Latest / DPC Life: Direct Primary Care Podcast / Direct Primary Care EMR Review: Atlas.md vs. Cerbo for DPC, Hiring an NP, and Setting Boundaries

Transcript

Direct Primary Care EMR Review: Atlas.md vs. Cerbo for DPC, Hiring an NP, and Setting Boundaries · DPC Life: Direct Primary Care Podcast

• 0:00
  People starting out listen up. Get your boundaries straight
• 0:02
  before you start, because you got to.
• 0:05
  You got to start the way you want to finish.
• 0:07
  She said it was the best money she's ever spent.
• 0:10
  And she was like, I just felt, I feel like I have some like,
• 0:13
  really good goals and like, really good recommendations that
• 0:17
  I can go either back to the nurse practitioner or to a new
• 0:21
  Doctor to say, like, this is what I want to deal with.
• 0:25
  I have hired so many people in my life that I do now have a
• 0:31
  pretty good sense of like, whether somebody's a creep or
• 0:34
  not. Welcome to DPC Life, the podcast
• 0:37
  where independent doctors share real stories, bold ideas, and
• 0:41
  the freedom of doing medicine on your own terms.
• 0:45
  I'm your host, Doctor Ann Gonzalez, and together we'll
• 0:48
  explore the winds, the struggles, and everything in
• 0:52
  between. Let's start in back today with
• 0:56
  my awesome partner, Doctor Rachel Kelly.
• 0:59
  Internal medicine and obesity medicine double boarded and
• 1:03
  we've talked before a couple times.
• 1:07
  First time we talked about kind of where we came from, how we
• 1:10
  started, and then we did episode on aesthetics.
• 1:14
  And then I think it'd be fun to do this like every month or so
• 1:18
  just to kind of give it a practice update, like what are
• 1:20
  we doing? Where are we?
• 1:22
  And then there's some topics that we wanted to talk about,
• 1:25
  things like Emrs and other stuff.
• 1:29
  You had some ideas? Yeah.
• 1:32
  We really wanted to kind of hit on some stuff that we really
• 1:36
  struggled with in the first couple of years.
• 1:39
  Like there are a lot of things that you can buy the books and
• 1:43
  you can buy the like how to set up ADPC and those are great.
• 1:48
  They're great. And they give you lots of, lots
• 1:50
  of like, I don't know, 20,000 feet kind of ideas to give you
• 1:56
  like the best idea about what DPC is like the whole theory and
• 2:01
  everything behind it. But when when you get down to
• 2:04
  like the nitty gritty, that's the stuff where we really
• 2:08
  struggled at times. The ER was a really good example
• 2:14
  of that. It's hard when you don't until
• 2:17
  you're in it. You can read about it when it
• 2:20
  seems fine. And then, then once you're in
• 2:22
  it, then there's stuff that comes up that you just don't
• 2:24
  expect it's going to come up. And so that's, that's where it
• 2:27
  gets hard. But well, let's do a quick
• 2:30
  practice update 1st and then let's maybe go into Emrs.
• 2:33
  How about that? So last time we talked, we were
• 2:39
  about to hire a nurse practitioner.
• 2:42
  And yes, so she's on boarded, She's coming once a week right
• 2:47
  now just to kind of on board some patients because she's
• 2:49
  still working out her fee for service job, her other job.
• 2:53
  Unfortunately for the other practice, they never actually
• 2:56
  did a contract with her. Not really sure why.
• 3:01
  That just seems I don't. Know.
• 3:05
  Unheard of. Who knows?
• 3:09
  Totally. Yeah.
• 3:10
  Why? I don't know why.
• 3:11
  Like what people to do things they do?
• 3:13
  Yeah, but anyway, so she didn't really have a contract.
• 3:16
  So it's very nice of her to say I will work two months and and
• 3:19
  then leave. You know, that was pretty
• 3:22
  gracious. He wanted her to work six
• 3:24
  months. Yeah, that's nonsense.
• 3:25
  That's that's. Crazy.
• 3:27
  So a real quick thing about hiring.
