NextGen?

[dzedalis]

After reviewing posts on this board, I have contacted multiple software companies to evaluate their product. However, I am also interested in NextGen but have not received a return call/email for 3 weeks after multiple calls.

Should I drop NextGen from consideration? Are they that good that they cannot keep up with demand, or is it a reflection of their service overall? E-Clinical seems to be the best system for the dollar thus far. Any suggestions?

Thanks.

[mel]

What kind of practice setup do you have? Number of physicians, type of practice, budget, and what you are looking for in the EMR? :confused:
& welcome to Docsboard :)
Mel

[Mike]

NextGen & ECW may not be a bad choices, but we would like to know how you got to these for benefit of everyone else here, and coments.
M

[witchdoc]

NextGen & ECW may not be a bad choices, but we would like to know how you got to these for benefit of everyone else here, and coments.
M
There has been complaints about poor & expensive support of NextGen,as well as difficulties with implementation. ECW is the preferred of the two.

[DrWinn]

There has been complaints about poor & expensive support of NextGen,as well as difficulties with implementation. ECW is the preferred of the two.

I'm not sure if this is really an apples to apples comparison. See this thread fromm AAFPlistserv. While I am certainly not pro NextGen or eCW, Dr. Ellis has some very good points.
Dr. Winn, CEO e-MDS
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My post was simply meant to offer an alternative viewpoint (from the perspective of someone who has used both products fairly recently) that there is in fact quite a bit of difference between NextGen and Medisoft.


There seems to be a fair amount of “prejudice” on this listserve when it comes to the higher priced vendors. The implication is always the same – that the “lower priced programs offer just as much functionality as the higher priced programs.” If this were the case why are the higher priced vendors continuing to do so well in the marketplace? Why are practices continuing to purchase NextGen, Centricity, eMD’s, etc if they could all acquire the same exact functionality and performance with another product at a fraction of the price? The answer, of course, is that there are differences in performance and functionality. Granted maybe not every FP wants or needs these additional features. Like your self, I’m only suggesting that providers consider all the options available to them, and not simply dismiss a certain class of products on the perceived notion that the added features don’t justify the added expense. Our experience has shown our providers and staff that there is indeed a very good reason for the difference in cost between these types of programs. In our case, the added functionality and efficiency that NextGen affords our practice most definitely is justifying the added expense.



As requested, here are a few examples…



Our Office Manager currently does all of our billing. The number of steps it takes to input a charge, post the claim, and submit it to the insurer is far less in NextGen than in Medisoft. Our Office Manager, who has worked with numerous billing systems, estimates that using NextGen to process a visit saves her about 5-10 minutes per claim compared to her previous experience using Medisoft. Now, extrapolate this to a typical 4-provider practice with each provider seeing approximately 25 patients per day. If you’re talking about a hundred claims per day, and you factor in a conservative estimate of 5-10 minutes saved per processed claim, you’d end up saving between 8-16 hours per day in potential staff time. Hence, you’re saving nearly an entire 1-2 FTE’s salary simply by using a more efficient billing system! This is one of the reasons why people are always amazed when I tell them that we will never have a need for more than a single employee doing billing in our office even if and when we expand to four providers.



Another benefit we’ve discovered is the ability to “troubleshoot” denied claims. NextGen makes it a simple straightforward process when going back in to the patient’s account to reconcile the denied claim. Medisoft was definitely more burdensome in this regard. This is true for all sorts of other “adjustments” that sometimes need to be applied to patient accounts. For example, it’s not nearly as complicated in NextGen as it is in Medisoft to process and reconcile a patient’s account when they’ve bounced a check on a certain visit.



There are numerous other “bells and whistles” that are incorporated into the higher-priced programs that simply make the programs more efficient to use. These advantages may seem trivial on paper, but in practice they are invaluable. I’m not familiar with QD Clinical, but one example that we found in NextGen that wasn’t apparent in most of the lower priced products we looked at was the ability to fax absolutely anything from *within* the EMR itself. I’m not referring to just medications or pharmacy refills. I’m talking about pre-formatted referral forms, patient records, images, labs, etc. NextGen allows us to fax any of these documents directly to the recipient without any need for printing out a paper copy or cover sheet or having to manually fax it using a stand-alone fax machine.



NextGen, as with some of the other premier vendors, is also rolling out a scanning processor that scans documents *directly into* the EMR. None of the lower tier vendors we looked at initially offered such a feature. Of course, having a lab interface was another major factor. While most programs now offer this feature, it was the manner in which NextGen allowed us to report the discrete data that set itself apart from many other vendors. We can set up the program to report the data in just about any format we choose. For example, think about the ease of tracking Hgb A1c’s or viral load counts in a patient with Hepatitis C or HIV when you can actually manipulate the way the data is presented to the end-user. There is also a “provider approval que” which allows the physician to electronically “sign off” on labs before they are filed within the patient’s chart. Again, some of these features may be offered in some lower-priced vendors, but the implementation and potential for end-user customization simply doesn’t compare to what we’ve seen with NextGen.



