New here, cost expectations?

Hey there! We are working on getting a small-to-medium sized practice (five providers, possibility of growth) up and running and are considering our options. We have some experience with big-box EMRs and would like to try our hand at OpenEMR if the price is right. Free sounds awesome HOWEVER we understand that there are hidden costs to free, always… time… customization… it all comes with extra.

Are there any comparably sized practices out there that could let me know your market area, patient volumes (daily per provider), documentation time and what you are paying for hosting the software, billing software/service, if you are using anything for patient outreach/portal and the cost on that, any ongoing service or FTEs that you associate with customizing/supporting the platform, and how long you have been using it.

Is this the wrong forum for such questions?

Hi @npeez price will be depend on the feature that you have to implement for your clinic send me your requirement on my email id nbhbiotech.hake@gmail.com

@npeez has already clearly posted the information he is seeking. If you have information relative to his question, please answer it here so others may benefit also.

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Customizations are the biggest cost. It is possible to use the program without customizing it.
I don’t know what you term as a large practice. I have been involved with a practice that was a multi-type of doctors working together. They came to me with 25 providers, 30 support personnel, and 25000 patients to start. They used the program right out of the box with no modifications. They have been using it for the past 8 yrs with no modifications. We upgrade them to the next version as the versions become mature. They only have hosting costs.

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It’s great to know that is possible, but I am looking for some quality of life information (if that makes sense)

If they are using the platform out of the box (which is awesome) how much time is spent documenting? What is the level of documentation? Are they succeeding in PI measures to get better reimbursement? What are their AR days and cost for FTEs billing?

Hey there Nilesh, I think a transparent conversation here might be best not only for me but for other providers with the same general question - see my initial post, please.

I am looking for a streamlined EMR so that physicians are spending less than ten minutes per patient in documentation time, for example. Something along the lines of “ways we can make sure the providers are seeing the number (in terms of productivity) that they are looking for”. Electronic order submission/relevant interfaces. This is a base level thing. I want to understand how people are currently succeeding/excelling with this platform.

I suppose this is a “bump” of sorts. I am still very interested in this info.

@npeez not exactly sure what you are expecting to get in terms of information, a lot of things are documented in the wiki, there’s also this very handy guide by visolve.

In terms of costs it will vary, are you planning on hosting your own solution or are you going to use AWS?

AWS costs can go from anywhere from $15 bucks a month to hundreds or thousands it all depends on how big and how much data you have on your instance.

I installed a local Open EMR instance for a client using docker and a M1 mac mini so the cost was $800-900 of the mac mini.

Open EMR has different roles so how much time a Dr. or a user spends performing specific tasks will come down to practice and familiarity with the platform, there’s no way to estimate this.

Others have talked about customization costs etc.

Not everyone uses the platform in the same way so don’t expect to get all the information since not every use case is similar to yours and/or are using all the features/functionality of Open EMR.

I hope some of this info helps, good luck.

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@benmarte yours has been the most useful response yet, but there is still a large margin here I am trying to close.

I am asking for market area because I understand that rural vs urban areas often have different practices. I am looking for patient volumes to understand what kind of a stress-load can be put on the system and provider for maximum quality/efficiency ratio, documentation time to further understand THAT number. I have a whole expanded set of questions depending on the responses I get to the billing portion, the amount one pays for billing services could really become a factor when making an educated decision on an EMR purchase.

In order to meet Promoting Interoperability you have to have a portal for patients. Are practices hosting their portal in the same virtual machine as their clinical EMR? What are users paying for support on the tool?

Hosting costs are great, I am assuming based on the cited AWS cost there is no need for a separate data server for secure information? (Scanned images, etc)

I hear what you are saying about varying use cases, but there are also fairly standard practices for use AND I would, ideally, like to hear from someone close to a well performing clinic (support staff or provider) with how much time they are spending. I have been a Clinical Analyst for most of a decade, I have worked with a small handful of different EMRs (six or so) and I understand there to be conventionally acceptable investment in time for quality documentation (in terms of usefulness for care and justifying billing at a higher level) I understand that there are varying levels of familiarity, but that is precisely what I am trying to sniff out.

I am not yet convinced (though I would very much like to be) that practices are prospering in all of these accounts (billing, support, efficiency) on $15 a month.