Practice Fusion EHR

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Creflo

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One day within the past week, someone posted on PM News that they received a call from Practice Fusion stating it would no longer be free. I hope this was an error, did anyone else see that post?
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I saw it on facebook as well, with the practice already being notified of impending cost by Practice Fusion. It's not surprising...why else would Allscripts buy them?
 
I believe someone mentioned that pre existing clients of PF will be started on a $99 / mo rate. I know many people that like PF, even in comparison to other costly EHRs.
If I choose an EHR soon, I will consider PF. However, if PF increases the monthly rate to around $600 / month (which I believe is average price of most EHRs), would they still have the same fanbase? At that cost I would start comparing them to other's such as eClinicalWorks / MediTouch, etc.
 
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Practice Fusion has not yet contacted our office regarding any fees. We're sticking with it until they notify us, and then we'll see how much they want. Our top choice for replacement at this time is Kareo.

Regarding that post on PM News -- I'm wondering why a company with as many clients as Practice Fusion has would take the time to make phone calls? Why wouldn't they send out a bulk email or form letter?
 
Things to keep in mind on EMR shifts:
1. cost to convert
2. Cost to move records
3. Can you simply access both records at once when continuing care on patients being followed before and after the conversion. Therefore you do not need to pay to import info which never works. Avoid paying for this , unless it is somehow the only option. Better off paying for both systems for a year and weaning off. Data conversions can cost thousands and not work properly
4. If you do in house billing, you will spend more money on a cheap or free EMR and linking it to your in house billing program. Free or cheap EMRs are best for outsourced billing.
5. Amazing charts is a relatively well liked low cost EMR
6. You can make up some money on EMR billing programs by not having staff fish out data from EMR and inputting it into a billing program
7. MACRA requires E Rx, lab module, and patient portals these can cost 60-1000 dollars each, yearly
8. Some hospitals will give you their EMR. Often times it is not even worth it to get for free because it will slow you down so much. They are based on guidelines more than patient care
9. Older versions of Dragon dictate work the same for the $99 non medical version as the $1000 medical version. But may or may not be compatible with your current EMR
10. You save more money in workflow than on sticker price
11. It may not be worthwhile to comply with MACRA but the implications of not doing so down the road may put you at a severe disadvantage. Its basically a gamble to pay lots of money for something that putters out and becomes unnecessary vs falling behind and not being able to catch up without another costly change in workflow and software.
12. If you have an "all in one " system you are better prepared to do billing yourself or keep closer tabs as to how your biller is handling your accounts
13. If you use a hospitals lab, they will often pay for your lab software and interface- also required by MACRA and another $1200 per year if you pay it yourself.
14. Some labs like Quest will offer free EMR with free eRx and lab interface. Generally free EMRs do not exist as All in one Billing and EMR packages
15. Clearing houses (Like Office Ally) sometimes offer a free EMR or EMR and billing module. If it isn't good don't bother. Some may have improved.
16. Office Ally is free as a clearinghouse. And works well. Their EMR was weak as of a few years ago, but may have improved since several years ago. You can still use the free Clearinghouse with any EMR. Some say the free clearinghouses are more on the payers side and delay payments and offer less arbitration when there is an issue with payment processing. I think Gateway EDI was a better user interface but overall bills got paid the same with paid vs unpaid clearinghouses.
 
Practice Fusion will be charging a fee of $99 per provider in the near future. Expect an announcement from them in March 2018 with full details. In a statement to CNBC a Practice Fusion spokesman said "We have a product announcement upcoming in early March, and we look forward to sharing it further with you and all of our stakeholders very soon".
 
I received this email today. They still haven't quoted a dollar amount. Easing us into it a little at a time, I suppose.

When Practice Fusion began over 10 years ago, our mission was to create a web-based EHR solution that helped independent physicians thrive. Although a lot of things in healthcare have changed since then, Practice Fusion remains strongly committed to this mission today.

