Active Forum Topics | Getting Started | Interviews | EMR Forum | Medical | Billings | Press & News | Voice Recognition | The Water Cooler
We are a 10 doc /3 office practice that is going from dinosaur Penchart to e-MDs. We were supposed to go live a few months ago but we are huge issues getting our data converted (it ain't going work) and getting training. We are a very EMR established practice having started using tablets and our EMR 5-7 years ago. We have pushed back our GO LIVE date 2 times already.
Were are now on our 3 project manager and we are just finding out that our data won't port well to e-MDs. We new it won't be great but it took a year to find out how unsuccessful it will be. e-MDs wants to train us but they do not want to look our current workflow to see how customize e-MDs to fit our current methods. "This is how we do it". Our practice has 40,000 patients and 10 doctors (some of which are old school and have a hard time learning a new way).
I think the software is going to be great but our trasition to is is more painful then we ever thought.
Anyone have same experiences with e-MDs specifically?
Are there similar experiences with many/all other EMR conversions?
Our frustrations are the we get new answers with each or our 3 project managers, the original sales person "is not longer with the company", 3 rd party conversion company is much less helpful they previously thought, and e-MDs look looking at our situation to see how best to aid our training.
Thanks,
Phillip B
Sorry to hear about your problems. We had no problems when we instituted eMDs three years ago but we were not doing a conversion as it was our first EMR the whole practice used. I used to use Praxis to create notes that were put in paper charts before we got eMDs so importing those notes was not a problem using Docman. Hopefully someone from eMDs will see your message on here and help you out as bad press on the Internet usually gets things moving quickly with all EMR companies. Most EMRs are somewhat rigid in regards to workflow. If you wanted an EMR that would adapt to your workflow as it is now you may have made the wrong choice in EMRs as eMDs is an older EMR in regards to architecture and thus has limited ability to be modified. There are EMRs that you can customize to your workflow but it will cost you to have the EMR company to make those modifications to their product. Converting data from older EMRs usually does not work and it is usually best to just import the notes in tiff or pdf format if they can be exported that way from your old EMR. The other problem you will likely to run into with eMDs is linking 3 separate sites to one server since eMDs uses older architecture than some newer EMRs that are more web friendly. You will likely need to uses Terminal Services which will add to your costs and is a little slower than being at the main site.
Bryan D. Uslick, MD CFCDD (Gastroenterologist) eMDs user since 3/3/2006. Currently using version 6.1 (Prior Praxis user.)
Provation MD endoscopy report writer
Thanks so much for the reply. I appreciate it
You bring up an interesting question regarding linking 3 sites. How are the sites being synched?
The reason I ask is because we just linked 3 sites in October. The docs described what they wanted, including the speed of a separate SQL Server in each facility. They also had a billing office ( as the center or hub). They previously used a single server with Remote Desktop as the means of communicating with a central server. They were not entirely happy with that arrangement and so wanted to embark on a SQL Server in each facility. Additionally, they did not want all encounters synched to all facilities daily. Instead, the 3 offices synch to the billing office once daily. Pt demographics get synched from that hub outward to all offices daily just in case a pt should visit another office.
So the underlying theme was speed-- each office has its own server; pt encounters originating there are stored there + at the billing office, but pt demographics are synched to the hub and from there back to all 3 facilities. It's all automated. If a pt visits a different facility than the original, the demographics are already at that alternate site and so the additional encounters can be synch with a button press to insure contemporaneous info.
What they did not want is to have all encounters stored at each site because there is not enough cross visiting among docs to warrant it, but they did want to be able to transfer encounters quickly when the need arose.
How did your group approach the problem with 3 offices?
Matt, how much does running 3 separate SQL servers increase the upfront and ongoing costs?
I am not "total tech" but the plan is to have a central onsite server (or two) and connect via terminal server or Citrix. I think more than likely the Citrix solution will win out for the providers and TS for regular office staff. We have not gone live but I have been testing the server and so far so good. But when we have 80 employees up and running I am not so sure.
Bryan,
The group had 3 facilities on one server and then went to 3 new servers (64-bit Windows 2008 with SQL Server 2008; 8 GB of memory).
