I just finished speaking with a client of mine (http://physiciancredentialingservices.com) who we are helping to set up his practice and we had an interesting conversation about EMR/PM software. He said that he was going to use EclinicalWorks as his PM and EMR solution when he opens in January. I was okay with his decision, until he told me that he was going to pay $1,000 per month to “Lease” the system and have it hosted on their server.
He felt that this was an affordable solution for his new primary care office. He told me that he was quoted over 100k from Nextgen, so the 1k lease option sounded like a really good deal. I do not like to single out systems to dissuade someone from purchasing, but 1k per month is not a good deal in my opinion. Oh, I almost forgot, that does not include training which is another 5k. Am I alone in thinking this is crazy? 1k per month in my world will cover the total cost for 4 physicians including licensing, hosting , clearing house fees, and support with one of the best ASP Practice Management/EMR & billing systems currently available. Usability and cost are the most important factors when considering an EMR/PM solution and I am curious if anyone else feels that 1k per month doesn’t pass a simple cost-benefit analysis.
If you are a user of Eclinical Works, can you please use this post to rate your experience with EclinicalWorks. I have demoed the software and was not too impressed with their level of support or response time to my interoperability and work flow management questions. I (and my client) are curious as to how some current or past users feel about the software.
My personal experience has not been that great with Eclinicalworks. We implemented it in our 4 physician practice about 2 years ago and I honestly wish we would have done a little more research before deciding on the right program. Overall I will give them a 6.5
I’m an Internist in MA. I opened up a solo practice in 2006, and was very excited to start with an EMR from day one. I chose eCW but I must say that, after three years using it, I’m very disappointed. The interface is clunky and cumbersome. It’s poorly designed from a user standpoint – too many clicks and screens to get anything done, way too “granular”. Space to enter free text or dictation is very limited. Writing notes takes about twice as long as used to when I just dictated (unless I use templates for every note, which does not fit my practice style).
More importantly, eClinical is lacking a lot that I would expect from an EMR. There is no decision support, extremely limited quality tracking and data mining, no patient reminders. No native support for MCMP/PQRI measures (you could program in “queries” for these measures but it would require designing a whole new data collection scheme as well as fairly sophisticated programing knowledge to create the necessary queries).
eClinical pharmacy support is very poor. Their pharmacy database is years out of date, many of the pre-assigned drug doses and intervals are wrong; and eCW refuses to integrate with established services like Dr. First because they have their own service for which they charge extra.
There is no way to batch review prescriptions, documents or labs – each individual lab test, document etc. needs to be opened and marked reviewed, each separate prescription requires four or five clicks to process. This is very time consuming.
Support (which you are required to buy at $200/month) is poor to middling. Most support requests are ignored or mishandled and then marked “completed” by their tech staff. You really have to keep on them to get any problem handled.
There are all kinds of unexpected “extra” charges they don’t tell you about. ePrescribing is extra, for example (and without it, you don’t qualify for insurance company rebates); and they charge $100 each time you want to install their client on a new computer.
We have also had many problems with document handling, especially their fax software, which keeps crashing and which they cannot seem to fix.
I feel like it was a mistake to purchase eClinical. I am actually looking now at spending thousands of dollars to try to migrate my date manually to a new EMR (since eCW doesn’t support standard data migration protocols).
In my opinion, eCW is a dinosaur and should not be on the market any more. There are other EMR programs that provide far better functionality. The fact that it is still available speaks to the poor job CCHIT does setting standards for EMR products.
What an excellent post. Thank you for the detailed account of your experience with ECW thus far. I have been concerned that many physicians have been bamboozled into thinking that ECW is a cost effective solution for their office. The whole ECW in Sam’s Club is a perfect example of this.
This is one area (Support) that greatly worries me as a former practice administrator. I understand what IT/EMR issues can cause in physician and staff productivity. I have seen first hand how IT issues can delay patient care and cause numerous headaches on the revenue cycle side. I believe (ECW) began outsourcing some of their IT support a couple years ago and there has been a sharp decline in the efficiency and knowledge of their personnel since that time.
