repeatedly checked with them if they support this OS and they affirmed yes, but in practice the techs have no access to Apple OS to troubleshoot, relying on my staff as test beds instead.

 

[Ligament]

No.
Depends on your volume. Can get close to 3% if your the bomb...
call ifedora, largest pain collection group and loosely sponsored by ASIPP.
Recommended by me and couple high volume pain guys.

I have recently switched to iFedora. They seem decent so far but need a few more months to see results. Rates are cheap.

 

[NJPAIN]

I've looked at this. It looks interesting.

Home

Improve efficiency and treatment outcomes with Modernizing Medicine's specialty-specific EHR systems and healthcare suites built by specialty physicians.

www.modmed.com

Its an interesting concept but pretty expensive, If I remember correctly if you scan a document in they have people in a bunker somewhere who will then place the document in the correct section of the chart. Same for labs and imaging. Obviously, you pay for that convenience.

 

[NJPAIN]

I ended up with eclinicalworks, only a few weeks into it after launch. So far, I'm not happy. Tech support is poor with techs that speak barely intelligible english; my staff cannot understand them. I've had multiple staff tell me this. They insist on phone calls for tech support as well; not email, not online ticket system, not email (unless we have a lot of back and forth refusing phone calls). This takes a lot of time from my staff. It is going to take a few months to get a full picture but so far, I'm not pleased with it. Also they do a very poor job of supporting Apple OS. We specifically and repeatedly checked with them if they support this OS and they affirmed yes, but in practice the techs have no access to Apple OS to troubleshoot, relying on my staff as test beds instead.

I'm sorry to hear of your experience. The number one complaint I have heard was that tech support was horrible. A fellow SDNer said "I can't understand them and I'm Indian!".

 

[RoloTomassi]

I've looked at this. It looks interesting.

Home

Improve efficiency and treatment outcomes with Modernizing Medicine's specialty-specific EHR systems and healthcare suites built by specialty physicians.

www.modmed.com

When I researched ModMed I saw a lot of bad reviews

 

[callmeanesthesia]

Aprima (or rather the company that bought them out) is raising their rates by 6%. I’m very interested to see what alternatives are out there but discouraged that there are no really great options. Sounds like maybe ModMed, Athena, PracticeFusion, and PrognoCis might be ok?
Aprima has been non-stop frustration, mostly because it’s a larger group and the orders and templates were haphazardly constructed, so on at least a weekly basis I’m having to deal with elements disappearing from orders, physical exam templates changing, and random errors.
I’ll have to look into the cost of those other options though. 3-4% of net collections would be a lot for our 12-physician group.

 

[drusso]

Aprima (or rather the company that bought them out) is raising their rates by 6%. I’m very interested to see what alternatives are out there but discouraged that there are no really great options. Sounds like maybe ModMed, Athena, PracticeFusion, and PrognoCis might be ok?
Aprima has been non-stop frustration, mostly because it’s a larger group and the orders and templates were haphazardly constructed, so on at least a weekly basis I’m having to deal with elements disappearing from orders, physical exam templates changing, and random errors.
I’ll have to look into the cost of those other options though. 3-4% of net collections would be a lot for our 12-physician group.

You can lock down permissions so people can't do that.

 

[callmeanesthesia]

You can lock down permissions so people can't do that.

Unfortunately the underlying setup is a rat’s nest, with text elements copied from one place to the other and cobbled together haphazardly, as each physician built out their own orders and templates. It’s like a piece of embroidery - looks fine on the front end, but a tangled mess on the back. Most of the time when something breaks, it’s out IT person who tried to fix something else, not realizing it was interconnected.

 

[PinchandBurn]

I have recently switched to iFedora. They seem decent so far but need a few more months to see results. Rates are cheap.

I use them too. Reasonable. I am still new, but service is good so far.

 

[drusso]

Unfortunately the underlying setup is a rat’s nest, with text elements copied from one place to the other and cobbled together haphazardly, as each physician built out their own orders and templates. It’s like a piece of embroidery - looks fine on the front end, but a tangled mess on the back. Most of the time when something breaks, it’s out IT person who tried to fix something else, not realizing it was interconnected.

Our group has one 0.75 FTE employee who is assigned to deal with that EHR's various levels of fvckery.