• 3:30
  So a lot of our DPC friends like just jump right in with the
• 3:35
  hiring. They like hire a nurse
• 3:37
  practitioner, hire a nurse, hire all these people.
• 3:39
  Yeah, office manager, even assistant.
• 3:41
  Yeah, all the people, yeah, we have been like super resistant
• 3:46
  to like the concept of hiring people.
• 3:49
  I think for me it was really like multifaceted, like why I'm
• 3:53
  so stressed out about hiring people.
• 3:54
  So in my previous life, I hired lots of people all the time,
• 4:00
  sometimes good, sometimes bad. I understand how hard it is to
• 4:02
  find like really good, solid people who like I've with you
• 4:08
  and get kind of life views and important when you have a small
• 4:14
  practice. The second is like, what do you
• 4:18
  do when somebody just quits? Because especially with like a
• 4:22
  provider, whether you're talking about a doctor or an ACP, like
• 4:26
  that's not somebody you can just hire like another one of
• 4:29
  quickly. And I mean a nurse, yes, like
• 4:32
  there are lots of nurses around. Somebody was asking us this
• 4:34
  morning, apparently at the young professionals thing, if you're
• 4:38
  hiring a nurse, there are a lot of people, like a lot of nurses
• 4:41
  around looking for jobs. So that's a little bit easier to
• 4:44
  hire. But, you know, we've really sat
• 4:47
  and contemplated for a long time about whether we wanted to hire
• 4:51
  a doctor, hire a nurse practitioner, what we're going
• 4:54
  to do, and finally, Karen, who is who we already worked with,
• 5:01
  like we already know her. Yeah, I mean, I worked with her
• 5:03
  for like 6 years. Yeah.
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  So like, she's not. And I think that honestly, I
• 5:09
  don't think we would have hired anybody unless it was somebody
• 5:13
  we had worked with. Yeah, yeah.
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  The thought of hiring someone completely unknown was that was
• 5:18
  stressful. And when Karen was like, hey,
• 5:21
  what about me? What am I chopped liver?
• 5:24
  Like, why don't you? What about?
• 5:26
  Making me even think that she want to like come and work with
• 5:29
  us. Like honestly I never asked her
• 5:31
  because I just didn't think she wanted to.
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  I know I thought she was very. So yeah, she, yeah, yeah.
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  But no, I'm so glad. Right, right.
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  And for people who are in a weird market like we are trying
• 5:47
  to onboard a new provider, like it's very stressful.
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  I would put the money into the advertising even though even if
• 5:58
  you like don't really have the money because you know you
• 6:02
  really want to like get them front loaded and you really want
• 6:05
  to get them busy because those people will tell other people
• 6:09
  and that word of mouth is going to pick up.
• 6:12
  So yeah, yeah, so right now we've got, yeah, we've got some
• 6:15
  ads going and then we're emailing like our old patient
• 6:20
  list and just telling them, hey, if you don't want to come, fine.
• 6:25
  But if you know someone who might need a Doctor Who maybe
• 6:29
  they don't have entrance and they need something.
• 6:33
  So yeah, trying to use our network.
• 6:36
  Unhappy with the current situation and they want it's one
• 6:43
  thing that even compared to like when we came into DPC and the
• 6:48
  the client, the climate has changed a lot in service really
• 6:53
  in four years. Yeah.
• 6:54
  I mean my mother the other day was like had a UTI and her
• 6:59
  doctor like was never even asked about what to do with that.
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  The front office staff just sent like told her two different
• 7:08
  times just to go to the urgent care and yeah.
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  And I was like that is such a waste of resources.
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  First of all, it's a waste of like everyone's time and it is.
• 7:20
  And the doctor I spoke to the doctor and.
• 7:22
  She had no idea. No, absolutely no idea.
• 7:25
  And she was like this front office person's been sending my
• 7:29
  patients to urgent care and without me knowing it.
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  And I think of that as such a such a like typical situation
• 7:36
  and fee for service, especially like these hospital owned
• 7:39
  practices where you have no control over your staff.