As far as workflow goes, Medisoft never allowed us to be “paperless” in that regard. NextGen’s workflow module displays the physician’s entire schedule for the day with real-time networked information regarding whether the patient has been checked in at the front-desk, whether they’ve been roomed (and what room they’re in), and whether they’ve checked out. At a glance, I have the ability to see every provider’s workflow at any given moment in time (including the Office Manager and/or Medical Assistants). It also allows us to customize each individual’s daily schedule template as desired. We can pre-load pharmacy information for any patient, as well as any specialist information, and diagnostic facility information, such that we only have to perform a handful of mouse-clicks to complete a referral for a patient, send a med refill, or schedule them for an MRI. The level of potential customization is truly astounding. We haven’t even begun to use the program to its full extent. With a little up-front work, you can customize any specific patient’s formulary (based on insurer), as well as lists of specialists (based on which providers are contracted with the particular insurer), etc.



In the future, we plan to have our patients enter all of their own past medical history, demographic info, test release forms, HIPPA forms, etc electronically using the NextGen patient interface. The ability of not requiring patients to fill out any paper forms is one factor that I consider when I refer to the concept of being completely “paperless.” Again, none of the smaller discount EMR vendors offered anything close to this kind of capability when we were evaluating different systems.



On a larger scale, you mentioned the example of expanding the practice. If you were to choose to expand your practice by opening up another satellite clinic, does Medisoft and/or SoapNotes network within an *enterprise* setting to allow seamless transfer of demographic, billing, scheduling, and medical records from one satellite location to another in real-time? NextGen not only offers this functionality, it also can be configured to be used easily within a multi-disciplinary setting. Not that I have any grand plan to expand our clinic beyond the scope of Family Practice, but it is nice to know that if I chose to do so, I could bring a Phys Med & Rehab specialist into the practice, and the system would seamlessly integrate their particular specialty without disrupting out existing database.



I cannot speak directly to QD Clinical as I have not used that program. However, I am quite familiar with SoapNotes. On a basic level, it is a truly excellent program. We wanted more than that. We wanted complete control over the appearance of the user interface and how the templates are structured. NextGen allows us this option. Some of the other vendors we seriously considered, including eMD’s, eClinical Works, and Practice Partner, offered some varying levels of customizability, but not nearly on the scale of NextGen. The only one that was similar was Centricity.



I agree that there are many good products on the market. It’s just interesting to me that whenever the issue of upper-tier vendors such as NextGen, Centricity, A4, etc comes up on the listserve, there seems to be an immediate tendency for some listserv users to start subtly “bashing” these products based only on their knowledge of the price-point alone. These individuals always fall back on the argument that there’s not enough of a difference in functionality to justify the difference in price. I think that is where the disservice lies. There is a reason why NextGen won 1st-place at TEPR this year. Yet people can’t understand this, because they make a snap judgment based on price alone. The reason NextGen consistently places high in comparisons like TEPR and the KLAS reports, is because it’s a superior-quality program that offers more functionality than most other programs. I always find it difficult to understand how some of the participants on this list can bash the upper-tier products when they’re not even using those products. The claim is consistently that their lower-priced EMR “can do anything and everything that the higher-priced EMR’s can do.” That’s plain silly. The premier vendors would have gone out of business long ago were this the case. The EMR market is simply far too competitive these days to not “selectively reduce” vendors who’s products are at the highest price-point, yet supposedly don’t offer any added functionality over the lower-priced systems. Are the higher-priced systems for everyone? Clearly not, as evidenced by some of the responses on this listserv. But to make blanket statements suggesting these products “not being worth their price” is a real disservice to a lot of listserv lurkers and potential EMR customers looking for some objective information.





John Ellis, DO

North Valley Family Medicine

Glendale, AZ

NextGen user since 03/04

[hirschr]

No call in three weeks???? Imagine the support you'd get once they got your money!

eCW is the leader these days. Support is tremendous- the compnay actively participates in a Yahoo discussion group and actually listens to suggestions for improvements and implements them.

[Surgeon]

My chart logic guy is here today installing my free upgrade to 6.0. They have fixed most of the things that bothered me about the program, as well as much improvement in their integration with Dragon Naturally Speaking, which also appears to be responding much better, and requiring less training. They have apparently been listening to someone, if not me, and making corrections accordingly. I was told again however that I am likely to eventually require an additional hardware investment of >$1500 over my initial purchase 1.5 years ago to keep the speed and accesibility up. Overall its running pretty smooth, though. The new version doesn't interface with the old data-strategies front office billing software, so more fixing to come to get it all working.

[threekiddad]

I enjoyed this letter. Our group just signed up with NextGen. We have only installed the EPM system which we'll go live on Monday the 20th. However, we have purchased the EMR and ICS. Everything mentioned in the narrative is what we believe to be true. We're a group of four internists and 2 NP's. We feel our return on investment will payoff not only monetarily, but also through improved patient care. I'll keep DocBoard updated on our progress. When I signed up, no one had listed themselves as a NextGen client.

[Surgeon]

Got it all working now, just getting all of my forms and stuff put in to allow complete resolution of the visit, ie pre-op orders, at the time of completing the chart. A couple of little glitches with key-strokes, and the use of the correction commands in the referral reply letters is not functioning well. Just have to stop making mistakes!