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

(Robin Dickinson) #26

[quote=“lklubinski, post:25, topic:321”]
That seems steep for a low-overhead practice starting out, though the EHR seems great and easy to use.
[/quote] @lklubinski

If it is easy to use and makes your life better, it may very well be worth it.

Initially I was turned away by price as well (MD-HQ is $250 a month). But then I realized that with everything it did for me, it was well worth it. I save more than $250 a month in my own time (or the staff I don’t need to hire) for my patients to be able to message through the portal instead of call, schedule their own appointment, view lab results on the portal, etc. Even just having the billing integrated saves me tons of time. Or the fact that the faxes are integrated into my workflow so I’m only using one platform for everything instead of logging into separate ones. And that my notes are super fast to type with the chart parts/templates. Anyhow, when deciding, make sure to consider all the time you’re saving.

I used Practice Fusion for about a month before realizing it just wasn’t going to work for me. I used a different EMR for another year or so before realizing how much time I was wasting. That’s when I decided it had to be completely integrated and with a robust portal that all my patients could use on their phones. I posted on a group I belong to for private practice physicians and a non-DPC doc raved about how much time she saved with MD-HQ and since time is money, that made sense to me. I found that it worked how my brain works (very important that you find one that works for YOU). Then I sat down with every patient during an appointment and taught them to use the new portal if they hadn’t figured it out on their own. It was simple and intuitive even for the less-tech-savvy when I did it with them for the first time. And now it more than pays for itself. I had two bad months this year of patients falling apart (apparently) but now I’m back to almost no phone calls, everything goes through the portal.

So yes, it can be pricey getting a good one but if you make the right choice and choose something that saves you a ton of time, it will be worth it.

(Ken Rictor, MD) #27

Hi Lissa The price of anything is always debatable to the value that it brings. My father used to say to me that the most expensive thing you can buy is something cheap. I have found that the price for Elation is worth the cost in quality and ease of use and many time saving features that helps me maximize patient time. The other factor is the willingness of Elation staff to adjust and make modifications based on our requests for services that we would need. Integration to HINT was also important to me and now I will have integration with Spruce.

I have had three electronic record systems but I have found that Elation fits my needs the best.

(Lissa Lubinski) #28

Thank you, Robin and Kenneth, for last posts. Appreciate reminder that what an excellent integrated EHR can do is save time and need for staff, both of which I’m wanting. Grateful for the thoughtfulness in responses!

(Robin Dickinson) #29

@Lissa_Lubinski Always glad to help! I felt so alone when I started and I don’t want anyone else to have to feel that way.

(Dana Sanderson) #30

We signed with Elation in December 2014 and had a Spruce demo two weeks ago but will not be signing up yet. The biggest issue we have with both of them is about the requirement for each patient to use a unique email address for each patient profile they would access. With a family practice including internal medicine and pediatrics, we have many patients who therefore require a separate email address for access to each of their minor children’s charts. Also, if a patient already sees a specialist whose office also uses Elation, that patient has to use different email address to access Passport (Elation’s patient portal) with our office. That’s too complicated.

Other than that, ElationEMR is a huge improvement over eClinicalWorks!

(Ken Rictor, MD) #31

Thanks for the feedback Dana. We haven’t had much of an issue with the email access but I know exactly what you are saying. I think Elation is aware that this is a big barrier for many practices and that this has become an issue. We used eClinicalWorks as well and you are so correct that Elation is a huge jump from eCW.

As I understand, Spruce will have connection to Elation in the next few weeks so that we can have a direct link.

(Robin Dickinson) #32

Oh, that’s really good for people to know. Almost a quarter of my patients are under 10 so don’t even have their own email. Plus a lot of my patients will all use the email address of the family member who actually checks their email. So there may be a mom receiving the emails for both her and dad and all the kids.

(Jack Forbush, DO) #33

I’ve had 5 (Centricity/Logician, SpringCharts, MacPractice, CareCloud, Practice Fusion)…ugh!

(Jack Forbush, DO) #34

What I have recommended to parents is to create an ileus email account for their children, i.e. janedoe+kid@whatever.com as most female providers allow for “wild card” email addresses. So far so good!

(Ken Rictor, MD) #35

That’s a good suggestion Jack . We can try that

(Dana Sanderson) #36

Thanks Jack. Up until now our clientele has balked at creating aliases, but you’ve given me the idea to perhaps write up a simple how-to for Gmail since that’s the most prevalent email provider in our practice.