• 7:43
  And I think it's gotten really, really bad and patients are very
• 7:48
  unhappy and they they don't the fact that they can never ever
• 7:53
  talk to their doctor about anything.
• 7:54
  Right. Yeah, Yeah.
• 7:55
  You just had a new patient come in.
• 7:57
  She came in because she wanted a cardio metabolic evaluation,
• 8:01
  right? Yeah.
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  And. As a primary, yeah, she was
• 8:06
  like, I wanted to talk like in depth about my cholesterol and
• 8:13
  my cardiac risk. She's like, I'm not a spring
• 8:15
  chicken. She's like, I would like to eat.
• 8:19
  I try to do as much as I can, but like, I don't know what my
• 8:22
  risk is. And we talked about it.
• 8:25
  And my, the nurse practitioner I see only basically just tells me
• 8:30
  like, there's only like this Med available.
• 8:32
  Only statins are available, only study is available.
• 8:35
  That's it. And I was like, well, there's
• 8:36
  like a whole world of new drugs available, first of all, that
• 8:40
  are really pretty revolutionary drugs that might really suit you
• 8:46
  a lot better, especially when you're talking about elevations
• 8:50
  of different things like LP as and stuff like that, or the
• 8:54
  small particles. And she was just like, I've
• 8:57
  never had a conversation with anyone like this.
• 9:00
  Never had a conversation with a doctor, a nurse practitioner.
• 9:05
  This has been really, really helpful and just explaining
• 9:09
  things and everything and and I think that's what DPC allows us
• 9:13
  to do. Yeah, Didn't you say something
• 9:15
  like this is the best money I've ever spent or something?
• 9:19
  She. Did she said it was the best
• 9:20
  money she's ever spent? And she was like, I just felt, I
• 9:24
  feel like I have some like really good goals and like
• 9:27
  really good recommendations that I can go either back to the
• 9:31
  nurse practitioner or to a new Doctor to say like, this is what
• 9:37
  I want to deal with. This is what my long term goals
• 9:40
  are. And she was like, I just really
• 9:43
  feel like this is what people want.
• 9:48
  People who who are really engaged in their healthcare.
• 9:51
  This is what we want to get out of out of our healthcare.
• 9:55
  Right, right. Yeah, someone on the Facebook
• 9:58
  groups was talking about just the other day like should you do
• 10:00
  one off visits? And I at first I was thinking
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  no, because I was thinking of like, oh, you have a cold, can
• 10:08
  you can I see you just for a cold or like a UTI or something
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  like that. But now I think about this kind
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  of visit like if you have a specific kind like a specialized
• 10:19
  type focused kind of consult, just like a cardio metabolic
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  visit, perimenopause, menopause evaluation kind of something
• 10:28
  that is really more of consultant then yeah.
• 10:32
  So bring them in, they see how it works.
• 10:34
  You talk to them about DPC and then like this patient is going
• 10:37
  to sign up, I think even her husband, right.
• 10:39
  At least that's the plan right now.
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  The. Patient's I think going to sign
• 10:43
  up for the practice. Yeah, for DPC.
• 10:46
  For DPC, yeah, I we've talked about this like a lot
• 10:50
  previously, OK. And being an internist doing
• 10:53
  obesity medicine, I have a very you being a geriatrician, like
• 10:57
  technically we are specialists, but it's like really hard for us
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  to get our heads around that the concept of doing consults,
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  right? But because I often times will
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  like downplay my expertise and be like just primary care
• 11:17
  doctor, but you know, I mean, like I'm an internist.
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  I mean, like I have a lot of tiny stuff.
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  And then all the training that I've done since I finished my
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  residency with Women's Health, with obesity, with lipids, with
• 11:30
  all this stuff. And I have found especially
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  because of the fact that there are so many AC PS working
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  independently now in the outpatient setting, that we have
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  a place kind of in the intermediary between that group
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  and the sub specialist. And the reason why I say that is
• 11:53
  because I mean, at least around here to see a sub specialist
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  right now, especially in somebody who has stuff that like
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  as an internist I would normally deal with by myself.
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  These people are spending 5-6 months waiting to see the
• 12:10
  cardiologist, to see the endocrinologist.
