IT Program/Project Manager
Comentarios: In 2006, a 3rd party integrator (no longer in business) sold NextGen to our organization and since this was their first time installing it, the installation and configuration was barely implemented. To mitigate, in 2011, additional Practice Management training from NextGen and EHR Training/template development resources from Ciscon were engaged to review billing processes and create clinical workflows. Thanks to NextGen/Ciscon, we were able to launch the EHR in 2013. Since then, they have helped us make significant improvements to the clinical workflow (customizing templates) and billing processing. In 2016, the NextGen reports allowed us to start receiving CMS Meaningful Use/ACI incentive funds.
Puntos a favor: 1. Highly configurable...an organization can develop/program/configure any template or drop-down list box to tailor it to their clinical staff! 2. Software includes everything a clinic/hospital needs...and with NextGen's MirthConnect product, any interface or integration to another system is possible and easy! Besides the EHR and Practice Management, NextGen provides a Patient Portal, ePrescribe capability, Rosetta and MirthConnect (allowing interfaces to any system like LabCorp, Quest, Immunization Registries.), and much more! 3. NextGen Support is awesome...and if there is a new staff member, just request Tier 2 or Tier 3 support techs so your challenges are addressed quickly by experts in every area of the product! 4. NextGen Training is helpful from knowledgeable and experienced staff who have worked in clinical and front office environments. For any upgrades or projects, or if you are brand new, leverage the advanced trainers for additional training for staff and learning how to utilize/configure the system by having them review your configuration. 5. NextGen Development and NextGen 3rd Party Integrators (like Ciscon) are amazing to work with...If you don't have time to develop templates or learn, contact them to obtain a quote. I have been most impressed with support team at Ciscon! They have been able to streamline Provider templates and save tons of clicks so the Providers just adore and appreciate the efforts! They were also able to train all the clinical staff on the new workflows.
Puntos en contra:
Like any EHR (vs a paper chart), there are lots of clicks for the clinical staff members.
In addition, the graphical user interface was so new to staff, this caused delays in the encounters.
(To mitigate, we spent time, money, and effort on training users as well as building customized templates...This was worth every penny!)
Not what we were hoping for
We have about eight months into this software and are still struggling with very basic issues such as claims not making it to the carrier and reports not functioning to our (or our clients') level of expectation. I cannot report on many fields in the system and despite being told in the beginning that their reporting tool was being enhanced and we could report on individual fields, and spend additional money to export data so we could create our own reports.
Clients are increasingly frustrated with inability to get eligibility checks on many of their common carriers and to get anything much beyond just confirmation of coverage (not outline of actual benefits, etc.) Collections module is clunky and we have not found it to be effective.
On the upside, claims entry is fairly simple, and auto posting is a breeze, as is data entry of patient information.
Puntos a favor:
Autoposting is fantastic. We find it does it correctly close to 100% of the time. When the system cannot effectively autopost, it "flags" the RA so that you can address it individually. When we initially converted, we found that importing patient demographics was refreshingly simple and something we could do on our own without additional costs.
Patient demographics are easy to enter and maintain.
Puntos en contra:
Reporting is completely ineffective. Canned reports don't balance against each other, and it's hard to quantify values. Not much assistance from Customer Service, although they do try to be helpful.
EDI process has been nothing short of challenging. From enrollment issues in the beginning to claims submission and follow-up issues, we are finding as we work AR several months later we're still having issues with some of our claims from early on which can't seem to arrive at the payer, despite acceptance confirmation from Healthfusion/ENS. It's costing us hours of time on the phone and lost productivity. We also cannot actually see the acceptance reports and are told we can't have access to those because they're in larger batches, which again creates additional phone calls and work on our part.
Dermatology Office Using MediTouch's HealthFusion for nearly 1 year
Comentarios: In 2015, I spent countless hours reviewing/sampling one EHR after another to find a good fit for what we needed/wanted in an EHR. We were moving from paper and wanted a cloud-based solution. As a dermatology office, we absolutely need the ability to document patient's skin findings on a diagram. HealthFusion was one of the few that gave this ability and even allowed us to upload our own images which we have designed for quick easy use. Most dermatologists will utilize a more derm-specific product such as Modernizing Medicine's EMA, PracticeStudio, etc, however, another criteria we wanted in our EHR was something that was truly platform-independent and browser-independent -- could work on a ChromeOS computer, a Mac, a Windows machine, Firefox, Safari, Chrome, Edge, Internet Explorer, etc. Again, MediTouch's HealthFusion EHR & Practice Management product provided this capability while other derm-specific products did not and continue not to. We also do our billing in-house and wanted a robust billing product. MediTouch is their own clearinghouse which is a big benefit so when there are issues, we don't hear from our vendor "Oh it's a problem with the Clearinghouse", instead MediTouch customer service tells us "Oh we need to fix that". Customer service is overall very good - it is here in the United States (Pacific Coast which is our local time zone) and available relatively quickly. So why not five stars? Well, the EHR itself is not designed very well for a specialty-specific practice like ours so we went through a process of customizing it for our needs. We are happy that customization was available however it was a daunting and time consuming process. While the EHR system allows for some meaningful use and PQRS measures it does NOT collect data for specialty-specific measures so it's basically useless for our PQRS/MU/MACRA reporting needs. Which is very unfortunate and might force us to move to a derm-specific product.
Puntos a favor:
Platform-independent (works on ChromeOS, MacOS, iOS, Android, etc.)