We happened to send out a survey to some of our users regarding cloud computing and its associated costs-- sort of what the market might bear as we've had an interest in it. The physician heading up this group responded in a similar fashion to almost everyone else-- Why would we want slower speed now that we have this infrastructure in place? Only 1 physician owner had an interest in cloud computing. They liked the speed and having control over the data.
The characteristic pattern on a new server install is the IT guy comes in, puts the infrastructure in place, comes back in a couple of times over the ensuing 2 weeks and then disappears into the ether for a few years. Once a network is setup properly, it needs surprising little tuning. For example, a facility running Medtuity ~7 years is just now replacing their Windows 200/SQL Server 2000 box (a busy place too. They've had their IT people out no more than once per year, I'll bet, over the last 7 years. Another group with 7 facilities does not even have an IT person on their payroll despite a server at each facility. The important point is to set a server up correctly at the outset.
Flip Burrer: We are a 10 doc /3 office practice that is going from dinosaur Penchart to e-MDs.
We are a 10 doc /3 office practice that is going from dinosaur Penchart to e-MDs.
You might want to contact Cyath.
He's a Penchart man.
Yea. It is hard to move data from one standardless EMR to another.
Sounds like your deployment is a big one.
I certainly wouldn't Go Live without the data conversion.
eMDs and you for that matter might want to subcontract the data conversion to someone with more skills.
I would contact Graham (gchiu) and pay him a few hundred (?) to diagnose how migrateable Penchart data is.
Obviously he knows how to get the data into Synapse, he'd probably have to research getting the data into eMDs.
One thing I know for sure is ...
The cost of re-entering the data for 40,000 patients is worth 2 million dollars of staff time !
And 5 million in heartache !
There are data conversion specialists out there ... tell eMDs to fork out the bucks and pay for it at their cost.
ASAP !
Keep us informed how it goes.
Matt,
Who does the OS patching and who does the Medtuity software upgrades for each facility? Do you do it for them remotely?
Margalit
Margalit Gur-Arie
On Healthcare TechnologyHealth Tech & Policy Bloghttp://www.onhealthtech.com/Health Tech Discussion Board
Medtuity upgrades are done by clicking a couple of buttons (Utilities -- Download). It remembers the last update date and shows a list of updates since that date. Click a button and those updates are retrieved and applied. With a single update from any computer, all updates on all machines are accomplished. The only rule-- restart Medtuity on all computers after an update so that all instances of Medtuity are the same build version.
There are two reasons for upgrading to the latest version-- a user needs a new feature or a bug fix.
The most common OS patching is........Microsoft's Automatic Updates set to "every day".
Thanks for the suggests. I appreciate the response
How does a user know the medtuity update took and they in fact the latest version?
Chris Wilkerson, D.C. Carson Doctors Group TabletPCs in Medicine Editor-in-Chief www.MedicalTabletPC.com Home: www.Digital-Doc.com
Send me a private message or email and I can possibly help put you in touch with someone at eMDs that can help you.
Just to update people...
e-MDs has responded quickly and definitively to this post. Actually was not really my intention to use this forum to grab their attention - but it did. I spoke at length with Jeff Falwell the implementation director at e-MDs. He spent a significant amount of time on the phone with me explaining why my office was having some issues and how to plan for better communication in the future. in fact they gave me Dr. Stearns' ( President of e-MDs) cell phone number and asked that I call if I have any further problems.
While it will take some time to see if the situation improves, I can say that e-MDs responded very positively to this post. Hopefully things will go more smoothly.
If people are interested I will be happy to keep adding to this post with updates. Thank you to all who responded with suggestions and private messages.
~ Phillip Burrer
I'm glad the communication has improved for you. Our 3 doctor office has been using eMD's for 3 1/2 years and have been satisfied. EMR's are still rapidly evolving and we will likely look back years from now in amazement at the compatibility and technology issues we are currently face.
Customer support is a critical issue for EMR's. My impression is that with federal subsidies on the way, the first user group has now passed and hordes of doctors are now buying or considering buying EMR's. Appropriate training of trainers is a slow process and there will likely be a lag over the next 2 - 3 years as EMR companies struggle to catch up with demand. EMR owners can comment on that but I'm willing to bet that is part of the problem you have faced.
Implementation can be hard but once it is running I think you'll like eMD's.
And finally, to answer your question, yes, definitely keep us up-to-date on your progress.
Best of luck.
Alan
PS see if you can get someone there to comment on when they expect the next big version change.