NextGen Office Erfahrungen

2015 certified
APMA partnered to work with them. NextGen uses APMA registry.
Health Fusion was already purchased by NextGen so they aren't going anywhere.
Customizable

1. It looks great when sales people show you but out of the box requires A LOT of customization. Of course, the good is that it is able to be customized - but YOU do it.
2. YOU do all work. They show you but you DO it
3. Many of the verbage they use looks good until you READ it. Then you realize how many changes YOU need to make.

They are improving the product consistently. There have been two product updates since we started with them in March. Customer service has improved greatly as well. 99% of the time someone who picks up the phone and helps you with your problems. They have daily webinars that are free of a particular topic, so you can log in, ask questions, get help, and then log off. The product has a lot of great things such as ease of sending the charges from the docs to the billing department, seeing the exact statement that a patient received so you can talk to them more intelligently, getting lots of detail on the claims, rescheduling a patient from one day to the next, and blocking a portion of the schedule or opening a portion of the schedule.

You can submit issues via email, but once they respond back, they close the case. Even if they didn't give you the answer you were looking for, you then have to email again and reference the case requiring you to print everything to keep track, because there is no way to follow the status of your case. If you submit feature requests, there is no way to know if they are working on it, aren't considering it, holding it for a future update, etc. There are specific reports that you can get, but if you need something that's not pre-built, there is very little way to obtain the info, if at all. I requested some kind of report writer. The reports all come out as an Excel spreadsheet which is good, because it allows you to manipulate and move around the data, but when you print it's very unwieldy and not pretty. They need to have a way to convert the report to a PDF format once you have it the way you like. Many of the reports don't offer options such as picking providers, locations, payers, so you have to manipulate the report after it opens to delete what you do not need, which is time consuming. The software is extremely dependent on location, which means everything you do has to be done by location creating a lot of work. If you have many offices, your docs do surgery in several locations and they are outpatient or inpatient. Changing or adding something has to be done many times, because you do it by location. It would be easier if there was a drop-down listing your locations and you only had to check the locations to which your additions or changes were applicable. Parts of the software feel as if they are too structured and everything has to fit into their predetermined way to do things. There is not enough flexibility and leeway to change portions that suit your practice. Vendor training was not great when we started and we paid for an outside vendor that works with Healthfusion to come on site and train us. I understand that the help and training portions have changed a bit since then and may be better. It has great potential if they would open up the software and be more flexible!

I like that there are two distinctive sides to this software: Practice Management and the EHR. This makes everything difficult though when learning it for the first time. It really breaks up what would be a fairly daunting task of switching to this system. I love that patients are able to register their information before their first visit-- this makes entering in new patients so much easier and faster.

You can only do some things through Practice Management and many others through the EHR. When admitting new patients I have to toggle between the two and often have to have several browser tabs open while entering in patient data. It took seemingly forever to figure out what kind of profile employees should be on-- should we all be administrators or not? We found that some permissions were not granted if everyone was not made to be an administrator and vital abilities were lost to some employees. After learning this system for about a year we are still figuring out ways to work with this system a little better. It is not intuitive and it is difficult to learn. There has to be a better system out there when switching to Electronic Medical Records.

The software is user friendly. I liked the reporting function and the ease of creating and sharing reports.

Some of the data could be misconstrued based on the various date options within NextGen. For example, there were transaction dates, dates of service and dates of entry.

Nice suite of features, they are continuing to add new features through aggressive mergers with 3rd party software and starting to focus on value based care.

The templates can be rather clunky and they look dated. It's also a bit slow compared to other EMRs I've worked on/with.

The real time updating is amazing a patient can call right away with questions and we can get the answers.

I really do not have a negative. I enjo9y this product.

Tracking appointments, updating patient information and EHR were all easily managed and integrated.

Scanning in insurance cards and identification cards was a very slow process. I wish it was more efficient in that sense. A patient backup holds up the whole office flow.

It does have medical diagnostic tools like the Vanderbilt already included as well as an Asthma action plan/Asthma control test and several other questionnaires that are rather necessary in primary care as well as collates the information (i.e you can compare today's Vanderbilt score with their last Vanderbilt score without having to hunt down that note).