In order to continue delivering easy-to-use, intuitive health IT solutions that support practices like yours all across the country, we are moving the Practice Fusion platform to a paid subscription model beginning on June 1, 2018. By charging for our products and services, we will be able to better serve you with accelerated feature development and improved customer service, all with the goal to help you save time, grow your practice, and focus more on what matters most—your patients.

We understand that this is a big change and want to make sure you have time to ask questions and consider your options. As a result, your practice will have until May 31, 2018, to purchase a Practice Fusion EHR subscription plan. If a plan is not purchased by that date, your account will be transitioned to a "limited access" version of the Practice Fusion EHR, which will only allow you to view, download, and print the EHR data and patient records you previously entered into the system as long as you continue to access them.

If you have questions or want to learn more about this transition, you can find additional information by logging into your Practice Fusion EHR account or contact our phenomenal customer support team.

Thank you for being a loyal Practice Fusion customer. We look forward to continuing to serve as your trusted EHR partner for many years to come.

Sincerely,

The Practice Fusion Leadership Team​

 
On the main sign-in screen of PF: "The healthcare industry is evolving, and so are we. To deliver the features and personalized service your practice needs now and in the future, we will move to a paid subscription model for our EHR beginning in June 2018." Attached is the Overview of Subscription Licenses.
 

Attachments

What are you guys thoughts on practice fusion thus far in terms of charting and its MIPs integration? I am trialing it and deciding if its worth the $99/month. Would you guys recommend other EMRs.

My thoughts thus far is that the charting just ok. Not really streamlined. Inputing medications seems like pain. Their customer service is one of the worst if questions or problems arise. Hard to get through to them and hard to get help from them.
 
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dddunit said:
What are you guys thoughts on practice fusion thus far in terms of charting and its MIPs integration? I am trialing it and deciding if its worth the $99/month. Would you guys recommend other EMRs.

My thoughts thus far is that the charting just ok. Not really streamlined. Inputing medications seems like pain. Their customer service is one of the worst if questions or problems arise. Hard to get through to them and hard to get help from them.
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Our office has used Practice Fusion for several years so at this point it is pretty streamlined. I have several templates set up for my most common issues so each note only takes me a few minutes. We use Dragon dictation and there is some kind of a weird glitch (I don't know if the problem is with Practice Fusion or with Dragon) where the cursor will jump in the middle of the sentence so that the transcription is off by one letter. It happens to both my partners and me and we've learned to watch for the typographical error. I add medications from within the note and since I'm familiar with the format I can do it pretty quickly. At $99 per month we are planning to stick with them for the time being. I think there's a learning curve to any EMR system, and I'm not eager to learn a new one. We're not doing MIPS because it's asinine.
 
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dddunit said:
What are you guys thoughts on practice fusion thus far in terms of charting and its MIPs integration? I am trialing it and deciding if its worth the $99/month. Would you guys recommend other EMRs.

My thoughts thus far is that the charting just ok. Not really streamlined. Inputing medications seems like pain. Their customer service is one of the worst if questions or problems arise. Hard to get through to them and hard to get help from them.
Click to expand...

my generic thought is that you get what you pay for...

this may not apply to anyone here, but it fascinates me that many podiatrists in general seem to be so worked up over a few hundred dollars a month for an EMR (just look at PMnews threads on practicefusion and requests for other free options), but have no problem buying/leasing nail and pain lasers, ABI machines, take up office space with retail shoe "stores", etc...most of which are worse investments (from my limited experience) than an EMR that could help you to see more patients and reduce staffing requirements and/or hours. Heck, something that could potentially give me more hours with my family every week would be reason enough to spend a few hundred every month for an EMR.
 
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Good thoughts dtrack22, it's all about time management. Is there an EMR that actually saves anyone time? Even when we paid for our EMR system plus monthly support we still spent a lot of time dicking around on the computer. I'm disenchanted with them all. It seems like things are just getting more and more complex. Clicky click clicky the mouse all day. My f-ing fingers are going numb. When I started practice we used voice recorders and sent the tapes (yes, tapes) to a medical transcriptionist. That was fast.

