eClinicalWorks vs. Epic vs. Intergy EHR

eClinicalWorks should be used in most medical situations. The program generally speaking works the way it should keeping track of patient records and the like. They have recently added an inpatient module for ASCs. Seems to work pretty well for smaller practices that don't require a lot of additional features or integrations.

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Epic is very good on the medical side and continues improving mental health and dental care. Having integrated telehealth via Zoom was a game-changer. During COVID, it was vital to have telehealth options and to ensure it was completely HIPAA Compliant and easy to document inside their health record.

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How well is the product customizable for workflow modifications for my clinic? Does the result flow easily for the provider or are there many chunky clicks required? (i.e. one modification to a workflow between the nurse and provider requires 27 clicks.. ok this accomplished the workflow that was needed but at what cost?) Can your system produce customized reports on the fly, is the data real time or lagging? Can the system be tuned in terms of document/note templates and the Graphic User Interface forms so a particular practice/provider/speciality needs can be taken into account?

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• One of the strengths of ECW can also be a weakness depending on the user's perception. ECW has a lot of redundancies. There are multiple pathways to perform a task. It can be appealing to advanced computer users because of the versatility. I have found that it tends to confuse lesser experienced computer users.
• The creation of templates is very easy and any provider in our system can create one. It definitely makes documentation more efficient. By creating a set of templates for the clinic, we are able to standardize the orders/procedures along established guidelines.
• We have converted our scheduling to open access. ECW allows us to set the follow up time and the end of the visit and then an alert is created. Front office staff can run the report and schedule patients closer to the actual time. It has improved our no show/cancellation rates.

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• There are doctors' notes templates with prepopulated fields in them. This saves a lot of time.
• Epic sends medication orders to pharmacies electronically so that we do not have to call. This saves a lot of time.
• Epic has a Secure Chat feature via which we can send HIPAA protected messages to any employee with the patient's name and record attached.
• It has a PDMP link. We can look up what controlled medications such as opiates patients have been prescribed and by whom.
• It links to MyChart, which is a platform via which patients can look up their own information without them having to call the doctors. This saves a lot of time.

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• Health Reminders- for different patient needs or preventive care/screenings. For example patients who have a diagnosis of Diabetes- their health reminders will show if they need an A1c, foot exam, eye exam, etc. and when it was last performed
• Orders Tracking- This helps nursing staff make notes on referrals or orders and they are able to look at the order tracking section for all patients and filter it by provider, order type, status, etc. to know what needs to be followed up on or what has been completed and so forth...
• Tasks- This is a nice feature that has many different options for use. It can be used internally to send a quick message to another user, a phone message, billing message, and any task gives you the option to make it "patient related" if necessary. It can be used by the providers when they make an order they can then send it to the nurse to complete. Lots of different ways for Tasks to be used

• Meaningful Use Reports should be capturing data in real time and generated fairly quickly instead of the MAQ dashboard extraction process.
• Their support teams are not very helpful at certain topics such as the definition/logic of Meaningful Use calculations. These are generally difficult to determine but several cases in regards to Meaningful Use take several days before it gets addressed.
• Training videos would be helpful on their support website.

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• Visual Updates: While Epic is constantly improving the user experience, there are a few features that still need a design refresh. While this does not effect functionality, it does have an impact on user perception.
• Ordering: While placing an order for a physician is very easy, a few changes to the workflow could improve the experience for physicians.

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• Sometimes, Intergy tends to crash on occasion, which is understandable.
• Also, when checking for insurance eligibility, sometimes Intergy will not accept a specific insurance card and I have to call up the insurance to make sure the patient is eligible for coverage. It would be nice if more types of insurances could be added.
• When creating recalls for patients to remind them to visit, sometimes the system does not cooperate properly.

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If we had an option to easily switch to another EMR product we would. However, an EMR keeps you invested solidly in it - once you've started you're then going to be stuck with it. The investment into the data in the system are such that you have no real option to back out of what you are in and move into something else. Again, if we could, we would immediately move to another EMR. The ability to use it and be supported by the vendor has decreased nearly to the point of inability to use.

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It is beyond measure the best EHR on the market.

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[In my opinion] the features allowed by the system are not designed for providers. [I think] the systems are inefficient, and new features tend to be "bolt on" features either as products purchased and added from other providers or simply a module created and strapped onto the software. There doesn't seem to be much idea around making things easier for the provider, though they like to state that provider burnout is something they are working on.