Browser-independent (works in Chrome, Safari, Edge, Internet Explorer, Opera, etc)
Cloud-based with no need for specific hardware/software in-house.
Local to our time zone (Pacific) with U.S. based customer service
Clearinghouse is in-house with the vendor
Speed of operation - there have been moments when the cloud-based
Puntos en contra:
Lack of specialty-specific Meaningful Use, PQRS, and MACRA measures
Need for heavy customization for the purposes of documenting specific scenarios (specialty or otherwise)
Extra components within standard documentation unnecessary for most specialties
Integration of PM and EHR could be a bit better
Just as bad or worse than any other EHR
Puntos a favor: communicates with my billing company, but I could just fax a superbill just as easily. does insurance eligibility checks, does eRx (but is often difficult to find the pharmacy unless you know the exact zip code, sometimes doesn't find the pharmacy at all, like Safeway's)
Puntos en contra: Wow, there is so much not to like... Word searching for ICD10 codes, past medical history and problem lists returns hundreds of search items that have absolutely nothing to do with the words being searched. Also, if you enter the words out of the order in which they would appear, you will never find them. Social History is much more than whether a person drinks alcohol or smokes. There is no way to put in valuable details of a patient's social history and automatically include it in your notes. A lot gets lost by having to adhere to some stupid engineer's formatting. Same with past medical/surgical/obstetric histories-you cant add any valuable details to anything (like which knee was replaced and what happened after their concussion, etc). The charting is so useless that I have given up and gone back to paper charting. I start an encounter just to put my billing through. Health Maintenance: I can't enter that a patient refuses to do a colonoscopy or mammogram. All I can do is "disable" that patient from being counted for meaningful use. Poor formatting: while they tout being iPad friendly, each page has lots of unused space, so there is a lot of scrolling just to enter data or get to the save button (and if you don't press save, you lost it). More poor formatting: entering vitals->information is so spread out that it takes two screens to enter. AND peak flow is on the first screen while height and weight are on the second "additional information" screen. Which is more important? Also watch out for the backspace button, sometimes it works like you would expect, and other places you will get logged out and lose all of what you were doing.
I must be missing something....
Puntos a favor: It does have medical diagnostic tools like the Vanderbilt already included as well as an Asthma action plan/Asthma control test and several other questionnaires that are rather necessary in primary care as well as collates the information (i.e you can compare today's Vanderbilt score with their last Vanderbilt score without having to hunt down that note). However, true to NextGen's form, the things that worked really, really well (like having the school physical form be automatically populated with the vaccines), they have somehow succeeded in completely screwing up, making the very, very few good things about NextGen a rapidly diminishing anomaly.
Puntos en contra: Where do I start??? Having to input data several different locations, it is SLOW and every single thing you want to do has to open a new window (read between the lines and understand that in an already slow program, every page you open has to load) and with all of the windows you open, there's no way to minimize them to go to another screen i.e you can't minimize the medications so that you can review the patient's last lipid panel, TSH, blood pressure, etc. You would have to close the medication module, open the orders module to review the lab then go back to the medication module and open it to make any medication changes. And if you want to make any medication changes or do any documentation at all, you have to have an open encounter and none of the encounters are labelled in any sort of orderly fashion so you have to open each encounter to find out where you put anything (again, think of each page having to load/open and taking 5-10 sec each). Medications: you have to associate a diagnosis with every single medication if you are a provider which is an awesome idea except that if you haven't previously entered that diagnosis, you can't actually save your medication and go back to it, you have to close out of the medication module, enter the diagnosis into the assessment and then go back into the medication module and re-enter all the same information again. Labs: there is no way to save quick phrases or phrases you use frequently so that conveying test results is, on a great day, a lengthy and painful process. Also, if you want to know how your current lab value compares with the previous ones, you have to open up the patient's chart and go into the order module. Entering orders: again, if the proper diagnosis isn't there, you can't save your work and open something quick to pop the diagnosis in, you have to lose all of your orders, "X" out of that screen, open up the assessment screen then go back to whichever area you were in (another lovely thing: everything is separated so putting in lab orders is separate from putting in diagnostic studies which is in a different tab than putting in referrals which is in a different tab than any clinic orders (like toradol, PPD, u/a, etc). Also, if you are ordering any sort of medication to be given in the clinic (like Toradol), if you forget to add that it's a medication, it deletes the order and you have to start all over. Various names depending on the section: sometimes it's filed under Pulmonary, sometimes it's filed under Lung, sometimes it's filed under Respiratory...and the sections aren't in any kind of order either. The routine way physicians document an exam is starting with constitutional and working your way down. Nope. Not in Nextgen. The main page of the physical exam has One Page Exam, then constitutional, then diabetic foot exam, then ears, (separate from) nose/mouth/throat then neck/thyroid then breast (huh????) on down. However, if you open up a quick-note [great concept if it worked but the software doesn't actually recognize anything is in any particular field (i.e. HPI, Physical exam) and ROS doesn't even save...so if you try to calculate the code it always comes up as a 99212)] and you want to modify the exam at all (because if you go into the one page exam and enter anything, because it doesn't actually recognize