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  Yeah. And these are things that like,
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  this is not like I need a stress test.
• 12:20
  This is like cholesterol, blood pressure.
• 12:24
  I mean, this is like basically it's.
• 12:26
  Very primary care. It's very primary care and there
• 12:30
  are people who would love to just, I've had a couple of
• 12:34
  people just want a second opinion and been a really
• 12:38
  interesting experience and I love doing consults now really
• 12:42
  getting into it like because it allows me you normally, I'll
• 12:47
  like the person I saw who wanted a second opinion.
• 12:50
  I saw her and then we had a second visit because I was like,
• 12:56
  I need to go back and like read all the literature and really
• 13:00
  like get up to date specifically with this topic that we were
• 13:04
  talking about. And it was a, a topic that's
• 13:07
  like in my realm. It's not like I'm treating
• 13:09
  people's rheumatoid arthritis or something, but it was definitely
• 13:13
  something in my realm. But I was like, I want to really
• 13:15
  make sure before I give you like my end recommendations that I'm
• 13:18
  like tip top. So I came back and I like gave
• 13:21
  her my recommendations and I told her exactly why.
• 13:24
  And this is the data, This is, these are the studies.
• 13:26
  And she was like, really like, this is very helpful.
• 13:29
  I really appreciate it. I did give her aim of a sub
• 13:33
  specialist who deals just with what she was dealing with.
• 13:37
  And there, that's really cool that those people exist now
• 13:40
  because of telemedicine too. You know that this person's in
• 13:44
  New York and she can, like, have a visit and talk about this.
• 13:48
  Yeah, yeah, yeah. Which?
• 13:52
  Previously that we require going to New York and getting an
• 13:56
  appointment, which would take months.
• 13:57
  And it's, it's very cool. Definitely, yeah.
• 14:02
  Yeah, it's very telemedicine has really like, like really opened
• 14:06
  up the world if you're willing to steer the patients in the
• 14:10
  right direction. Right to the.
• 14:12
  Specialist. Yeah.
• 14:15
  So, OK, Well, yeah, it's very good.
• 14:18
  Yeah. So what else is going on in the
• 14:19
  practice? We got a new office manager.
• 14:23
  She's so great, she is. Fantastic.
• 14:26
  And we love our previous office manager that left us, can't
• 14:31
  replace her really. But our new office manager is
• 14:34
  just, yeah, I know we've been very, very lucky in that sense.
• 14:38
  We have been. Yeah.
• 14:40
  Yeah, we have. Been and you were talking about
• 14:42
  the kind of reluctance to hiring people.
• 14:44
  Now I'm just like, yeah, let's hire everyone.
• 14:47
  Seriously, I think I I have hired so many people in my life
• 14:51
  that I do now have a pretty good sense of like, whether
• 14:56
  somebody's a creep or not. Of course.
• 14:58
  I mean, there are going to be people who trick us.
• 15:00
  But you. Yeah.
• 15:02
  I think in like earlier in your career, it's hard because you
• 15:06
  like really want to believe that everybody's a good worker.
• 15:10
  Yeah. And and I now we're kind of at
• 15:13
  the age where we're like. We know stuff we.
• 15:16
  Know stuff? Yeah, yeah.
• 15:19
  When you're 2030, you're pretty naive about some stuff
• 15:21
  sometimes. And yeah, we've seen stuff.
• 15:24
  So let's see what else. I think those are the big things
• 15:28
  right now, yeah. I think things are going OK.
• 15:31
  We're really like trying hard to onboard patients for our nurse
• 15:37
  practitioner. We're really trying to build
• 15:39
  statics. Practice as usual.
• 15:41
  Per use. Per use, yeah, but aesthetics,
• 15:45
  it's actually right now it's a good time for both aesthetics
• 15:49
  and DPC because one, it's laser season.
• 15:52
  So aesthetics, great time, great time.
• 15:54
  Laser season is my favorite time of the year, right?
• 15:57
  And then for DPC, it's open enrollment almost.