However, true to NextGen's form, the things that worked really, really well (like having the school physical form be automatically populated with the vaccines), they have somehow succeeded in completely screwing up, making the very, very few good things about NextGen a rapidly diminishing anomaly.

Where do I start??? Having to input data several different locations, it is SLOW and every single thing you want to do has to open a new window (read between the lines and understand that in an already slow program, every page you open has to load) and with all of the windows you open, there's no way to minimize them to go to another screen i.e you can't minimize the medications so that you can review the patient's last lipid panel, TSH, blood pressure, etc. You would have to close the medication module, open the orders module to review the lab then go back to the medication module and open it to make any medication changes. And if you want to make any medication changes or do any documentation at all, you have to have an open encounter and none of the encounters are labelled in any sort of orderly fashion so you have to open each encounter to find out where you put anything (again, think of each page having to load/open and taking 5-10 sec each).

Medications: you have to associate a diagnosis with every single medication if you are a provider which is an awesome idea except that if you haven't previously entered that diagnosis, you can't actually save your medication and go back to it, you have to close out of the medication module, enter the diagnosis into the assessment and then go back into the medication module and re-enter all the same information again.

Labs: there is no way to save quick phrases or phrases you use frequently so that conveying test results is, on a great day, a lengthy and painful process. Also, if you want to know how your current lab value compares with the previous ones, you have to open up the patient's chart and go into the order module.

Entering orders: again, if the proper diagnosis isn't there, you can't save your work and open something quick to pop the diagnosis in, you have to lose all of your orders, "X" out of that screen, open up the assessment screen then go back to whichever area you were in (another lovely thing: everything is separated so putting in lab orders is separate from putting in diagnostic studies which is in a different tab than putting in referrals which is in a different tab than any clinic orders (like toradol, PPD, u/a, etc). Also, if you are ordering any sort of medication to be given in the clinic (like Toradol), if you forget to add that it's a medication, it deletes the order and you have to start all over.

Various names depending on the section: sometimes it's filed under Pulmonary, sometimes it's filed under Lung, sometimes it's filed under Respiratory...and the sections aren't in any kind of order either. The routine way physicians document an exam is starting with constitutional and working your way down. Nope. Not in Nextgen. The main page of the physical exam has One Page Exam, then constitutional, then diabetic foot exam, then ears, (separate from) nose/mouth/throat then neck/thyroid then breast (huh????) on down. However, if you open up a quick-note [great concept if it worked but the software doesn't actually recognize anything is in any particular field (i.e. HPI, Physical exam) and ROS doesn't even save...so if you try to calculate the code it always comes up as a 99212)] and you want to modify the exam at all (because if you go into the one page exam and enter anything, because it doesn't actually recognize there is data there, it deletes everything except what you've just entered) you go into the "Additional" tab where the headings are (I kid you not) Neck/Thyroid then Breast then Psych then Ears then Constitutional then Respiratory then Nose/Mouth/Throat then Musculoskeletal then One Page Exam then Cardiovascular then GU then Abdomen the Skin/Hair then Head/Face then Eyes then Lymphatic then Vascular then Extremities then Rectal then Back/Spine then Neurological and on... The ROS starts with Cardiovascular and marches on down to end with Respiratory and then Vascular and one might think it was alphabetical except Reproductive is sandwiched between Immunologic and Metabolic/Endocrine.

ROS: Since I brought up the review of systems, let's stop there for a moment. There are not things listed that a patient would say; they start out strong but then in Respiratory they include things like "Known TB exposure" (not really ROS but rather PMH or even HPI) and under Cardiovascular they include "Claudication" (not likely something a patient is going to complain about) and my personal favorite, under the female ROS is "Abnormal Pap smear." While there is the ability to pick "Other," most often the drop down menu that is supplied is a restatement of the things in the first menu so you have to hit escape and just type in your own words (or the patient's words).