there is data there, it deletes everything except what you've just entered) you go into the "Additional" tab where the headings are (I kid you not) Neck/Thyroid then Breast then Psych then Ears then Constitutional then Respiratory then Nose/Mouth/Throat then Musculoskeletal then One Page Exam then Cardiovascular then GU then Abdomen the Skin/Hair then Head/Face then Eyes then Lymphatic then Vascular then Extremities then Rectal then Back/Spine then Neurological and on... The ROS starts with Cardiovascular and marches on down to end with Respiratory and then Vascular and one might think it was alphabetical except Reproductive is sandwiched between Immunologic and Metabolic/Endocrine. ROS: Since I brought up the review of systems, let's stop there for a moment. There are not things listed that a patient would say; they start out strong but then in Respiratory they include things like "Known TB exposure" (not really ROS but rather PMH or even HPI) and under Cardiovascular they include "Claudication" (not likely something a patient is going to complain about) and my personal favorite, under the female ROS is "Abnormal Pap smear." While there is the ability to pick "Other," most often the drop down menu that is supplied is a restatement of the things in the first menu so you have to hit escape and just type in your own words (or the patient's words). And on top of all of this, it has the audacity to be glitchy. One of the things it does for me is, even when I've entered an assessment, sometimes it doesn't recognize that it's there and then tells me to enter an assessment...news flash: because of the way the software is set up, you can't enter a plan without an assessment there, so if I got to the screen where I could enter a plan...clearly there's an assessment there...however, you can't argue with a computer... I titled this "I must be missing something" because if you go to their web page, they've got all these awards that they've won, etc and I just don't see how anyone could award them for anything. This software is abysmal at best and, if I leave my current place of employment it will be because of THIS. Not my boss, not the patients, not the money, the EHR. And this was adapted because the Illinois Primary Health Care Group that is over all of the FQHCs thought that this was the best option for Health centers that are taking care of a challenging population who needs things to be easier for them not more challenging. And with this software, I am more likely to miss things that need to be done because EVERYTHING is on a separate page and with 15 minute visits, who has time to do all that with a slow EHR??? Funny thing is, there's an update that may have fixed several of these issues but you can't task anymore so we can't upgrade. That would mean that every time you needed your nurse to do something, you couldn't send it to her, every time you wanted the front desk to schedule something you couldn't send it to them, every time you needed a follow up lab or test ordered, you couldn't send it to anyone to call the patient and do it. So either I'm missing something HUGE or the people who are evaluating NextGen and give it anything better than "Epic FAIL" are either working for the company or involved with someone who works for the company. My new analogy has become: if I did my job as well as they did theirs, I would be in prison for Manslaughter....
Great potential, but needs some improvement!
Puntos a favor: They are improving the product consistently. There have been two product updates since we started with them in March. Customer service has improved greatly as well. 99% of the time someone who picks up the phone and helps you with your problems. They have daily webinars that are free of a particular topic, so you can log in, ask questions, get help, and then log off. The product has a lot of great things such as ease of sending the charges from the docs to the billing department, seeing the exact statement that a patient received so you can talk to them more intelligently, getting lots of detail on the claims, rescheduling a patient from one day to the next, and blocking a portion of the schedule or opening a portion of the schedule.
Puntos en contra: You can submit issues via email, but once they respond back, they close the case. Even if they didn't give you the answer you were looking for, you then have to email again and reference the case requiring you to print everything to keep track, because there is no way to follow the status of your case. If you submit feature requests, there is no way to know if they are working on it, aren't considering it, holding it for a future update, etc. There are specific reports that you can get, but if you need something that's not pre-built, there is very little way to obtain the info, if at all. I requested some kind of report writer. The reports all come out as an Excel spreadsheet which is good, because it allows you to manipulate and move around the data, but when you print it's very unwieldy and not pretty. They need to have a way to convert the report to a PDF format once you have it the way you like. Many of the reports don't offer options such as picking providers, locations, payers, so you have to manipulate the report after it opens to delete what you do not need, which is time consuming. The software is extremely dependent on location, which means everything you do has to be done by location creating a lot of work. If you have many offices, your docs do surgery in several locations and they are outpatient or inpatient. Changing or adding something has to be done many times, because you do it by location. It would be easier if there was a drop-down listing your locations and you only had to check the locations to which your additions or changes were applicable. Parts of the software feel as if they are too structured and everything has to fit into their predetermined way to do things. There is not enough flexibility and leeway to change portions that suit your practice. Vendor training was not great when we started and we paid for an outside vendor that works with Healthfusion to come on site and train us. I understand that the help and training portions have changed a bit since then and may be better. It has great potential if they would open up the software and be more flexible!
Professional billing service review of this software
Puntos a favor: What I like best is that it is cloud-based. I also like that I can scan and upload documents to the patient's chart, and when you pull up a patient, you can pretty much see all the information on your patient regarding demographics, insurance, authorizations, and what is outstanding.