• 16:01
  It is, yeah. Actually wait, I have to show
• 16:03
  you this. This is new my new T-shirt so
• 16:09
  can't really see. I love that.
• 16:11
  November 1st, I think that's the date of open enrollment starting
• 16:14
  and that's why Doctor Ferrigo picked that day.
• 16:16
  I'm not. I can't remember if that's
• 16:18
  right, but. That's a good, that's a good day
• 16:20
  to do that. I know.
• 16:22
  This year may be a very weird year too, because of the ACA
• 16:27
  subsidies going away possibly, and I don't know how that's
• 16:31
  going to work out. Yeah.
• 16:34
  And then with the ability to use Hsas for DPC in January.
• 16:41
  So it's been weird because it's always been like this Gray area
• 16:45
  and I've always had patients who are like, no, I don't care, I'll
• 16:48
  use it and then the HSA be fine. I mean, I've had patients
• 16:52
  literally pay for talks with their HSA and their HSA is never
• 16:58
  thing about it like so. But you know, one thing I am
• 17:03
  noticing in the like aesthetic sphere, a lot of companies are
• 17:08
  now saying like all the red light companies and all the like
• 17:11
  sauna companies, they are all say you can use those days for
• 17:16
  all this. So they've really opened up, you
• 17:20
  know what you can use that money for in the healthcare space.
• 17:24
  So it's really nice that they've included us in that.
• 17:30
  Yeah. So if, if people haven't looked
• 17:33
  at this before, there's a whole website, I think it's called
• 17:36
  Hsas, something I don't know, but if you Google it, you can
• 17:40
  find it. It's a whole website with all
• 17:42
  these kinds of products and things that you can use your HSA
• 17:45
  for, like sunscreen, the red lights, heating pads.
• 17:49
  I mean, stuff that I was like, oh wow, you can use.
• 17:52
  I need to get my card out. Start buying some of the stuff.
• 17:56
  I know my sister was telling me she's going to buy a sauna like
• 17:59
  in a bird sauna. Great holy.
• 18:04
  Cow. Nice, so there's one at Costco
• 18:07
  that she's going to get. Amazing.
• 18:14
  Oh my gosh, that's too funny. So yeah.
• 18:17
  So then what else? There was one other thing I was
• 18:20
  thinking about and it just flew out of my head.
• 18:22
  But anyway, yeah. So that's that's kind of the
• 18:24
  practice update. Anything else about We want to
• 18:27
  talk? About Emrs.
• 18:29
  Yeah, let's, OK, let's, let's talk about our twisty journey
• 18:32
  with EMRS. Yeah.
• 18:36
  So we how many emrs have you used in your life would you say?
• 18:42
  I've only had a couple of jobs, thank God.
• 18:46
  Knock on wood, right? Let's see, In residency I had
• 18:49
  one and. You guys were not on EMR when
• 18:53
  when you were in Med or? Residency.
• 18:55
  Right in residency. Did you have favorite?
• 18:57
  Charts or we were no we were EMR, but it was yeah, it was EMR
• 19:03
  but it was like we are dictating and but then some of the places
• 19:08
  where we rotated were still paper charts for sure.
• 19:11
  And so that was I think that was practice partner.
• 19:14
  And then when I went to my first job here, I think that was also
• 19:17
  actually I think they also use practice partner.
• 19:21
  Yeah, which was weird. It was kind of nice to just ease
• 19:25
  into that. And then at our last practice we
• 19:30
  had two different started with one, changed over to Athena,
• 19:36
  then Atlas, and then Turbo. So like 5.
• 19:39
  Maybe you must have had more. Maybe 5?
• 19:45
  So I did a bunch of rotations in medical school at different
• 19:50
  places. For the.
• 19:52
  Universities. So yeah.
• 19:55
  So we were like, we kind of had a sort of a paper ish.
• 20:01
  Dictating EMR when I was in medical school at my hospital.
• 20:05
  But like then we went and I think I used Epic then and then
• 20:09
  there was one that I can't remember the name of it that
• 20:12
  isn't nobody even uses anymore. My residency used something
• 20:15
  called Org and then they got rid of that and started using Epic
• 20:20
  there and then I we were on Cerner.