I think a big issue with EMR systems is that they shift work to the physician that was previously done by his or her support staff. Instead of paying a person to do the work we (the doctors) are doing more of the tasks ourselves then are paying a software company for programming and IT support. I'm currently doing several hours of training in preparation for my hospital system's new $100M EMR and a lot of the selling points are that I would be able to do more from my own screen, for example the system will allow doctor-to-doctor direct referrals. Great, so someone wants to send a patient to me and I'm supposed to pull up the calendar and book the appointment? I hope my receptionist brought a People magazine to work so she doesn't get bored.

A chart note is like the check at a restaurant that tells you what you ordered that visit. Most of your money should be going towards food and service, not towards a fancy check. An EMR is like a machine that creates a super-fancy check with way more detail than anyone actually uses, and it's taking up too much healthcare money. It's becoming the focus of healthcare rather than just documentation of what was said and done during the visit. Moreover, the money we're spending on EHR has dubious financial return on investment. We could hire less staff but someone's doing the tasks (turns out it's us). If you get fast with the computer then you can get home at a reasonable hour but it's still more time consuming than dictating your note into a recorder and paying a transcriptionist to type it out. All that data will supposedly make America healthier somehow, even though people don't want to change their own habits? That should work...

Good lord, I sure went off on a rant didn't I? What a nut!
 
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NatCh said:
If you get fast with the computer then you can get home at a reasonable hour but it's still more time consuming than dictating your note into a recorder and paying a transcriptionist to type it out
Click to expand...

I agree that dictating/documenting the "important stuff"-only is faster than using any EMR. The problem is that CMS controls what is important, not the provider and not the EMR software. A majority of the dictated notes I've seen would fail a medicare audit for the billed level of complexity. They absolutely have all the information you SHOULD have to have in the chart, and any doc could read them and follow along with your diagnosis and treatment plan, but that usually isn't good enough for CMS (and now many commercial plans in my area). I don't think anyone likes the checkboxes or clicking, but the EMR systems aren't the ones dictating what information goes into the chart, the government is. The EMRs job is to make it as idiot proof and as efficient as possible to get that information into the chart. So, if there is a product that saves me or staff phone calls, scanning, faxing, etc. and allows patients to enter some of their own information, and makes adding pictures to the record easier, and speeds up my ability to check off CMS's boxes, etc...then it may be worth the money IMO.
 
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Yep, the amount of data the government wants keeps going up. We're creating mountains of data. Will it actually improve health? TBD. My money is on nope. Meanwhile, we have to keep checking those dumb boxes and generating three page notes detailing how we treated a plantar wart.

Which EHR system are you using at your practice?
 
eclinicalworks...which is one legal decision/settlement away from being bought by someone else lol. They got a $1 billion class action suit pending at the moment

its ok, would be one that I say is not worth the money compared to even a $99 version of practice fusion
 
As I’ve discussed, I’m doing more and more consulting work for insurance companies and less and less patient care. The time is now right for me to move in that direction.

So I see charts from every EHR and ironically, the easiest to read and follow are eclinicalworks!! I know nothing about their lawsuit.

I also see a lot of practice fusion notes and most suck. Is it the program or the laziness of the doctors for not creating complete notes that make sense ?

EHR makes doctors lie. When you repeat a prior note you are in essence full of sh-t. Sure, you may change a few things but you likely did NOT perform vascular exam again, a neuro exam again, a med history again, etc. Nor do most docs write “no changes in exam”’. You are documenting an exam that you probably didn’t perform EVERY visit. Kind of a giveaway when I read 2 years of notes and the vitals have never changed.

I read months of wound care notes with NO changes in wound size and the notes are verbatim.

I read post op notes, yet the surgical history says “none”.

