— Alex Baskous, MD, Anchorage, Alaska
Gordon Comstock, MD, practices family and geriatric medicine in Arcade, New York, a low-income area in rural western New York, near the US/Canadian border. His medical practice has over 3,000 patients, many of who are elderly and on fixed incomes.
At his former ten-provider practice, Dr. Comstock saw his colleagues spend nearly $280,000 on an EHR system they found to be “unwieldy and difficult to use.” He was determined to find a reasonably priced alternative that would reduce his overhead expenses so he could afford to practice medicine in an underserved area.
For a one-time licensing fee, the Amazing Charts EHR provided Dr. Comstock with an affordable alternative to typical EMR/EHR solutions priced in the tens of thousands of dollars. His entire staff was able to begin using Amazing Charts immediately with no formal training.
Providing high-quality healthcare to underserved populations is one of the main reasons Gordon F. Comstock, MD, decided to pursue a career in medicine. He earned his Medical Degree from Case Western Reserve University School of Medicine (1977), after which he completed a family-medicine residency in Rochester, NY. He finally settled at a National Health Service Corps site near the high-needs Appalachian Region of western Upstate New York, where Medicare and Medicaid payout ratios are lower than in other parts of the state, making it harder to attract medical professionals to the area.
In the mid-2000s, Dr. Comstock was operating a satellite office associated with a 10-provider group in Springville, NY. He tried using the EHR their business manager had evaluated and selected for the group, WebMD's Intergy (which has since become Sage Intergy).
“While this EHR had some advantages over a paper chart, it was rather unwieldy and difficult to use,” says Dr. Comstock. “There were too many little pull-down menus, and sometimes it was hard to find basic things among all the data fields. I usually ended up just dictating a note later because I couldn’t document everything during a visit.”
There were other issues that hurt office productivity as well. “We regularly lost information,” recalls Dr. Comstock. “During one software upgrade, for example, we lost all of our immunization records! Plus, the practice had to hire a full-time person just to scan paper documents like referral letters and lab reports into the EHR.”
Adding insult to injury, the EHR solution was expensive: “I believe the practice paid something like $278,000 for ten providers, which included the computer hardware, installation, and training. I remember we also needed more training and the vendor kept coming back to the offices to deliver these $5,000 training courses. After spending all that money, my former group eventually switched to another EHR.”
Dr. Comstock separated from the group practice in late 2006, and began looking for an EHR that would fit with his desire to remain practicing in this underserved rural area.
“We came upon Amazing Charts through the diligent efforts of my business manager, and wife, Ginger - who used the Internet to search for an affordable EHR,” says Dr. Comstock. “We were very interested in another EHR, but when we installed their demo disk, we found it was just a canned demo.
“On the other hand, Amazing Charts let us download a full working version and try it with our actual patient data. Everyone in the office got to try Amazing Charts and see exactly how it worked for three months before we bought it.”
Installing Amazing Charts didn’t require expensive networking gear, IT consultants, or other resources.
“It was easy to get Amazing Charts up and running in about one afternoon,” Dr. Comstock says. “The Guardian Angel support team helped us solve some in-house networking issues with no per-incident charges. Later on, they helped us recover data that we thought was lost forever.
“Then we essentially used the built in ‘help’ feature to learn how to use the software. Even medical and PA students can use Amazing Charts as soon as they walk in the door. It may be difficult to get them to write something intelligent and meaningful, but they can always use the EHR immediately to create a note.”
Today, Dr. Comstock’s practice is thriving and currently employs up to 10 full-time and part-time personnel, including a physician’s assistant and nurses, two front-desk staffers, and a business manager.
“Everybody in the office uses Amazing Charts for something, whether it’s looking up insurance records at the front-desk, or assisting me in entering vitals while I finish up with another patient,” explains Dr. Comstock. “The feature that really won over my staff is the ability to find out if a patient has an upcoming appointment scheduled by simply typing their name at the top of the screen. Amazing Charts also makes it very easy to print out, say, a patient’s medication list, and send it over to the emergency room.
“In my experience, Amazing Charts is the closest an Electronic Health Record system can get to how a family doctor likes to generate a note. It just feels ‘normal.’ A lot of the referral letters I get from specialists are indecipherable because they are generated by EHRs that don’t communicate what the specialist actually saw and thought. Amazing Charts always allows me to express myself in a way that not only captures the data points, but also captures the subjective narrative of my thoughts and observations.”