(Jack Forbush, DO) #37

I had some patients/clients balk to begin with as well as they thought that it would make managing their email more difficult, but after some education about how this works and creating filters, etc…they’ve been on board.

(Ken Rictor, MD) #38

Yes I have found that patients really have their own preference for communication and some are totally foreign. Having a variety but not too many choices is good. It also depends on notification and how the system can get a hold of the Provider without killing your time in the process. Our email tool is good and we have many that use the portal and standard email response.

(Robin Dickinson) #39

Yes, anytime you introduce something new, be prepared for training! I have nearly everyone trained to the portal but it required me taking time during appointments to help them get it all figured out on their phones or tablets.

(Bruce Jung) #40

I am curious as to why people are not using or recommending AtlasMD? It costs ~$300/mo, includes membership management (no extra Hint fee of 1% of all billings), inventory management (no MDScripts $0.05/pill fee or $50/mo min nor Flexscan - just quoted >$80/mo) and no need for Spruce (at $99/user in your clinic/mo). If I add all of these to the cost of Elation (now up to $350/mo) I am way over $750/mo (around $830/mo) and close to 3 times as expensive as AtlasMD. And what about Amazing Charts with an unintegrated Hint? (If you don’t do med dispensing?) I ask all this because I just came out of InLightEHR which was closer to $250/mo and included decent enough membership management with an intuitive, simple, yet quite robust EHR. Thanks for any advice.

(Robin Dickinson) #41

We talked privately but in case anyone else is wondering, I can’t manage without a robust patient portal (so not Atlas) and fairly integrated tools (so not Amazing Charts). The quality of notes and patient summaries is also important to me. That said, you have to find what works for your brain and your situation. All payment platforms will charge to run payments but beyond that I have MD-HQ for about $250 a month (no staff).

(Bruce Jung) #42

Thanks, Robin, for your insights. As an FYI, it appears that MD-HQ is now up to $350/mo with a $1k-2k upfront “loading” fee. I am with you and like to have neat, thorough notes. My patients have been used to Twistle (which I would not call robust by any means), but it sure was convenient to message them with attached labs that came into InLightEHR and “text” with them about medical problems. I am reviewing AtlasMD, MD-HQ and ElationEMR. Elation is the most intuitive to me from a charting perspective and their portal solution is improving, but no affordable (to me) membership or med dispensing solution keeps me vacillating back and forth. I’ll let you know what I end up with as my InLightEHR access is running out in 1.5 months…

(Robin Dickinson) #43

@thedocshoppe I know several docs who have been put into crisis mode because of InLight shutting down…to lose your whole system at once really stinks. The important thing is finding what works best for you. Since you were involved with InLight from the beginning, I’m sure nothing is going to work as well for you because everything else is there proforma. I feel like I’m offering condolences here but seriously, I can’t imagine having to suddenly change everything! Best wishes with it!

(Michael Kagen) #44

I’m using Elation, HINT, and Spruce. I recommend all three especially in combination.

(Larry Riddle) #45

Thanks to all for sharing your experiences. We’ve been using Elation EHR but are beginning our transition to MD-HQ. We used Elation for a year and love it for it’s ease of use. We recently also added Hint integration for managing membership/retainer patients, and Spruce for patient communications. The Elation + Hint + Spruce is a very nicely integrated trifecta that handles most of the major challenges for practices.
That being said we’re beginning our transition to MD-HQ, which after much research and trial we’ve determined is a better fit for our type of practice. We’re a direct-pay, integrative medicine practice offering both memberships or per-visit, fee-for-service payment models. We also retail natural supplements, and offer some ancillary services.
MD-HQ is better tailored to integrative/functional medicine, and the customize-able forms options that load into charts is a huge time saver. MD-HQ also offers a native inventory management capability, which is another huge time suck for staff. We intend to retain use of Spruce, though it doesn’t automatically push patient communications into charts like it does with Elation (there’s a manual work-around for now).
No one EHR offered that perfect combination we sought - ease of use, customize-able forms, automatic upload of patient intake forms, inventory management, charting tailored to integrative medicine, patient portal, Point of Sale capability for retail transactions, recurring billing management for retainer patients. Obviously a lot to ask of any vendor. IMO MD-HQ comes closest when combined with some other, third-party offerings (eg: Spruce, Hint). We’ll continue to look for that pink unicorn as we scale and learn more about the market.