• 20:27
  I've used Athena centricity. So like yeah, if you use like a
• 20:32
  ton of EMRS, OK. And one thing I noticed about
• 20:36
  the DPCEM Rs versus the like big, what I would call a big box
• 20:41
  EMR for like Athena or Centricity for the outpatient in
• 20:46
  the outpatient is DPCEMRS are built for doctors and the fee
• 20:53
  for service are built for administrators.
• 20:57
  And so they're like inherently difficult for doctors.
• 21:00
  Yeah, yeah, in insurance, right. So that was the first thing that
• 21:05
  like I was like shocked about, OK.
• 21:08
  But the first EMR we had in like in DPCI felt like it was this
• 21:16
  exercise in total rejection of mainstream and it was so pared
• 21:23
  down. And I can say what we did.
• 21:27
  We used Atlas. Yeah, yeah.
• 21:29
  Yeah, almost harder than using Athena because like it had no
• 21:36
  utility like of any kind. So I think it definitely it
• 21:41
  takes the right person right for that.
• 21:44
  Like if you like simple, you know it works.
• 21:47
  It absolutely works. And it's very cut dried.
• 21:50
  There's it's really no frill, right?
• 21:53
  And that's how you are. Yeah.
• 21:56
  Like I think my husband would. He is a doctor as well as I
• 22:00
  think he would look at it and be like, this is exactly what I
• 22:02
  want, right, Yes, like to the point, but I kind of was like, I
• 22:08
  think I need some stuff just a little.
• 22:11
  I am a little bitty Princess, so I need a.
• 22:15
  I need some like I found it like I can't remember anything OK
• 22:21
  like I can't remember anything I can't remember.
• 22:24
  Just do things I need. Reminders.
• 22:27
  I need portal, I need a reminder, I need portal, I need
• 22:32
  like other things because I absent minded and busy and like
• 22:37
  way too busy so we had to find the middle ground.
• 22:41
  Don't. You think?
• 22:42
  Yeah, yeah. And I think the portal we
• 22:45
  mentioned before, the portal was really nice because it did take
• 22:48
  a lot of stuff off our phones, the texting, which is really
• 22:52
  good. That was a good thing.
• 22:54
  Because we don't have a So if you have a nurse in your office,
• 22:58
  someone who like is the person between you and the patients,
• 23:03
  like I don't even matters, then you know, they can text whatever
• 23:06
  number you give them and the nurse can deal with that, send
• 23:10
  stuff to you. But when it's just like you,
• 23:14
  your office manager, patients, it was so overwhelming, you
• 23:18
  know? And our office manager was only
• 23:19
  one day a week at that time. Yes, so it was.
• 23:22
  Basically us most of the time. And I think first year, it was
• 23:27
  almost like full burnout first year because it was just this
• 23:31
  constant barrage of patients contacting us for stuff like,
• 23:39
  yeah. That may have been partly our
• 23:42
  fault too, because of boundaries.
• 23:46
  Non boundaries, No boundaries of any kind.
• 23:51
  So yeah, it's starting out, People starting out.
• 23:53
  Listen up. Get your boundaries straight
• 23:55
  before you start, because you got to.
• 23:58
  You got to start the way you want to finish.
• 24:00
  If you want people talking to you all the time and texting you
• 24:02
  constantly, go right ahead. But if you don't want that,
• 24:05
  don't do it from the beginning. Right.
• 24:07
  And I think that one of the things that people don't realize
• 24:11
  when they have a medical assistant or a nurse at a fever
• 24:16
  service office is how often people call the office and how
• 24:23
  often they want something. Because so much of it is done by
• 24:26
  your medical assistant. And you're sort of like blown
• 24:30
  away by the amount of stuff. It becomes extremely
• 24:35
  overwhelming if you don't have a system to deal with it.
• 24:39
  Yeah, that's one thing I would tell people.
• 24:42
  Like right off the bat, you have to understand that there used to
• 24:47
  be a person who dealt with your patients percent of the time and
• 24:51
  you got 10. One weird thing that I had no
• 24:56
  idea is like so many people come on the wrong day or at the wrong
• 25:00
  times. So much.