Puntos en contra: There are many things I do not like about this product. Posting secondary payments is a hassle. You end up having to manually post most of the secondaries because this software gives your claim a new ID each time the claim is submitted. Even if paid by the primary and you create a secondary claim, there's a new claim #. This causes the secondary ERA payment to not know where to post the money. The claim number should stay the same for the life of that claim. Also, they tell you that you can look up the claim easily when posting a secondary claim by doing an advanced search by the patient's name. Most of the time, this is not the case. You end up having to click on multiple pages to find the claim number so you can post the payment. I also am not a fan of the reports and the lack of filtering. Our sales guy told us that the software reports could be customized and if there was a report we wanted, we only had to ask. If there was an enhancement we wanted, we only had to ask. However, I can't even pay for a report or enhancement. When I ask for any enhancement, I am told it is not possible or that it will become part of the list, which never gets looked at apparently. Even the most simple request don't happen. For example, if an authorization is not active any longer, this should not print up on an authorization report forever. This causes the report to become gigantic. They will tell you that you can filter these things out yourself, but that is extremely tedious, especially after using the software over a long period of time and especially if this is a report you need to use every week. Another thing about the reports is that many of them are not live. If you do work today, you can not see what is accurate until the next day. The reports will show you what was what as of close of business yesterday. Also, the salesman told us that they worked with almost every insurance company and therefore we would be able to check claim status, track claims, check eligibility, referrals. This was a large exaggeration. They have maybe five insurance companies that can do 1/2 of that. Customer service is sometimes slow to respond, and they usually don't give very helpful answers when you send a written inquiry. The best thing to do is to call. But even then, they might not be able to help you because what you want, they simply don't have available. Also the fee slips you will have available to use from their system are terrible. The options are very limited, and the font is extremely small and hard to read. I am a billing service, and all of my offices complained. When I asked if the font could be enlarged, I was told no, even though there was much room on the slip that was not used. Training on this software was pretty much train yourself. You are allow three one-hour phone training sessions. You are given a lot of homework to do on your own first. If you can not make your appointment promptly, they will cancel it. If you are at your appointment but waiting on them, that is a different story. You have to do much of the setup with this software on your own, and it is not as simple as they would have you believe, especially exporting data from the old software to the new. They will tell you that if you can use an Excel spreadsheet, you can do it yourself. I had expert Excel spreadsheet staff do this for me, and it took forever to get it done. It was a nightmare and very expensive. This is because there are many requirements that are very vague. They offer pretty much no help. If you have to resubmit a claim multiple times, all the claims get new claim numbers, and the claims you do not want stay in the claim history. This causes what you are looking at to be confusing. Even if you just have to resubmit a claim because the insurance says they do not have it on file, it stays on claim history with a new claim number. Finally, when you have your insurances loaded in your payer list, they do not load with the addresses or phone numbers. You have to do this manually. Even when you do this and you want to print your aging report or work, the report shows without the insurance phone number or address. This is a large inconvenience when working your aging. It is also very hard to separate your insurance companies.
Comentarios: We are a single physician clinic in rural Texas. My physician is also my husband, and he is a board certified Family Practice osteopathic physician practicing in the same clinic for almost 30 years now. Our clinic is busy, and my staff is small. Employees are cross-trained in medical assisting and clerical duties and often cover each other depending on patient needs and/or staff absences. Having MediTouch PM software has given me a peace of mind, regarding patient care business needs, that I never had with prior computer programs. The system gets the insurance information correct and the insurance forms completed so much better than anything I've used in the past 15 years or more. I have less missed charges thanks to the patient page showing the listing of a patient's office visits. If the charges have not yet been entered, there is an "ENTER" beside the date just waiting to be clicked. This better assures the correct dates are posted. Staff uses the recall options to follow up on patient care and schedule future appointments with less chance of letting a patient slip by without follow up. The Electronic Remittance Advice documents are wonderful - no more paper and everything in one place. The search options allow us to go back to anything as needed. Automatic posting saves time and frees staff for other tasks. At present, we are operating with one less staff member as when we first began to use the system. As the physician's manager and wife, I appreciate that I can work on this day and night (for better or worse) without being tied to the clinic building. I am here at my home desk completing this review right now. I can finish posting claims, follow up on denied claims, generate and print statements all without carrying home boxes of papers. Having the data for both management and health records stored off-site is a blessing to me. The constant fear of system crashes and failed backups is over. I do not have the burden of upgrading to newer and more powerful servers at the clinic, but can use money to by better single computers that can connect with HealthFusion remotely and not to a central in-house server system. I am still learning many aspects of the system, and anything not yet learned is entirely my own fault as HealthFusion has improved the training materials greatly over the past year. They are now easy to find and access. My time is all that needs to be planned because they have done everything else for us. Reports are available if I want them, too. I have seen our clinic income increase; payments come more quickly and less error thanks to the MediTouch PM system. Whenever I do find areas that I think need attention, the customer service is quick to respond and have taken my suggestions into implementation on a few occasions. They are very personable and professional whenever we call, although I tend to use email when possible. The replies are quick and complete. We signed up for the programs in November 2010 based on promotional programs that were offered via the American Osteopathic Association. We didn't jump in to actually using the product until the following June when e-prescribing was required. If I could go back, I would have started the programs' use much earlier. I was simply afraid to jump in and leave our old systems behind. To my surprise, the transition has been easy. Thank you very much for the chance to share this experience. I do not mind providing more details if needed.
I love MediTouch PM Software
Puntos a favor: I love the A/R features. I love how fast I get paid by commercial vendors. I love how intuitive it is on helping avoid claim issues. I did not have any issues with implementation. I have had nothing but good experience with support. We have had this EMR for over a year (and I have dealt with a few) and this is by far the best I've used. We have not had any issues with it going down. We have called when we have thought the system was down and they have guided use through issues with browsers, internet speed etc. So we were always glad we called, problems solved when we thought it was on their end. Yes, claim eligibility check is only on some providers but if you get to know how to use it more in depth it can be VERY helpful in further info not just for eligibility but for knowing primary care provider etc. I have had ZERO issues with auto post and yes, I have double checked. I also really like their statement service, I review each statement before I "send" them to them to send for me but no more issues with bad addresses etc and well worth the money. Their "help" section is great. The help sheets are AWESOME. I email support more than I've ever called them and they send me helpsheets when I can't find them.