ECW is not alone in tacking on additional charges, many EMR/PM companies “specialize” in this technique. They get you in with low subscription fees or reasonable physician licensing fees then hit you with a nice fee every time you want to add a user or need a vital system upgrade. Think of how many offices are going to be forced into paying for the ICD10 coding upgrade $$$$$. Most EMR companies know that the pain of switching systems is too much for most offices to even consider.
I also like that fact that you inept CCHIT is in determining the appropriate standards needed for the various EMR products.
Thanks again Dr. Schamess for the valuable information. I notice that you have some great posts on your site so I have added your site to our blogroll.
Not a fan of eClinicalWorks … they keep blaming our network, when after further investigation, it’s always been their end.
Stay away from eClincialWorks!
Just signed up about 4 months ago, I couldn’t agree anymore with the above points (identical problems). Unfortunately, I am a victim.
For the users who have already signed up, it would be phenomenal if we put our efforts and problem solving experiences together.
http://www.ecwusers.com is one place I’ve gone to find stuff, but I’m not sure if the real information on problem solving is being hidden.
Wish we could file a law suit.
My parent company (i work for their lab) has chose eClinicalWorks for a set of their affliate clinics. They went with this EMR so that they can improve from their flag ship EMR and give better solutions.
I was managing in integrating this EMR with our lab system. After working with several EMRs and HIS systems, this is the worst vendor i have worked. Not very pleasant Currently the whole lab is scared of this EMR.
Very bad experience working with their employees and my parent company IT also agrees with us.
Now we are realizing that the flagship EMR is far better than eClinicalWorks.
Stay away from eCW. Their entire IT support staff is a joke. The recomend 2 application and database servers but can not give you any info on how they are to be configured, they wont configure them and if you have a cluster environment they cant support it. The system is built on a patch work of “open source” software like MySQL and appache web server so they circumvent any software licensing. likewise they will post issues they cant fix to the open source forums for MySQL.
*They constantly upload and install open source or free utilities to
fix you problems and leave all kinds of software and file/folders
cluttered about the system.
*When ever there is a problem it is always your network or server
hardware.
*Every software version upgrade has crashed our system forcing us to
use paper charts for up to 14 days.
*They will schedule times to work on system problems then not call.
*When they do work on your system they always want everyone to log out
and not do any work in the system. (we are a 700 user practice..go
figure that out)
* Their software requires every user have full admin acces/rights to
the system. (HIPPA no no)
In short their entire business is a joke if you have more then 2 physicians.
I am employed by a clinic that just bought eClinical Works. Obviously not designed by physicians who will be using this all day every day. Waaaayyy too many clicks to get anything done. Certainly NOT an improvement in efficient use of my time. Definitely a risk for developing carpal tunnel disorder. The progress note structure does not meet the standard we have used in training our residents…who ever heard of putting the lab and xray orders in the treatment section? And the lab results aren’t even in the notes, only the lab orders are. If you want to see lab results, you have to use more clicks to go to another whole area of the software.This is just insane. The nurse’s clinical goals are put under the History of Present Illness section…we think these should have their own section, and not clutter up the HPI. There is no patient education material, as we had been led to believe. This whole thing is just EMR run amuck. I have used 3 other EMR systems, and this is by far the worst.
I have had approximately 4 years of experience using eclinical works. It is absolutely horrible. I crashes daily and often freezes which wastes valuable time each day. The headquarters in Boston has poor service quality and often doesn’t know how to correct the problem since these problems occur daily. I WOULD NOT recommend this company to anyone. If anyone is considering this product, chose something else or you will be frustrated daily. Worse product on the market!!!!
IT Grunt can you contact me I have some questions we are in the process of implementing this system??? Please as soon as possible.
ymarrero@mitral.com
This is very good company.
I am using their services.my friends are also used their software.
I am an IT consultant, helping a physician with a new office startup, we are looking into EMR and clinical is one of the choices, we have looked AmazingChart and waiting room, I am open for suggestions, please advice.
I put a mouse click counting program on my work computer used only for the eClinical chart work the last couple of days. 3958 mouse clicks to complete only the doctor parts of 40 family practice visits level 99212. Plus a ton of typing to generate the HPI, document treatment and discussions. This is separate from all the clicks required by the nurse to document her parts of the note. I bet nobody has studied the effects of long term clicking at that level of use on doctors’ or nurses’ hands. I know it is making my hands quite painful.
