Re: eMDs cloud (long response!)

[Guest guest]

Jim,

We use Tangible Solutions' Happe-MDs product. We are VERY happy with

our decision. We have been on it now 18 months. It is definitely

ready for prime time. We did not see any slow down, and we have only

had one time (in the first 2 weeks we went live) where connectivity

was an issue, so about the same failure rate as when we had our

in-house server (in the 5 years we were on our in-house server, we had

to resort to paper backup 3 times for one reason or another).

It seems like we paid extra when we initially set up the portal. $250

seems to be the going rate for them to set up that sort of stuff.

($250 for fax server setup, $250 for sure scripts, etc.). But once it

is set up, there haven't been additional fees.

We don't use an immunization registry (CA is not up to speed on that,

and we don't see kids), nor do we use any lab interfaces right now (we

couldn't get any of our local labs to pay for the interfaces, and we

are only willing to pay if it is bi-directional), so I can't answer

your question there.

Steve is using an iPad in the exam room, but a desktop (well,

currently, his old toshiba tablet) in his office for printing

purposes. That is the caveat of using the iPad - you cannot print

from it in the Citrix environment. And Steve is a little faster

typing on a regular keyboard, thus using the desktop in the office to

start and finish his notes, and using the iPad in the room for

completing templates. I know that Tangible is now charging a separate

user fee for each iPad, but we were grandfathered into our original

agreement, which was no extra charge for the iPad. I think practices

were getting around their total number of user licenses by having some

people work on iPads, which was effectively doubling their users. In

our case, Steve is the only one that uses the iPad, and no one uses

his desktop when he is simultaneously using the iPad.

Customer support at Tangible has been very prompt with responding if

we have any issues (the biggest issue we tend to have is getting

routed to a server that doesn't have Word working, which is an easy

fix!) We did have to buy a new fax server because it needed to be

configured somehow by them. That was about $900. Setup/conversion

was easy. We Fed Ex'd a backup of our data to them, they installed

everything, and away we went. Total down time was about 36 hours, but

that had to do with the images that we had to pull off of our image

server. I'm sure if the IT guy that initially set us up had done it,

we would have been down for only 24 hours.

I love being able to log in from anywhere. No hulking my laptop

around any more! I have had a few issues logging in from my Mac, but

mainly it is a keyboard shortcut issue in Bill. If you do point and

click and not shortcuts, you probably wouldn't notice.

The downside is that you get the upgrades slower than you would on

your own server. But that is because they are testing it in the

Citrix environment before they upload. And you do occasionally get the

finger pointing from tangible to e-MDs and vice-versa, such as we got

with the last upgrade....and it was definitely a programming error on

e-MDs part. It does seem that e-MDs responds to tangible quicker than

to a small practice to get issues resolved, as that issue was resolved

in less than 24 hours. I'd probably still be waiting on e-MDs

otherwise...

I also like not having to worry about the backup. We were using tapes

before...bringing one set home, swapping it each week, etc. there is

a shared drive that you can use at Tangible (you do have to ask for

it), so everything goes on there and gets updated daily. I also have

found myself using the Reference Document functionality of DocMan much

more frequently than before.

Our next steps are to get Steve a new desktop (he is in process of

researching them) and to get a new scanner. The setup of our new

office would make having a Fujitsu scanner at the front desk a much

better work flow (plus one at the MA desk). And our scanshell is on

it's last legs.

Feel free to contact me off-list if you have any other questions!

> ,

> We looked at the cloud about a year ago, but decided to wait. eMDs was not

certain it was ready for prime time. Our server is getting older and I was

waiting for this to reevaluate. Which company do you use, I forgot. Do you have

to pay extra for the portal? Is it easy to do connection to externals such as

the immunization registry, does it work the same? We only use the free Labcorp

interface, is that a problem? Since our tech support has to come from Denver, we

sometimes have to wait for some things, so it might make it easier for us.

Lastly, we have thinking about getting the new iphone/ipad ap for eMDs which

woulld cost us about 40/month, and obviously we would not need to do that.

> Do you find any downsides?

>