Elation EMR: What's your workflow?


(Jason Larsen) #1

We have been doing paper charts since our opening in 2014, and it has served us quite well.

But, as we are hiring another physician soon and are looking to improve our front-office efficiency, it looks like Elation is going to be the answer to our front-office paper-chart woes…

My question is… for those that use Elation, what does your workflow in Elation look like? From patient scheduling, to check-in, to charting?

We are considering (for one physician), having a tablet (iPad or similar) for referencing patient charts, and also a clipboard where he can write notes in the exam room, then dictate into Elation at his desk. He really prefers to be ‘present’ with the patient and without a computer in the exam room. Does this sound like an OK workflow in Elation?


(Siobhan Benham) #2

I have been in solo practice for just 2 months. I daily wonder if my choice of EMRs was appropriate. I was ready to sign with InSight EHR before they went belly up and then found Elation.
Elation’s cost is reasonable.
Navigating thru the chart is easy.
Scheduling is easy.
Like anything there is growing pains, and this program has limitations. I have found some work arounds, and am hoping that the Elation engagement offers more for my needs.
In general, I might shop around more, but the tablet with note book should work great.
Good luck! Hope that helps some.
Also the support has been great, I don’t always get an answer I want, but I quickly get answers.
I have never used paper charts and the transition maybe different for you. I do like the Patient Passport feature.

(Dr. Peter Lehmann) #3

Love Elation. Not perfect but best I’ve used over the past 20 years (and I’ve used a lot) in terms of being “lean” – you can avoid the BS most EMRs are crammed with.

I have two offices, each with Doc or PA and one MA each.

Scheduling can be done by a gradeschooler. Click in box, pick patient name, use either present appointment length or adjust on the fly. Easily allows double booking time (say an MA blood draw at same time another patient has a regular clinic appointment).

Check in is simple, note starts at check in. For me in DPC “check in” really isn’t significant. “They’re here Dr. Lehmann!” (literally). There are lots of options (checked in, room number, cancelled, etc.).

My MA usually does vitals (not always – I often do it). I usually take my computer in the room to have access to old notes, data, etc. but just jot down important stuff on a piece of paper (my MA usually prints out med list for me to review with patient and I often just take some notes down on that).

Notes are easy. It is easy to make templates if you want. I don’t use them as DPC volume is low enough that I can put together concise notes that are not cookie cutter (except for things like earwax, URI, skin tags, etc.).

Love the ability to take a pic on my phone, email it to myself, save to desktop and then drag into the note. Same with an EKG image (or any other image for that matter).

Referrals and letters to outside docs are simple. Same with patient letters.

I don’t think it’s feasible to use the built in fax (1500 pages/month included) to just fax a single piece of paper OUT like an order. We keep RingCentral to manage faxes. Incoming faxes, should you choose to use that (free fax number) work well. Easy to file into a patient’s chart.

Lots of options for notes: simple office visit (SOAP), routine office visit, H&P, phone note, email note, etc.

Messaging between staff is super easy to use.

Would be glad to answer more questions.

I will say I stayed away from Elation the first 18 months of my practice. Used Practice Fusion because it was free. It was the right decision at the time. Way happier with Elation. It is linked to my billing system (Hint), linked to my prescribing software (MD Scripts), and my messaging system (Spruce).

(Jason Larsen) #4

@drpeter - Thanks for this information. It’s very helpful.

I especially like your idea of printing out a med list and using that to write notes in the exam room. That seems like a great way to let Dr. Edgerly (at our clinic) limit his time looking up information in the exam room and just being with the patient, while still being able to jot down notes as he usually does.

Thanks again for your input - that is very helpful.

We’re doing a ‘soft-launch’ on Elation next week - it’s always stressful transitioning systems. I think this will help overall efficiency for our front office, though, and hopefully keep our physician’s efficiency up as well.

Thanks again!

(Trinette Moss) #5

I use a separate program Kareo for scheduling b/c i like the customizable reminders for patients to get a text reminder or email reminder of their appt at a time I set [2 hours, 2 days, 2 weeks etc]. Not necessary at all but i like it, and patients like the reminders.

When a patient shows up my nurse checks them in and does vitals and prints them a med list. We check it against what patient is taking and make updates. I will often use that paper for notes or a separate note pad. The patient usually goes home w/ hand written instructions [b/c my typing speed sucks] but there is a really nice feature in Elation for typing and printing this out.

I do my note after they leave, but if you can type fast it can be done in a few minutes. My problem is i’m too descriptive & wordy but its how i work/remember. :wink: Sometimes i will use Dragon but not often unless is a really complicated patient.

New patients get an invite to the portal if they want one.

They have made steady improvements in the last 2 years so I am happy with it so far.

(Brianna Wilson) #6

I’ve done walk throughs with Elation and MediTouch. Schedule a walk through with both as
they are different. Both are cloud based and both have a really great set up that is user friendly from all appearances. In both you only pay for the provider and not the support staff.

Elation is $350/mo per provider with optional Engagement package at $100 including patient portal.

MediTouch is Ipad “touch” software and I was really leaning towards this one and doing what you suggest with using iPads mostly with desk top at front. You pay for encounters so example is $350/mo for 100 encounters per month. They have a great portal with forms patients fill out prior to visit for ROS but elation is just starting this in January. This one has televisits imbedded. Elation does not but I will be using Google meet ups. efax is an extra $70.

I can give you contacts for each if needed. I’d recommend either but only based on first glance.


(Rudi Kauffman) #7

Just to be clear, I am not a clinician, but just the business guy at a young (2ish year-old) DPC in Ohio. With that said, we just revisited our medical record decision (we’re using Elation) as part of our scheduled ongoing improvement efforts and in response to a recent price increase. After interviewing our full-time doc, part-time doc, nurse, and partners who interact with our records, I repeatedly heard that it was truly amazing for ease of use and quality of output.
The thing that makes me most nervous is that Elation appears to be trying to pad its margin a bit and I’m not sure where/if it will end. The price increase going into this year was substantial and it appears that new features are going to be available at an added cost to create tiers. It may well be that Elation is just moving to a more robust margin while still remaining somewhat more lean than the bloated costs found elsewhere.
Taken together, there was a strong affirmation from providers of staying in the Elation-Hint ecosystem with some wariness about costs going forward. At present, the providers explicitly prioritized privacy which took Practice Fusion out of the running (though they also stated a preference for the ease of use of Elation.)
Regarding workflow, we have no computers in the exam room so notes are taken by hand and then the doc enters them into the chart. We have built out a wide-range of templates that are quite brief allowing for easy/quick reading when reviewing charts. We use the non-medical “Dragon NaturallySpeaking” for more involved notes. With half-hour appointments, 35 office hours a week, and around 840 patients, notes are usually completed after each appointment with, perhaps 2-5 more involved notes being finished-up at the end of the average work day taking between 10 minutes and 2 hours. If you’re interested in more numbers or a doc’s perspective, feel free to message me and I’ll get you in touch with Ryan.
Good luck!