IT Grunt nailed it!! So I joined his team…
I thought I was alone trudging through the muck that is eCW. I can’t compare this application to others, as this is the only emr I have ever used, but eCW is completely awful.
When it does work, which isn’t often, it’s okay at best. The outsourced tech support is a joke!! I open a ticket, wait days to hear back if at all, and when I do receive a response the tech’s main goal is to close the support ticket, not to solve the problem. I have had issues redirected to our server admins and our lab company and EVERY TIME (no exaggeration) the problem is sent back to eCW.
And the CLICKS!!! All day long I hear about the number of clicks it takes to complete anything. I rarely use the system for emr, mostly I am in the system to fix the nonsense that is eCW configs, but when I am forced to partake, I instantly understand the click issue. eCW has tried to offer too many features and in doing so, they have completely ruined there interface.
I could literally go on for days!! But I will refrain, as my ecw lab interface is requiring attention at the moment.
Be forewarned, eClinicalWorks is pricey, difficult, and will require a dedicated IT employee to keep it running. (My own job security is the only eCW pro I can think of
Just a quick comment, general in nature, to those complaining about “clicks” in an EMR. As a seasoned EMR sales rep, it sometimes gets a bit frustrating to read / hear these complaints. When preparing to perform demonstrations it’s quite simple to setup templates in order to demonstrate how a progress note can be completedt, in the appropriate sub-specialty I might add, with minimal clicks; we all know as sales reps how doctors DON’T like the thought of having to “click” through a note. Therefore, we utilize the features of the software that allow you to create shortcuts, macros, to create default for things like your ROS and Physical Exams. We demonstrate how bubble sheets will allow the patient to input their own History Reviews. And with the use of Dragon Medical v.10.0, I can even demonstrate how to complete a very thorough 99214 note with absolutely NO clicks and in less than 4 minutes.
The key word in my dialogue above is “preparation”. No EMR comes ready to use out of the box. Without the adequate preparation up front, trying to use a product as is will ALWAYS cause these frustrations. Sometimes it’s lack of training, but from my experiences over the past few years, the doctors that go into the process with realistic expecations, that know they will get out of it what they put into it, don’t have these problems. Unfortunately, they don’t comment on these blogs either, because they’re happy with their product, they’ve done what what was necessary to insure speed and efficiency are realized in their product. And it came with due diligence during the implementation process.
Having said that, I feel like the expectations of the physicians is unrealistic in many cases. I have never told a doctor that implementation of an EMR is going to make their life or their jobs easier. I have told them that they will have quicker access to real time mission critical data, that the software will alert them of dangerous drug intereactions based on past medical history and current subscribed meds, that accurate documentation will take the guess work out of billing and insure that they are not underbilling and that their documentation will support their E&M, that their notes will look better, more legible, that it WILL help improve the quality of care that they provide their patients; but never that it will make their life necessarily any easier. It can, but not out of the box . . .
This is a horrible product.. Don’t ever buy this software. As mentioned it is made from all the Open source available like MySql and Apache. They always blame any issue on the network though the problem resides on their end. They initially make a lot of promises and then the only thing you do is spend money to get all the hardware they recommend (which is absolutely ridiculous)..
Thanks to all of you. I am not a victim of eCW! Actually I am looking for a decent EMR with integrated E-RX for a small Psychiatrist practice with.
Thank you.
Jalal
I have been using the system for 6 weeks in a three person office. I think the previous comments made absolutely are accurate and sum up the problems. The screens are not intuitive or organized well. My nurse demonstrated to me that to screen one document into a patient file probably requires 30 clicks. Previously you would just put in the patient folder and be done with it. I have had to hire extra staff members and pay overtime just to keep the office running. I calculate it takes approximately 30% longer to see each patient and I must get to the office earlier just to prepare for the day, so I end up seeing less patients. The bottom line-If I had another chance I would never never purchase this system. And yes it frequently freezes, and has periods particularly in the evening around 7-8 PM where it runs very slow and they insist it is a problem on my end even though my IT professional says we have have no problem at the office. I wonder if is a problem with their server.
and one more comment-If they cannot fix my system it may be worthwhile to organize ourselves and obtain an attorney.
Good Morning!