And on top of all of this, it has the audacity to be glitchy. One of the things it does for me is, even when I've entered an assessment, sometimes it doesn't recognize that it's there and then tells me to enter an assessment...news flash: because of the way the software is set up, you can't enter a plan without an assessment there, so if I got to the screen where I could enter a plan...clearly there's an assessment there...however, you can't argue with a computer...

I titled this "I must be missing something" because if you go to their web page, they've got all these awards that they've won, etc and I just don't see how anyone could award them for anything. This software is abysmal at best and, if I leave my current place of employment it will be because of THIS. Not my boss, not the patients, not the money, the EHR. And this was adapted because the Illinois Primary Health Care Group that is over all of the FQHCs thought that this was the best option for Health centers that are taking care of a challenging population who needs things to be easier for them not more challenging. And with this software, I am more likely to miss things that need to be done because EVERYTHING is on a separate page and with 15 minute visits, who has time to do all that with a slow EHR???

Funny thing is, there's an update that may have fixed several of these issues but you can't task anymore so we can't upgrade. That would mean that every time you needed your nurse to do something, you couldn't send it to her, every time you wanted the front desk to schedule something you couldn't send it to them, every time you needed a follow up lab or test ordered, you couldn't send it to anyone to call the patient and do it. So either I'm missing something HUGE or the people who are evaluating NextGen and give it anything better than "Epic FAIL" are either working for the company or involved with someone who works for the company. My new analogy has become: if I did my job as well as they did theirs, I would be in prison for Manslaughter....

communicates with my billing company, but I could just fax a superbill just as easily. does insurance eligibility checks, does eRx (but is often difficult to find the pharmacy unless you know the exact zip code, sometimes doesn't find the pharmacy at all, like Safeway's)

Wow, there is so much not to like... Word searching for ICD10 codes, past medical history and problem lists returns hundreds of search items that have absolutely nothing to do with the words being searched. Also, if you enter the words out of the order in which they would appear, you will never find them. Social History is much more than whether a person drinks alcohol or smokes. There is no way to put in valuable details of a patient's social history and automatically include it in your notes. A lot gets lost by having to adhere to some stupid engineer's formatting. Same with past medical/surgical/obstetric histories-you cant add any valuable details to anything (like which knee was replaced and what happened after their concussion, etc). The charting is so useless that I have given up and gone back to paper charting. I start an encounter just to put my billing through. Health Maintenance: I can't enter that a patient refuses to do a colonoscopy or mammogram. All I can do is "disable" that patient from being counted for meaningful use. Poor formatting: while they tout being iPad friendly, each page has lots of unused space, so there is a lot of scrolling just to enter data or get to the save button (and if you don't press save, you lost it). More poor formatting: entering vitals->information is so spread out that it takes two screens to enter. AND peak flow is on the first screen while height and weight are on the second "additional information" screen. Which is more important? Also watch out for the backspace button, sometimes it works like you would expect, and other places you will get logged out and lose all of what you were doing.

Once you customize documents, questionnaires, custom forms, physical exam information - it simplifies your work and you can be more efficient.
Easy to customize once you learn how - my previous software took me long hours for several months to fix and even then it was not so easy, I had to keep typing additional data for my office notes.
Saves time creating paper super-bills ( with my previous software I had to do it manually for every patient, then give it to the biller to post it), here once you close your note, the claim is actually ready to post... faster payments.
The chief complaint has many set up questionnaires that are easy to use by staff and helps the health provider to quickly review the concerns, facilitates the interview, simplify the provider's work.
Billing - has many ways to see the claims. Recall list for follow ups, blood tests, etc - once you order a test that is a follow up or in your note you document the follow up... automatically show in the recall list. Nice appearance of the finalized progress notes, many of the areas are automatically saving and you do not have to worry about losing your data. At the end of the day, you can review open encounters to make sure you finalized all your notes.
Interfaces with labs and vaccine registries are available and work very well.
Labs show automatically - there are icons on top of the page that make easy to find labs, tasks, messages, prescription requests, etc.

Unable to see several tabs or pages at once, you need to save and close what you are doing to go some other part of the chart or if you need to open other patient's chart at the same time you are with one patient in the room - same applies for the PM portion and it is time consuming because you can not multitask.

