If you were going to start your DPC practice again, which EMR and communication tool would you use?

(Ken Rictor, MD) #1

I am asked many times by docs starting or converting about the resources they should from the inception of DPC. There is a growing market of products and services today. I am interested in hearing what others are using and why they made that choice.

(Dr Mark Turshen) #2

As 2 docs starting out of residency, with a micropractice model and using our own money for startup… cost was the biggest factor. We went with Practice Fusion for this reason and have had no issues at all. Wouldn’t change at this point.

(Richard R. Samuel, MD ) #3

We too use Practice Fusion. It has its flaws, but you can’t beat free…RRS

(Ken Rictor, MD) #4

Thanks for feedback Mark. Starting right out of residency is gutsy and definitely the way to go. I wish I had had this model. In 1988 when I started my practice FFS was the only way to go and it was very easy and productive. I have had the reflective time to see how bad our FFS is

(Ken Rictor, MD) #5

Thanks for feedback. I originally used Atlas MD converting from e-clinical works with my FFS practice. AtlasMD was great with communication and med dispense. I used this for about a year and then changed to ElationEMR. Elation was more old school for me with note taking ( maybe my generation of docs). I liked the integration with HINT and now the integration with Spruce.

(Michael Tetreault) #6

The DPC Journal EHR Report 2017 finds the same vendors (as above) very popular among prospective and currently operating Membership Medicine physicians [nationally from 2015-2017]. Those widely used and referenced included: Epic; eMD; Athena; Amazing Charts; Quest and Practice Fusion. Elation and Atlas.md EMR were also mentioned by some physicians in specific oral interviews. https://directprimarycarejournal.com/cmt-dpc-journal-ehremr-report-2017-membership-medicine-trends-national-vendor-use-parallels-subscription-based-healthcare-solution-use/

(Robin Dickinson) #7

I think the important thing in choosing an EMR is finding one that works how your brain works and makes your life simpler. It’s different for different people.

For me, I wanted to be 100% paperless and I wanted everything integrated. I write really detailed notes and patient instructions so I needed something that would have good templates and would make the instructions as simple as possible. And I have no staff so needed a robust patient portal. I also am a tinkerer so a smaller company that would actually let me make suggestions or would customize things how I want them was nice icing on the cake. So for me, MD-HQ was the perfect fit. But again, that’s me.

I think choosing an EMR is a lot like a dream house. You make your list of non-negotiables and your nice-to-haves and you try to find something that works for how your family lives. We needed a big dining room because I’m the oldest of seven kids and host most of the big family gatherings. My sister barely cooks and hates having people over so that wasn’t a priority for her.

Make your list and look for what suits you best, not necessarily what anyone else recommends.

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(Ken Rictor, MD) #8

Thanks for the reference Michael. It is great that there are so many choices out there today and they are constantly getting better and more specific to DPC…

(Jack Forbush, DO) #9

This seems to be a recurring issue for me, but knowing what I know now (and after way too many EMRs), I’d hop on with ElationEMR + Spruce (current setup)

(Lissa Lubinski) #10

I’m considering this and need to see it in action/try the demos. Can ElationEMR be used with MacBook? Currently have Toshiba laptop which is almost dead and need new laptop ASAP that will be reliable and function with cloud based EHRs. Open to feedback! And what is the general cost of Elation?

(Lissa Lubinski) #11

What about a patient portal with PracticeFusion? I’ve heard it’s not very user friendly. Are there ways around this?

(Ken Rictor, MD) #12

Hi Lisa. I use the MacBook Pro and MacBook Air for elation. It works great with no problems. I am also using a iPad Pro on the road so that I can have access. Although Elation notes that they don’t have compatibility yet with iPads, I found that the iPad Pro works fine. In a pinch you can use an iPhone but that is really just to check your schedule or look up something quickly but not good for documentation. Generally your cost of the Elation EMR is about 250$ a month per provider.

(Lissa Lubinski) #13

Thank you, Kenneth! Is there a start up fee for Elation? Do you use Hint as your billing platform then?

(Lissa Lubinski) #14

Thanks, Jack. What is Spruce? What other EMRs did you try/do you use currently. Or is that ElationEMR + Spruce is your current set up? __

(Jack Forbush, DO) #15

Spruce is a HIPAA compliant messaging app. It connects to ElationEMR via a Hint connection. I’ve used logician/centricity, springcharts, MacPractice, CareCloud and PractieFusion. The only hangup I have with ElationEMR is lack of an iOS/smartphone friendly interface

(Robin Dickinson) #16

@drken I like the “real” notes too and on my search for an EMR discovered that only certain ones allowed for that. I ended up with MD-HQ but there are a number that work for this. I think that’s part of the soul searching that needs to be done when looking for an EMR. I knew I like thorough notes and patient summaries and templates that allow for that without spending excessive time.

(Ken Rictor, MD) #17

No start up fee for Elation and yes we use Hint. I agree with Jack that the combination of Spruce and Elation has worked well with communications as well. We are waiting for integration with Sprint and Elation. That will really expedite communications directly from the medical record.

I think that you want to be able to have a platform that is scalable and you should be able to link services so you can build an engine that is personalized to your use and liking.

DPC is really like this in general. We can fit in any health situation without interference to care.

(Lissa Lubinski) #18

Thank you so much. Helpful information. So Elation + Spruce offers the Patient Portal aspect? Is it easy to use from patient’s standpoint? And I like “real notes” as well, the ability to tell a meaningful, but hopefully not too wordy, story about my patient’s condition/situation. Does Elation allow for you to create your own templates or at least parts of text you use often and don’t want to retype again and again? Does it allow for patient summaries or something you print for a patient at the end of the visit (or that they could view in their Patient Portal equivalent)?

(Lissa Lubinski) #19

Thank you. So you sound overall happy with ElationEMR. So Spruce then allows you the HIPAA compliant way to discuss labs, etc, with patients via ElationEMR? Can patients initiate messaging?

(Lissa Lubinski) #20

That’s a lot of how my brain works, too, Robin. Thanks.