Puntos en contra: I would like a better way to weed out the non paid lines with auto post instead of dumping them all to the appeal bucket. I would like to be able to attach a claim to the billing comments and be able to send them to another employee to review. I wish that I could upload our own forms to save in the system- I do not like the forms library at all, pretty well worthless to us, I would like it if I could upload, name our files and use it that way.
Wish I had chosen another EHR. Not happy !!!
Comentarios: I really think that HealthFusion must have paid the AOA a huge sum of money for it's endorsement. This software was NOT ready for prime time when the AOA eagerly endorsed them a few years ago. Their support takes forever to address a work ticket. We have asked for some simple changes and updates and 2-3 years later, they have still not been addressed. The Verizon secure ID app for electronic prescribing of controlled substances is ridiculous. After 3 years of using this program, we are too heavily invested to easily switch......but I think it is time to bite the bullet and do it.
Puntos a favor: When it works, it is fairly fast. Support has improved somewhat since Nexgen took over. That's about it.
Puntos en contra:
Too much down time / slow downs. It improved a bit several months ago, but has been giving us problems again lately.....not as bad as it was 6-8 months ago, but still too many bad days. No ability to access records locally if their server is down.....not even for read-only. The company has been unable to support, or have refused to support the ability to have redundant read-only data at the client's site. So when their service is down, your practice is dead in the water.
No ability to view schedules or charts......nothing. Totally unacceptable.
Tracking the patient's prescription history is needlessly complicated, as is the Problem List. The company could not have possibly consulted actual working physicians when they wrote this program. Their electronic prescribing of controlled substances and the Verizon UIS secure ID app is slow and clunky. Even worse, Verizon has locked me out on at least 3 occasions and I have been unable to e-prescribe. And NO, it is NOT user error. The verification process to get re-credentialed is redundant and confusing. Furthermore, there is no way to directly deal with Verizon to solve the issue.....the on-screen message says "Do not contact Verizon directly.....contact your EHR company". But when I do that, it takes DAYS to get a response.
We have been on Nextgen since 2009. We are a pain specialty. We had MAPS templates for paincare we
Puntos a favor: The customizations that are possible. WE are a specialty so it is important to capture the data, that is not always PCP. We have needs for rx report to be integrated which is coming in the new upgrade. We need to interface labs so doctors have quick and easy access to results. We have a responsibility to the community to keep them safe from people misusing or selling their medications. The templates and documents are easy to customize. The Nextgen support is helpful. We are excited to hear what the future hold for paincare, through their VAR Itelagen. The integration between EHR and EPM is coming along. Interfacing with labs, HIE. The reporting is made easy captured in the back ground for MIPS. They provide access to websites to become experts in there system. The help desk is not afraid to say if they don't know something and direct you to someone that does. The hosting is made easy. We are told it will be a 30-45 day transition very excited. The application has come a long way in looks it has been designed to be easy to access, it has shortcuts that only need to be hovered over to see data a quick glance. The Patient education was a nice add. It is user friendly and attaches to the encounter as a record it was done. The clinical reconciliation is a great add and makes things easy.
Puntos en contra: I wish the upgrades were easier. oTHERWISE i AM VERY HAPPY WITH THE SYSTEM.
NextGen has been easy to learn and has grown with the changes that occur in the medical field.
Comentarios: We transitioned from paper charts to this EHR. The process was challenging but nextgen navigated us through all of the ups and downs it takes to get through scanning paper records and training staff. We have improved all processes since the initial implementation. We have from scheduling on the front end to the billing and statements on the back end we improved those processes. We took our antiquated tickler tab system for prior authorization of our outpatient surgical procedures and moved it to an electronic way to tracked, authorize and then schedule procedures. This cut down on any procedure being schedules before it was approved. This help improve revenue in the long run. The benefits of patient portal are still being realized. Patients can communicate with office staff on their own schedule. After implementing online billing and payment options our payments on account have increased a great deal.
Puntos a favor: The ability to track authorizations using tasking and worklog as patient portal and how the messages easily populate into the front desk inbox. Patient portal can easily route the messages appropriately. And last, the ability to customize it to the needs of our specific practices slash specialty!
Puntos en contra: The ongoing upgrades although I know that is necessary for any EHR. Also there is no "reschedule" option for appointments. You can cancel then rebook and look at reschedule history but I personally like a reschedule button then follow the sequence needed.
Comentarios: We are a relatively small 6-provider midwifery practice in Anchorage, Alaska. We used Lytec for years, but wanted to move to something web-based that was highly functional, but also affordable for mid-level providers. HealthFusion stood out as one of the only companies that was willing to differentiate in pricing between a group of MD's, and a group of NP's and midwives, as the difference in the amount of reimbursement is obviously significant. We found the [slightly more time-intensive] self-serve training process to be well worth the savings in up-front costs, which was another big difference between HealthFusion and other players in the market, like Advanced MD and NeuMD, to name a few. We find it quite easy to use, on the whole. We appreciate the fact that when we do make suggestions as to how to improve certain processes or interfaces, our suggestions tend to be adopted, or at least addressed by the engineers, via customer service... And speaking of customer service, theirs really is excellent, as their salespeople will of course tell you. Our calls are always answered promptly and our issues dealt with promptly - plus virtually everyone on their CS staff is extraordinarily pleasant to talk to, so calling CS is never a chore. I also like the fact that their sales people stay in touch with the customers, so I can always call Greg and get the same level of attention that we did when he was trying to make the sale, which I've discovered is quite rare among other companies. The only gripe we might have - and I have no way of knowing whether this is unique to them or par for the course among web-based software providers - is that the site does go down or experience difficulties about once every other month, but usually only for a few hours. Certain processes like posting insurance payments take longer with HealthFusion than with our old client-server software, but that is also partly because our old software just let you input whatever you wanted, whereas HealthFusion has you posting the actual insurance checks before you can apply the payment to claims so that they are linked and verifiable. This is but one example of how their PM can be more time-consuming to use, but is much more rigorous from an accounting and audit standpoint, which is good overall. I trust the numbers that come out of HealthFusion's PM much more than Lytec's reports for things like outstanding A/R and productivity numbers for each provider. I've had an easier time staying on top of aging claims with HealthFusion than I used to with our old software. Overall we are very happy with HealthFusion's PM, and are just now starting the process of integrating their EMR into our practice.