• 25:02
  And I had no idea because we were in the back and somebody
• 25:06
  else, we'd have to tell them, no, your appointment is tomorrow
• 25:09
  or it was yesterday or like it's at 5 or 4 instead of 2 or
• 25:14
  whatever. You know that it just.
• 25:16
  It's amazing. And when we implemented the text
• 25:19
  message reminders like that thing, that has helped a lot
• 25:25
  because people are like, Oh no, that's not the right day.
• 25:28
  Or. And so then they have to call,
• 25:30
  yeah. It still happens though.
• 25:32
  We don't. Still happens, Still happens
• 25:34
  sometimes. Yeah.
• 25:35
  And that's a good point. That is a good point.
• 25:39
  So I think even more important than like picking the right EMR
• 25:42
  is like making sure that like you understand right off the
• 25:47
  bat, you know, what kind of person you are and what your
• 25:51
  needs are. And that's really hard to figure
• 25:55
  out early. It is because you don't you've
• 25:58
  never had the, the more basic DPCMEMR versus fee for service
• 26:04
  EMR. So I mean, I agree, didn't
• 26:07
  realize. So we went from Atlas to Servo.
• 26:10
  We looked at Arrow DPC, which at that time was actually
• 26:13
  transitioning from arrow to hint.
• 26:15
  And so I think it was just, it's had some growing pains and we
• 26:20
  thought that's made us a little bit wary of that.
• 26:23
  So we decided to go with Servo, which had a portal, which is
• 26:26
  really, really nice. And it's, it is, I will say it's
• 26:30
  more expensive for sure. And it's got a lot more stuff.
• 26:34
  And so people who don't want all that stuff, Atlas works
• 26:36
  perfectly. And I mean, there's nothing
• 26:39
  wrong with Atlas. I'm not trying to say don't.
• 26:42
  It does a lot of good things, but we just felt like we needed
• 26:45
  more structure. I would say more structured.
• 26:49
  The reminders are really good. The ability to send.
• 26:52
  I can't remember now if Atlas does text reminders for
• 26:55
  appointments. Serbo will send an e-mail.
• 26:58
  You can time it. You can time it, either you want
• 27:00
  it to go well, there's an immediate confirmation, then an
• 27:03
  e-mail one to two days beforehand, or you can send it a
• 27:06
  week ahead of time. It doesn't matter.
• 27:07
  Whatever you want, you just make it the time you want.
• 27:10
  And then the text and the text we changed.
• 27:12
  We used to do it like 2 days ahead, then we did it one day
• 27:15
  ahead, and now we do it a couple hours ahead of the appointment
• 27:19
  because two days ahead, one day it's still too early.
• 27:24
  Yeah, no one remembers even then.
• 27:25
  Yeah, I think generally like we had, we hemmed and hawed about
• 27:30
  this portal situation. I remember the conversations we
• 27:33
  had where it would be like our our patient, Yeah.
• 27:37
  Do we need? It is it.
• 27:38
  Will our elderly patients use the portal but they like?
• 27:42
  Really, they love it. Love the portal and I am really
• 27:46
  surprised that first of all, servos portal is pretty easy to
• 27:49
  use. We'll say that it's it's very
• 27:52
  simple. It's not like ultra complicated
• 27:55
  like some portals I've been in, like I have my doctors at UNC
• 27:59
  Health and the portal is like it's a lie.
• 28:05
  There's too many buttons. It's like very busy.
• 28:08
  This one, it's like very pared down.
• 28:10
  It's very easy, very, very simple to like send a note and
• 28:15
  it's very easy on our side of things to respond, which is
• 28:19
  really important for me because it's like inside of the EMRI
• 28:24
  thought when we were on Athena, the portal was cumbersome from
• 28:32
  on our side, difficult to respond and there were like too
• 28:35
  many options on how to respond. Like I feel like it just needs
• 28:39
  to be like respond or don't respond.
• 28:42
  Like also I love on servos where you can redirect, like you can
• 28:48
  respond to your medical assistant, like do something,
• 28:55
  yeah. Like a task.