I chose this software because it was designed by physicians, specifically osteopathic family physicians. It is organized in the traditional SOAP format so it is intuitive to most of us. It took me a little while to get comfortable with moving around in it but it is second nature now. I like to freelance my subjective paragraph and it's easy to do. Pull down's appear as if you didn't actually listen to the patient. The tech support is outstanding. I can call them and they are always helpful and very patient with a physician who may not totally understand every nuance of the program.

In the Rx number of days section, there needs to be a 5 day option, z-packs are 5 days and a 3 day option. Yes, I can type it in but I'm lazy. And if I type in an inhaler for 90 days, it has a problem allowing me to just send three inhalers. Same with BCP's.

I love the A/R features. I love how fast I get paid by commercial vendors. I love how intuitive it is on helping avoid claim issues. I did not have any issues with implementation. I have had nothing but good experience with support. We have had this EMR for over a year (and I have dealt with a few) and this is by far the best I've used. We have not had any issues with it going down. We have called when we have thought the system was down and they have guided use through issues with browsers, internet speed etc. So we were always glad we called, problems solved when we thought it was on their end. Yes, claim eligibility check is only on some providers but if you get to know how to use it more in depth it can be VERY helpful in further info not just for eligibility but for knowing primary care provider etc. I have had ZERO issues with auto post and yes, I have double checked. I also really like their statement service, I review each statement before I "send" them to them to send for me but no more issues with bad addresses etc and well worth the money. Their "help" section is great. The help sheets are AWESOME. I email support more than I've ever called them and they send me helpsheets when I can't find them.

I would like a better way to weed out the non paid lines with auto post instead of dumping them all to the appeal bucket. I would like to be able to attach a claim to the billing comments and be able to send them to another employee to review. I wish that I could upload our own forms to save in the system- I do not like the forms library at all, pretty well worthless to us, I would like it if I could upload, name our files and use it that way.

The product support was horribly useless. The techs and their supervisors knew very little about the product. The Nextgen system itself is the real problem though. It takes so many clicks to perform the very simplest retrieval of information or data entry. The windows to see information or enter are tiny, 1 cm in height and cannot be adjusted. After a full year, our office of 4 MDs and 3 NPs (all tech competent) were still only able to see 10 patients per 8 hour day, and still spend time after hours to document. Awful.

In all honesty, I cannot find one redeeming quality to this EMR, compared to any of the others I've used extensively or on its own.

The answer to the problems were always: "It's being addressed in the next version roll out". This is a half-baked EMR. It's use is a danger to patient care and a real liability. We abandoned it.
The system is intended to have the clinician enter all HPI, IMP and Plan by point and click check-boxes. If these are not used, then it does not collect meaningful use data. However, the clinical utility of the text it generates is so generic, so hard to generate, and so cryptic that it is of no use to retrieve the facts of the the case. The only way to enter your thoughts, history or plan is to free text it (in addition to the mandatory point and clicks), doubling your work.
It doesn't even have a way to carry over information from past notes HPI or plan, so that it can be easily adjusted.

Integration between practice manager (scheduling) and EMR (records) software. ability to carry forward and safe smart phrases to speed up note writing

Exercise log completion is tedious and takes too long relative to other sections of notes. Some sections of evaluations are not intuitive as where to find things.

Uses Google Chrome.
Very fast, especially when using "wired" vs WiFi.
Mac-friendly.
E-Rx of Controlled Substances works well.

Support is much better with Nextgen than with HealthFusion, but still rather slow
Occasionally, their server goes down and we are dead in the water. Thankfully, this has improved, but still should NEVER happen in this day and age. With that in mind, they should allow for a Read-Only in-office server so that we could at least access the most recent office visit and the patient's meds when their server is down, but there is no accomodation for this.
Rather difficult to make changes in the templates if you are not VERY good at this sort of thing.
The listing of meds and problems requires closing the office notes to view. These should open in separate windows. Also, you should be able to view more than 1 office visit at a time, but instead, you must close 1 OV to look at a previous OV.
Initial training from HealthFusion was virtually non-existent. We were just referred to online videos. Maybe there is now an option for on-site instruction, but we never received it.