eClinicalWorks headquartered in Westborough offers their EHR / EMR solution, which can be upgraded to a full practice management solution at higher pricing tiers.
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ESO EHR
Score 8.7 out of 10
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ESO Electronic Health Record (EHR) is a web-based patient care documentation and reference system for emergency medical responders and firefighters. It's designed to provide easy access to information about patients' medications, allergies, history, etc. from a tablet while in the field, and allow healthcare providers to document patient encounters quickly.
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.
For most EMS providers, ESO EHR is an ideal solution: It meets 95% of the needs for the typical EMS provider, provides an unparalleled ease of use for field personnel documenting patient care, and is easy to implement and administer. Large EMS systems should carefully consider the limitations of the underdeveloped quality management modules for QA/QI programs. Large or progressive EMS systems with an advanced data analytics/data science capability should be aware of the significant challenges and limitations ESO EHR poses for data use outside of the standard analytics reports.
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.
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.
The biggest gap is that doing QA/QI is not scalable or streamlined for a large provider. Managing an effective QA/QI program takes an incredible amount of labor and extra work.
The lack of customization and custom fields heavily limits use of ESO EHR to capture new data points for internal quality improvement or research projects.
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.
[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.
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.
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.
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.
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.
ESO EHR won out due to ease of use for providers and for administration. Other vendors had greater ability to do data analysis, quality management, and customization but ultimately were significantly more difficult to learn, use, and administer.
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.