• 28:56
  Just move it. Over, yeah.
• 28:58
  Like I love that and I didn't used to use it, but it is like
• 29:02
  very, very helpful. Now.
• 29:05
  I do think that there are too many like task things across the
• 29:08
  top. Like I don't understand what
• 29:10
  some of them are for. There's like, like, I don't
• 29:14
  know. Yeah, yeah, yeah.
• 29:16
  There's a couple things that it's kind of you have to have.
• 29:19
  Your your your. System of how you want to use
• 29:21
  them. That's definitely like when you
• 29:23
  said you need to know yourself. Yeah, you want to start out
• 29:27
  trying to have some sort of system of how to deal with
• 29:30
  things. Yeah, the sending prescriptions
• 29:34
  was trickier in Atlas. Right.
• 29:38
  Yeah, because you had to fax them.
• 29:41
  That is very much like AI don't like that and then you had to
• 29:44
  have like a separate thing in order to send anything that was
• 29:47
  controlled and I can't do that. I like the fact that this is
• 29:51
  hooked up to sure scripts. You know you can get so they
• 29:53
  have all the meds in there. It's like being sent correctly
• 29:57
  the same exact system as all the pharmacies.
• 30:01
  They can send electronic back to you.
• 30:04
  I'm like very much of the opinion that I would love to get
• 30:07
  rid of faxing 100%. Like I wish it was all gone from
• 30:11
  medicine. We get like a of nonsense.
• 30:17
  No, and we get charged for it too, which sucks.
• 30:19
  We get charged. It's for junk facts too.
• 30:23
  Yeah, not not cool, not cool people, but yeah.
• 30:26
  So Emrs there's oh, there's a bunch of new ones now.
• 30:30
  Acute are there? Yeah.
• 30:32
  Arrow is now hint health Sigma MD.
• 30:36
  And then elation. Forgot about elation.
• 30:38
  That's been around for a while. Well, who have?
• 30:39
  Used a list and I liked it. Every so often.
• 30:43
  I'm like, maybe we should get a new Oh my God, but it's.
• 30:47
  Like so much. That it's.
• 30:50
  Like moving so much their place now.
• 30:53
  Right. And in order to be competitive,
• 30:56
  these companies have to start integrating more.
• 30:59
  So every year they like try to integrate something into into
• 31:04
  the EMR like I would love for them to what's the the thing
• 31:09
  that we do like spruce, spruce. To be integrated great of like
• 31:16
  something like. Spruce was integrated, but Freed
• 31:19
  is integrated with all of the cloud based DMS now.
• 31:22
  Push it now, yeah. I think Atlas has AI integrated
• 31:25
  in it now which is pretty cool. That's very.
• 31:28
  Cool. OK.
• 31:29
  So like very cool plug for Atlas and that, but I think that Atlas
• 31:34
  has made a lot of changes to get an easier EMR use and Atlas I
• 31:39
  would say their customer. Service great.
• 31:42
  They was always messaged like almost immediately.
• 31:46
  Like do you guys even sleep? Seriously, I was like.
• 31:50
  That guy doesn't. And it's like the same guy.
• 31:52
  He's like always awake. Yay Kirk.
• 31:55
  Yay, Kirk. Yeah, I think that.
• 31:59
  We probably would have stayed on Atlas had it had a portal, I
• 32:02
  think. So like, we're a portal.
• 32:03
  Option. I think we probably because that
• 32:05
  was really what we 100% needed at the time.
• 32:09
  Yeah, yeah, I think they might have.
• 32:11
  And they were about to start some sort of portal ish
• 32:15
  something. Well, that's pretty good review
• 32:17
  of Emrs. If anyone has questions about
• 32:19
  EMR, we can tell you a whole bunch about them.
• 32:24
  If anyone has questions, you can put them in the comments and or
• 32:27
  message us. Glad to talk more about it.
• 32:30
  Thank you so much. We'll do this again.
• 32:33
  Thank you for listening to DPC Life.
• 32:36
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• 32:49
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• 32:53
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