Brainlock Posted November 10, 2013 Share Posted November 10, 2013 Will all practices have to convert to EMR in 2014? Any practice that doesn't will have to pay a price? Thanks Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 10, 2013 Moderator Share Posted November 10, 2013 yes unless you get an exemption - 0.5% of all medicare payments exemptions are hard to get and I think the only one that is a blanket is the "no internet available" which is likely not very common in the USA Link to comment Share on other sites More sharing options...
LKPAC Posted November 12, 2013 Share Posted November 12, 2013 We have EMR and wouldn't go back. Better records and patient care IMHO. Link to comment Share on other sites More sharing options...
Brainlock Posted November 12, 2013 Author Share Posted November 12, 2013 Which system do you have? Do you know anything about Practice Fusion? A lot of people seem to like it. Link to comment Share on other sites More sharing options...
LKPAC Posted November 13, 2013 Share Posted November 13, 2013 EClinicalWorks. Love it. Link to comment Share on other sites More sharing options...
swooshie1 Posted November 13, 2013 Share Posted November 13, 2013 I'm currently rotating with an orthopedist (private practice) and his decision is to pay the fine rather than invest in EMR. He made a statement to me that "research shows that, in orthopedics, transitioning to EMR results in a 10-15% drop in revenue, and productivity, PERMANENTLY." Anybody have any insight on this ? I haven't asked him yet for the citation ...... Link to comment Share on other sites More sharing options...
Derbingle Posted November 13, 2013 Share Posted November 13, 2013 We're using Cerner in ED, production dropped initially by 50% and general consencus is we have not fully recovered, nor will we bc the notes are time consuming and tetious in order to satisfy billing. Used Epic...good but complex. McKesson was the easiesy by far. Thats all i got. Link to comment Share on other sites More sharing options...
SHU-CH Posted November 13, 2013 Share Posted November 13, 2013 Which system do you have? Do you know anything about Practice Fusion? A lot of people seem to like it. We have used PracticeFusion to set up a "virtual clinic" for our students to practice using EMR. It seems to be working fairly well. It is free, so if you should be able to set up an account and try it out to see if you like it. It has a lot of educational video clips and help links to get you up and running. Link to comment Share on other sites More sharing options...
wilso2ar Posted November 13, 2013 Share Posted November 13, 2013 I'm surprised amidst all the threads on EMR I have not seen anyone mention e-MDs. We started this about 18 months ago and works great. Faster, better notes. Less work for office staff and had been able to meet meaningful use thus far. Link to comment Share on other sites More sharing options...
jmj11 Posted November 13, 2013 Share Posted November 13, 2013 I've used Practice Fusion for three years and am starting to phase it out. The reason I used it? It is free. But for a sub-speciality it is quite frustrating to use and way beneath the standards that I wanted. I was actually far along in creating my own EHR based on Microsoft products (Excel and Word) in a very complex way using visual basic programming. Then I got to the point that was beyond my abilities and hired a MS programmer. I soon found out to reach the product I wanted would take a very long time and be very expensive to produce. Through my research I found gloStream, which is the only MS product based system and I can merge what I've created with their system. I've met with them for about six weeks and am going to start with their system on Jan 1. The problem with PF is that is the Walmart of EHRs. It is widely used and very generic. It would fine for a family practice, if you don't mind their logos on your referral letters, faxes and patient information sheets. But when you are narrow but very deep the system is not malleable enough to create a high standard product. Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 13, 2013 Moderator Share Posted November 13, 2013 second the above thoughts on PF - it is okay... but not great might get better soon as they are switching to HTML and supposedly other changes.... but time will tell Link to comment Share on other sites More sharing options...
burnpac Posted November 17, 2013 Share Posted November 17, 2013 Which system do you have? Do you know anything about Practice Fusion? A lot of people seem to like it. We have been using the iPad based app, DrChrono, for more than one year in a busy plastic surgery practice. Infinitely flexible and customizable templates, faxing, medical grade dictation, e-prescribing, lab integration, etc., etc. I complete 90-95 % of notes and consults prior to the patient leaving the office. You don't buy the software; you pay by the month, per clinician. The software is continually updated and improved based on customer input. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 17, 2013 Moderator Share Posted November 17, 2013 We're using Cerner in ED, production dropped initially by 50% and general consencus is we have not fully recovered, nor will we bc the notes are time consuming and tetious in order to satisfy billing. Used Epic...good but complex. McKesson was the easiesy by far. Thats all i got. agree. going from paper or dictation in the e.d. cuts productivity by 50% and you never get it back. you end up doubling staff to see the same # of pts. even 10 yrs out the productivity suck persists. I have seen this pattern with 3 different emrs at 3 different facilities. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 17, 2013 Moderator Share Posted November 17, 2013 I'm currently rotating with an orthopedist (private practice) and his decision is to pay the fine rather than invest in EMR. He made a statement to me that "research shows that, in orthopedics, transitioning to EMR results in a 10-15% drop in revenue, and productivity, PERMANENTLY." Anybody have any insight on this ? I haven't asked him yet for the citation ...... good choice. if I ran a private practice I would pay the fee and dictate all my notes. Link to comment Share on other sites More sharing options...