I've always been intrigued with the idea of automating as much as possible in the doctor's office. In addition, I am very compulsive about the quality of clinical note that I write. Over the years this has created circumstances where I would get behind on my documentation simply because I didn't have the time to write a quality note until the weekend. I have spent a very large amount of time off work on completing these charts.
I saw MediTouch at a Texas Osteopathic Medical Association meeting and was fascinated with the scope of it's abilities in practice management and medical documentation and the relative simplicity of its use. The reasonableness of the cost was also attractive to me, particularly after going home and calculating the amount of money I spent on printing, mailing, and licensing fees for my checklist medical record system which I was using at the time. I was amazed to find that it saved me $1500.00 a month by a conservative estimation; not to mention improving the accuracy of my insurance filing, and the turnaround time of my payments.
The responsiveness of the people at HealthFusion is also quite good. If there is an issue, there are multiple ways to get in touch - including after-hours emergency contact ability, which I have actually used once on a Sunday night. My problem on that occasion was resolved almost immediately.
Implementation was a major learning curve as we did it on the fly (as we had been encouraged to do), and while this was extremely trying, it did speed the implementation process along quite well. The fact that the training program is on the Internet and easily accessed is quite good; although, as a constructive criticism, the training program actually could benefit the user if it were streamlined and changed from the format of hour-long lectures.
I love walking into the treatment room with an iPad under my arm and not having to leaf through six-inch thick charts to find last year's laboratory work or an x-ray that I need to compare to this year's.
I really love ePrescribing in the patient room to any pharmacy in the country, and knowing a call back will not occur because the pharmacist can't read the prescription. The first year we started using the system, I was on a Mediterranean cruise and refilled some prescriptions using my iPad from a lounge in the ship because I could.
As for my documentation compulsion, I dictate personalization nuances into the available visit templates in MediTouch using Dragon NaturallySpeaking (which I have been training for over 8 years). I walk out of the office with all of my charts done, and all of my insurance claims completed almost every day.
User since 2011
Puntos a favor: The EMR portion of the program is very easy to use. You can access it from anywhere to work. I did my billing from the Bahamas one year. It makes meeting the meaningful use criteria very simple, and does most of the work for you, where other programs are much more difficult and too time consuming. The monthly price includes all updates and support, which is very reasonable. They have a great learning site and you can access the information on updates at anytime.
Puntos en contra: The billing portion of the system is not up to par if you live in New York State. It does not have a compatible NYS medicaid form, but will charge you if you want them to create one. It's secondary billing posting is awful if it is not able to be auto-posted, which is mostly because of New York State insurances. You have to manually look up in each account a secondary claim number you need to post it to the insurance payment, then go back into the posting module to actually post the payment. You have to create and send each claim individually to insurance companies, unless you want to pay more for them to create batch files. If customer support is not sure about something and they tell you they will get back to you, several occasions I never heard anything and had to repeatedly call back to find out the status.
I am a Pulmonologist in a busy private subspecialty practice. I have experience using several diffeent electronic health records. Our practice has been using the NextGen product for more than 7 years--so I can speak as a battle tested user of this product. There are certainly some advantages to using any decent electronic health record including access to outpatient records across campus, handling of phone calls, archiving of information, etc. However, the NexGen product has a long, long way to go to catch up. For communication with other physicians the product is atrocious. Computer generated notes are laden with typographical errors, grammatical errors, truncated sentences, and at times gross inaccuracies. For instance, our current template for physical examination puts no output into the office note for the pulmonary exam (and this is for a busy pulmonary practice!). Here is a recent example of text from a COPD follow up note template:
Reason(s) for Visit:
1. COPD - routine follow-up -The patient is seen in follow-up for COPD. The COPD - routine follow-up began since the last office visit. The COPD - routine follow-up has worsened. It occurs daily. The patient rates the severity of the symptoms as mildly severe. Symptom is aggravated by moderate activity. Symptoms relieved by resting and sitting. .... On top of this there are nonsensical changes of font size and style in midsentence that make office documents look like ransom notes. I care about the quality of my written work, so I literally spend hours each, most of our template improvements are wiped out. In my view, NextGen was clearly built first as a billing instrument, not as robust tool to promote all aspects of physician practice. The awards are certainly not for the quality of office notes or layout of screens for the enduser. Labs do not import into notes. Micro reports are difficult to read and necessitate scrolling through multiple windows. Data trending graphs are clunky, improperly scaled and often misplotted. As a practice group, we have tried to work with the NexGen programmers and have been very dissatisfied over 7 years with their lack of responsiveness and seeming inability to fix identified problems. Often when one problem is solved many more are created. As a result, our practice has invested a large amount of funding to support a local programmer to try to correct many of basic flaws in the software that should be part of the package out of the box. Unfortunately, with major system upgrades most of our template improvements have been wiped out.