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You should invest time into taking a training class before using Epic, but once you get the hang of it the usability features are endless! My favorite part about Epic is how it is automated and "trained" to catch user errors that would typically be missed in normal documentation/charting. This ensures accuracy and eliminates errors.

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Very user friendly and efficient

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I often cannot assign a proper diagnosis under the assessment section; and as mentioned, sometimes (about once a month) the dictation just freezes because "the request has timed out" (even restarting the iPhone/ laptop does not help).

You put in support cases through a support portal. [I believe] for no apparent reason, the company decided that their support cannot have access to actual patient records and as a result, it's required that they have to connect remotely to a computer system in our network, and log in as one of our users to do anything. This also entails that they are completely incapable of diagnosing problems and require significant amounts of user input and time to try and begin any sort of work on the problems. [In my opinion] this takes away from patient care and other concerns. Also, while you can put in as detailed a ticket as you want, when you are called, you have to go over the ticket again, as they don't seem to read or care what you put in, as it's more important to them to go over everything in painful detail. Often times you must explain to the tech how the process works. In the past month, we were upgraded overnight with zero warning, which caused issues the following day as we had to update every single computer in our network (over 300) and it requires administrative privileges so couldn't be done by a user. This also doesn't update any information in the programs list, so there's no way to tell whether the update happened or not.

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The initial training was good but would have been even better had I been more familiar with the system before taking it. I found learning how to deal with Epic while working in the field at the same time was a (pardon the pun) Epic learning curve. I really think there should be a scribe who does the data entry and others can focus on what they do best.

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Usually they are very helpful. I would prefer they do some of the actual changes I am requesting instead of having me do the work. I feel that they could walk you through it, instead of letting you figure out the desired results on your own.

Paid for training, did not help. They trained prior to go-live, but it was so long ahead that users weren't able to function well when it actually happened, they seemed unable to provide adequate support. [In my experience] further support is typically very boilerplate, and is thus not useful, and has additional cost.

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Well-vetted lesson plans that teach you what you need to know for success.

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While not as effective as in-person training, it is still adequate.

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It's very important to limit your schedule during the weeks after go live but it is equally important to have a resource that is the lead at the practice that ensures that milestones are met leading up to the go-live date. Someone must be the point person at the practice otherwise milestones will be missed and the implementation will run into problems.

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Epic has a regimented implementation process that ensures a successful go-live.

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Track all hours and don't sign off on anything if you are not 100% happy.

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I was attracted by the final note format of ECW. I said then and still say that most EMR's clinical notes are terrible to try to read and follow in orderly fashion by comparison...BUT the devil is in the data entry and that is where "you live" as a clinician. Incredibly frustrating software because of inflexibility and restrictions of multi level data fields that can only be opened one at a time (i.e. no "toggling" between windows... ooen read and close...then reopen other data entry window....then close and repeat if you need to refer back to original window of data. This applies throughout the software and is due to its reliance on SQL architecture from what I have been told). Kills productivity.

Epic gives extensive customization options in terms of utility and view. I have found this to be highly useful and efficient EHR as compared to other EHRs we use in our organization.

We moved from Intergy to athenaCollector and athenaClinicals. Athena is cloud-based, meaning we can access it from any location that has internet. My staff misses the ease of scheduling in Intergy, but the accountability of users' productivity is amazing. We had more control over document classification with Intergy, but sometimes that's a double-edged sword. When some people label a document "MRI-Lumbar spine" and others call it "Lumbar Spine MRI," there is some redundancy and sometimes important documents get missed.

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• I will just share one area that our organization saw the ROI in a very short time period. That is the elimination of a dictation service for most of our specialty group doctors when we introducec Dragon Medical. This functionality brought a tangible benefit and a significant ROI in a short time period.

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• Being able to track and document all of our services in the same place has made an exceptional improvement in continuity of patient care, both internally across departments (medical/dental/mental health) and externally with specialists and other healthcare organizations on a national scale.
• Continuous improvements in Data reporting and analytics make tracking and implementing quality improvement measures throughout the year easy.
• Massive improvements to the ELLA training platform, combined with detailed and interactive training materials for all system areas, make onboarding and staff training much easier!

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• Intergy has had a positive ROI. The financial tracking and tools have been easy to use and helped recover additional monies for practices.
• Claim Tracker allows practices to have a real time view of all unpaid claims.
• The E&M calculator helps providers choose the appropriate code for billing compliance.