burnpac Posted November 18, 2013 Share Posted November 18, 2013 I'm currently rotating with an orthopedist (private practice) and his decision is to pay the fine rather than invest in EMR. He made a statement to me that "research shows that, in orthopedics, transitioning to EMR results in a 10-15% drop in revenue, and productivity, PERMANENTLY." Anybody have any insight on this ? I haven't asked him yet for the citation ...... I think that it depends on a lot of factors. In our private practice, our EHR has made us more productive, and has supported increase revenue as our notes meet the criteria that allows a higher level of coding, with little effort. The hardest visit is the initial consult, but once we have all the past medical history, meds, allergies, social history, etc., it is a piece of cake to bring that information forward to the current visit. Any needed narrative is facilitated by the built in adaptive medical grade dictation. I don't ever have to print out notes as I can secure fax them from my iPad immediately, once signed, to a referring provider or pre-op -- a big time saver. Our practice's complete medical records is with me at all times instantly accessible from my iPhone or iPad. Another critical factor is age and comfort with technology. At our facility, providers of earlier generations are really struggling as they have never had computer skills, and have never been forced to acquire these skills to transition to a new charting standard. I wrote a blog some time ago about this, and my conclusions based on observation is that we need to lighten up on the less technologically savvy folks and allow attrition, and the influx of younger providers to ease the transition to the EHR. In the hospital, I do a lot of plastic surgery, craniofacial and hand consults, and I love using Cerner's Powernote consult template. It automatically gathers all the entered social history, past medical / surgical history, meds and allergies, and diagnostics with little or no effort. I have developed a number of macros for medical decision making and treatment plans, as they are nearly all the same for the types of conditions we routinely treat. I'm able to maximize E & M value to the highest levels, and that makes it worth the additional effort (for me). H and Ps are another document that I always do on Powernote in house. As we have a lot of reconstructive readmissions, I save a lot a time by copying an existing H and P previously done on the patient, and just updating it for the current admission. I spend more time on the front end, so I can generate future H and Ps on the same patient with minimal time and effort. In my opinion, specialty practice like orthopedics, would greatly benefit from a good EHR like DrChrono, as you do and see the same things over and over again, and it would be brain dead easy to develop the exam templates and macros needed to make charting nearly painless. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 18, 2013 Moderator Share Posted November 18, 2013 I Another critical factor is age and comfort with technology. At our facility, providers of earlier generations are really struggling as they have never had computer skills, and have never been forced to acquire these skills to transition to a new charting standard. I wrote a blog some time ago about this, and my conclusions based on observation is that we need to lighten up on the less technologically savvy folks and allow attrition, and the influx of younger providers to ease the transition to the EHR. There are lots of folks in their 40s who never used computers until 2000 or so. there was one guy in my pa program who owned a laptop. it is easier for folks who grew up typing, playing computer games, etc but there are lots of us with 20+ yr left in practice who type poorly and hate working on computers .(and yes, I am typing this with 2 fingers as well as doing a research doctorate the same way....doesn't mean I like it....). I was in the last class at nebraska for the postgrad MPAS that was allowed to turn in handwritten assignments...funny story- my dad the neurologist convinced me NOT to take a typing course in junior high because "if you learn to type people will treat you like a secretary your whole life, take something useful like wood shop or auto shop". so I did. and he was right about the secretarialization of medicine....pay folks who make 50-200/hr to do data entry work that could be done by an 18 yr old high school grad with a typing course under their belt...makes no sense.... Link to comment Share on other sites More sharing options...
cbrsmurf Posted November 19, 2013 Share Posted November 19, 2013 Auto and wood shop probably comes in handy for thkse ortho cases Link to comment Share on other sites More sharing options...
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