So we can all blame the EHR, but if you put sh-t in, you’ll get sh-t out. EHR is here to stay, so you must adapt and actually READ your notes. Take out stale information and enter new information. I’m willing to bet that if you actually proofread some of your notes you’d be horrified by the errros in your notes. The errors you entered. It doesn’t matter what system you use.
 
What do you guys think about the query in the last PM news about making your own EMR?
 
NatCh said:
What do you guys think about the query in the last PM news about making your own EMR?
Click to expand...

Many moons ago, prior to “official”
EMR, I dictated my notes. My accountant wasn’t happy with the dictation bills I was paying. So I created templates for new patient visits for the most common ailments AND follow up visit templates. The follow ups didn’t repeat the nonsense or all exams. It got right to the point.

Obviously, I had to plug in the correct info for each patient, so many of my templates had many choices that could simply be removed from the notes.

I was able to complete very readable and accurate notes in less time than my current EMR. Screw MIPS and MAPS and all that crap. The only concern now is electronic prescribing.

If I wasn’t winding down my interactions with patients, I’d go back to my self made system. Worked like a charm. And it “thought” like me since I created it.
 
Uh-oh, is this a business opportunity for some young go-getter? Make a bare-bones inexpensive EHR system with electronic prescribing capability for people who do not want to participate in MIPS, MAPS, MACRA, FACRA, and all that crap.
 
NatCh said:
Uh-oh, is this a business opportunity for some young go-getter? Make a bare-bones inexpensive EHR system with electronic prescribing capability for people who do not want to participate in MIPS, MAPS, MACRA, FACRA, and all that crap.
Click to expand...

Young go-getter? How about two “seasoned” veterans like us? I’ve already got most of the work done.
 
To do my best work I’ll need a sofa in the Creative Department corner office where I can lie down and think.
 
NatCh said:
Good thoughts dtrack22, it's all about time management. Is there an EMR that actually saves anyone time? Even when we paid for our EMR system plus monthly support we still spent a lot of time dicking around on the computer. I'm disenchanted with them all. It seems like things are just getting more and more complex. Clicky click clicky the mouse all day. My f-ing fingers are going numb. When I started practice we used voice recorders and sent the tapes (yes, tapes) to a medical transcriptionist. That was fast.

I think a big issue with EMR systems is that they shift work to the physician that was previously done by his or her support staff. Instead of paying a person to do the work we (the doctors) are doing more of the tasks ourselves then are paying a software company for programming and IT support. I'm currently doing several hours of training in preparation for my hospital system's new $100M EMR and a lot of the selling points are that I would be able to do more from my own screen, for example the system will allow doctor-to-doctor direct referrals. Great, so someone wants to send a patient to me and I'm supposed to pull up the calendar and book the appointment? I hope my receptionist brought a People magazine to work so she doesn't get bored.

A chart note is like the check at a restaurant that tells you what you ordered that visit. Most of your money should be going towards food and service, not towards a fancy check. An EMR is like a machine that creates a super-fancy check with way more detail than anyone actually uses, and it's taking up too much healthcare money. It's becoming the focus of healthcare rather than just documentation. Moreover, the money we're spending on EHR has dubious financial return on investment. We could hire less staff but someone's doing the tasks (turns out it's us). If you get fast with the computer then you can get home at a reasonable hour but it's still more time consuming than dictating your note into a recorder and paying a transcriptionist to type it out. All that data will supposedly can make America healthier somehow, even though people don't want to change their own habits? That should work...

Good lord, I sure went off on a rant didn't I? What a nut!
Click to expand...


You absolutely nailed it. I hate that slogan. But you did.

I have used many EMRs, big, small and in between. Good luck finding one that gets you home faster, especially if you are trying and not have a pay cut following HITECH/PQRS type regulations
 
NatCh said:
What do you guys think about the query in the last PM news about making your own EMR?
Click to expand...
Well, making your own EMR is not for the novice. Someone said that most software projects end in failure. EMR is even more so. It's better to find one that provides customizations, such as NoshEMR and Solismed.
 
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