Clinically Useless. Lost Productivity. Cryptic data entry/retrieval
Puntos a favor: The product support was horribly useless. The techs and their supervisors knew very little about the product. The Nextgen system itself is the real problem though. It takes so many clicks to perform the very simplest retrieval of information or data entry. The windows to see information or enter are tiny, 1 cm in height and cannot be adjusted. After a full year, our office of 4 MDs and 3 NPs (all tech competent) were still only able to see 10 patients per 8 hour day, and still spend time after hours to document. Awful. In all honesty, I cannot find one redeeming quality to this EMR, compared to any of the others I've used extensively or on its own.
Puntos en contra:
The answer to the problems were always: "It's being addressed in the next version roll out". This is a half-baked EMR. It's use is a danger to patient care and a real liability. We abandoned it.
The system is intended to have the clinician enter all HPI, IMP and Plan by point and click check-boxes. If these are not used, then it does not collect meaningful use data. However, the clinical utility of the text it generates is so generic, so hard to generate, and so cryptic that it is of no use to retrieve the facts of the the case. The only way to enter your thoughts, history or plan is to free text it (in addition to the mandatory point and clicks), doubling your work.
It doesn't even have a way to carry over information from past notes HPI or plan, so that it can be easily adjusted.
Wide improvements over the last two years
I've been working with NextGen EHR in a clinical setting with multiple specialties since 1999. As a Health Informatics EHR consultant, I have the opportunity to support practices internationally and am exposed to numerous EHRs. NextGen is amongst my top 3 favourites.
PROS: NextGen is fairly intuitive. It is easy to navigate through an encounter and locate the tools you need to manage your patient's care. The EHR offers a progressive workflow so you won't need to jump around between disjointed tabs or sections of the EHR to document an encounter or procedure. From one set of templates you can work through an entire encounter with every component readily available - SOAP/APSO, Care Coordination, patient communication and so on. Within easy reach is the ability to order and manage diagnostic and lab tests, immunizations, and monitor preventive milestones. There are many opportunities to view and manage common areas of the patient record so you won't need to jump out of an encounter to review medications, allergies, chronic problems, or medical histories - just to name a few. NextGen accommodates multiple specialties ranging from Primary Care, Behavioral Health, surgical specialties, and optometry and so on. Best of all, there are plenty of time-saving tools that work like Macros ¿ build, then load when applicable to a patient or encounter. This includes frequently reached for medications, phrases, treatment plans, PE and ROS findings...even an entire SOAP note for common complaints. Using these tools is often easier than dictation. NextGen is certified across all Regulatory Healthcare measures.
CONS: No doubt, this is an expensive product. Their implementation process is a nightmare. In my humble opinion, their Implementation process often lacks focus and project plans given to new clients are cookie-cutter and not at all relevant to the client's organizational needs. Milestones and deliverables tend to fall short. Training is oft left to tedious eLearning modules and recorded webinars. This is no way to learn a system as adaptive as NextGen and organizations adopting this as their EHR will find themselves frustrated long after go-live. I can't stress enough the importance of in-depth, workflow specific training, customized to how you do business.
SUMMARY: No EHR is perfect. But, out of the box this EHR will likely serve your needs and, with adequate training, you will find that physician adoption may be surprisingly high.
Comentarios: We are a solo Family Practice. MediTouch is our first EHR system and we saw about eight demos before choosing this one. We loved the PM portion, but were not sure about the EHR. Since MediTouch does not require a long contract or huge start up fees we decided to give it a shot and started using it about 2 months ago. The doctor is still learning to use it and we have installed Dragon naturally speaking for him. The medical assistant's portion is pretty easy, they got it quickly and use it for vitals, medical history, family history, allergies, and social history portions. They have minor problems, like smoking use, it has the option of how many packs per day, but not how many single cigarettes per day. They also document chief complaints, but we are still working on customizing them. MediTouch comes with every possible question you can ask for all sorts of complaints so we have to go in to each individually to select the questions that your doctor would want. If you don't customize, you cannot just leave questions blank or it will not save in your encounter. It's a bit time consuming, but this way you get only the questions that your doctor would ask. As far as the review of system, physical exam and so forth, our doctor has been dictating wherever he can. He is not a great typist so he prefers doing it this way. We have saved his negatives so that he just goes in to change any problems. This saves him a lot of time, but he's not using it for every single patient yet. At the beginning, the doctor thought it wasn't possible for him to use this system, but after some practice he feels if he puts in more time into learning it, he can do it. If you don't want to dictate, the system is mostly clicking, not much typing which I think is good, but if your doctor is not a computer person, this might be time consuming for him. Using a dictating system may help. The diagnosis portion is easy and the Escript portion has been great. If you get a request for a patient whose information is not yet in MediTouch, you do have to put it in before authorizing. Sometimes its difficult to find a pharmacy, unless you know what to search by, but that doesn't happen often. Overall, we like the EHR portion of MediTouch, it just takes practice and time to customize the system to how you want it. I like that it has the capability of making the progress notes, just as the doctor would have in a written note. I think he will be using it for all patients pretty soon.
NextGen is a highly customizable product that allows clients to modify the templates to suit them
Comentarios: I enjoy the vast amount of customizations that can be made with the templates and allow us to use the application as we need it to work today. With the right staff in place to manage, enhance, and support the NextGen environment, it can prove to be a strong asset to your team. The biggest issue with NextGen is the size of the company and how large their scope is--meaning the customer service is usually tougher to deal with than the application. Poorly trained tech support agents paint a very bad picture and make me feel like not reporting or getting involved with reporting issues and trying to explain why the application as a break. It appears as agents are encouraged to push everything to IDEAS and avoid reporting a break in the application. It is a great product from my perspective, I am a Developer and can manage the environment efficiently.