I would be very interested in speaking to anyone regarding their experience with eClinicalWorks as this is one vendor we are seriously considering for our clinic’s EMR. Please call me at
515-284-2088. Thank you! Becky
I am not surprised to see the negative comments here. But there IS a great cost-feasible system available which is well-organized, user-friendly, with minimal clicks and windows” through an ENTERPRISE-BASED system called MD-2. This application is available through TECNEX SYSYEMS, a competitor of eClinicalWorks. The price is right, and almost every physician and/or administrator that has seen a demonstration of this product is amazed and excited to see how simple but powerful this EHR-PM system is to use.
My comments are based on being a healthcare provider myself, a registered nurse. I’ve seen demos for eClinicalWorks, NEXGen and Practice Partners and in comparison would recommend this product hands-down.
If you don’t believe me, then consider that I walked away from an excellent position and over 15 years employment with a major healthcare system in Texas to join this company. It is worth the time to demo if you are evaluating various systems.
Good Luck and my best wishes to each of you as you look to implement an electronic system in your practices!!!
I would recommend that anyone interested in purchasing EMR/EHR software download our free tools found here:
You can download Ten Steps to Selecting EHR Software or Apples to Apples Software Price Comparison Guide.
You might also benefit from reading the Evaluating Software Vendor Viability.
Hope this information helps.
thanks,
Andrew
Thanks to all for the valuable contribution about your experience with EclinicalWorks. I was about to decide in few hours about the software, but now I will Think again.
Plus, the review are very current not few years old.
I have one question, did any one cancelled eClinalWorks after purchase and which software did they went to?
Looking for software for one Provider Practice.
Finding this to be a good venue for EMR reviews. I am a CPA who is trying to assist my clients in their EMR research – we have some vendors come to our office so the PM’s and Providers don’t have to coordinate the vendors themselves – PM’s and docs can come to our office or view remotely. I’ve seen ECW and thought had a lot of clicks; disappointing to hear about the down-time issues too, as they are one of the vendors we have on schedule to show clients. Going to check out the FastStart Consultation to see what they are about, so can advise my uncertain PM’s and Providers. Will be keeping tabs of this site for other viable comments and suggestions since they are current- good luck all.
I disagree.
I understand that all EMRs are not the ideal that the news and government is making them out to be. That being said, I have suffered terribly as an Eclinical purchaser and user for the last six years. It is an absolute nightmare and every bad detail mentioned in the other posts is true. As a doctor, it has made my work harder, take longer and the end product is worse than the paper files we were using before EMR. On top of all that, I have found I must constantly police the system because it is so faulty that it makes dozens of mistakes and loses data without even so much as a warning to the user. Using Eclinical is very similar to getting trapped in quicksand. You struggle and struggle thinking you are making progress. It’s only when you stop to catch your breath for a second that you realize you’ve sunk lower and are closer and closer to going under. My entire practice has fallen victim to Eclinical works. Those who say that they’re happy with Eclinical do not seem to be looking at the system in depth or questioning the quality of the medical records that Eclinical is creating. They pretend to care and be open to communication and suggestions from their users. They are not. They hold fancy conferences and meetings that are nothing more than a lot of glad handing and self congratulation. Eclinical deserves very close scrutiny and auditing from either the government or an oversight medical body. They are not to be trusted and are putting medical record quality far behind private profits. If it is not too late for your practice, avoid Eclinical at all costs! Do not become another one of their victims, they are not a good EMR company.
We currently and have been using Sage Intergy since early 2009. Of the start it is not the cheapest system, but an extremely stable one. The support from Sage is Phenomenal. Every service request is handled promptly and on avergage we have a resolution within 48 hours. The downsides are that Sage is not quick to adopt or incorporate a change. We have made a couple of recommendations, which go through a research process and are made part of future upgrades, but I think the process is a little too extensive for simple things, but then again I am not expert on database and enterprise software’s.
Initially, I was completely lost in EMR, but after having implemented 2 seperate practises with the help of trainers and clinical support, I am a little short of amazed of the features and the interoperability. There can be a few changes made in the workflow and features, which would place this product above and beyond any other products out there.
In time, we shall see.
You may call me at 813-943-7114 to discuss any and all experiences with Sage Intergy.
At last, I am glad we did not jump on the ECW band-wagon.