Puntos a favor: highly customizable
Puntos en contra: poor tech support and response to Known Issues and reporting Known Issues
Not as promised.
Comentarios: Colleagues, keep looking; I did many hours of research on my final 3 choices, with at least 4 different presentations on MediTouch to myself, my office manager, head nurse and two other providers. Just can't foresee all the glitches, roadblocks, and problems until you buy it and are using it...kind of like the ACA, right Ms. Pelosi? "Let's pass (buy) this bill so we can see what's in it,"
Puntos a favor: Easy to modify "template" or document on the fly. Scheduling portion is good. Financial reports are good.
Puntos en contra: Average customer support, at best. You get passed from person to person, promised call-backs are usually days later than promised, sometimes do not occur at all.. Conversion not as promised. Medications documentation is confusing, redundant, very inefficient. Does NOT autopopulate labs results for tracking over time (cannot look at flowsheets unless you individually enter each result into the flowsheet, which is ridiculously inefficient), yet we were shown examples of lab flowsheets. Lots of problems with their electronic claims submissions. If I could get out of my contract (after 1 year of use now), without paying for the full 3 years I signed up for, I would do it immediately!
Meditouch EHR in a Interventional Pain Clinic
Comentarios: This is one of the few EHRs that actually turn out looking like a medical note rather than a list after list of repetitive data that is hard to follow and actually see what is going on with the patient and what they are taking for current medications. The note is constructed in the SOAP format so that it is easy to follow. The platform allows customization for office/ASC procedures that are easy to setup after initial orientation and it also allows for multiple options for physical findings in the exam. Care360 is similar in that it is a SOAP note format, but doesn't have a billing component built in and requires Kareo or another billing program that doesn't marry to the EHR easily.
Puntos a favor: Customization, Readability of completed notes, no confusion on problem lists, medication lists, etc. No laundry list after list after list causing you to wonder "where's the meat" of this note that will tell me what's going on.
Puntos en contra: There is a lot of data on the page so it is sometimes hard to read everything on a standard iPad. At my age, I should probably use a "Pro" sized iPad. Other than that, not much.
Comentarios: We are a small medical billing and practice management firm located in the Dallas area. I've spent the last 18 months sitting through demo's of PM and EHR products on behalf of my clients. There are a lot of good products out there, but Healthfusion offered something the others didn't which really fits the needs of some of my clients. It's an All-In-One PM, Clearinghouse, and EHR (meaningful use ready) all for a reasonable monthly fee. There are no huge up front investment costs that take away financial resources that could be spent on patient care. Because it is 100% online, we can use the system anywhere as long as we have an internet connection. Since continuity of information is vital for our service, we love that we can access the front desk schedule and clinical information at the doctor's office in real time. The document feature in the patient chart is a huge help and something we didn't have in our last system. Real time eligibility is a big time saver. The best part about this company itself is their support. I was under contract with a different vendor for many years and my biggest complaint was that they never answered the phone - that's no exaggeration. The monthly support fee was significant, yet I couldn't get the support I was paying for. HealthFusion has been a breath of fresh air. From the Sales Team (love you, Andrea) to Implementation, everything went incredibly smoothly. I spent a fair amount of time asking a ton of questions, which were always welcome 100%. The ongoing customer service has been amazing. The team over there knows me pretty well and are always cheerful when they answer. I love the live webinars because I can always learn something new, hear other user questions, and ask any questions I have. These webinars happen every week! I'm giving 5 stars for all except functionality and quality. There are just a few things that I feel are "missing". To be fair, HealthFusion has been very responsive to my comments and has assured me they are working on adding additional features that I have been asking about. Bottom line is that HealthFusion is making me look great to my clients, it's been fairly easy to learn (after I took the time to do my training), and overall it is saving me a few hundred dollars a month in support fees. My clients and prospects love that I have a product to offer them that won't cost a fortune to get started.
From patient perspective this software is pathetic
Puntos a favor: You can email your doctor. You can see appointments. You can see previous statements. Whoopee, basic functionality that any software can do.
Puntos en contra:
I design and implement software solutions for a living. I would be embarrassed to sell and implement NextMD. My Doctor's medical practice uses NextMD/NextGen. This software is very unresponsive to navigation inputs. When you view areas such as charts (which rarely works when you click on the View my Chart drop down), the data is not user friendly in presentation and it's difficult to retrieve. Additionally doctor will only electronically provide me lab results if I officially request. The documented instructions provided by the software vendor on how to request are totally incorrect and each 6 months I have to figure out how to do it again. When I complained to Doctor's office, they told me many people have had problems requesting their records using this software.
Additionally, their approach to access "security" is the usual standard lawyer bull of threatening statements followed by their technical approach of "What's your mother's maiden name". Wow, something anyone proficient in google can find.
Bottom line is from a user perspective this software is pathetic and not very usable. I find it hard to believe any medical practice would purchase it.
Some good features overshadowed by Rigidity and poor support/training
Puntos a favor: Looks nice, can pull forward past visits that can be edited.
Puntos en contra: Little customization available. The difficulties of this rigid platform are compounded by lack of substantive training resources and poor responsiveness. Customer support is well intentioned, but overwhelmed and understaffed.