Basically, this solution is Open Source. What you see is what you get, but… you can hire someone to provide support and custom development. The cool thing about FOSS (Free and Open Source Software) is it gives you a lot of flexibility. If you have the know-how, you can set up a server and run OpenEMR for free at no cost. If you are a good self learner, you can watch the on-line videos and learn how to use it. It can be free, but at the same time you can be much more productive if you hire a consultant to walk you through the installation, explain your hosting choices, provide your staff with a support contract and training, and provide custom software development if the out-of-the-box CE doesn’t meet your needs.
Let me directly answer some of your questions:
1: How is Openemr with specialized practice like plastic surgery?
OpenEMR comes with the community edition forms. If you need different types of forms, you can create your own forms using the Layout Based Forms creating tool or if you need something more advanced you should consider hiring a developer. Specialized practices use OpenEMR but sometimes they need to pay a developer to make the changes they need.
2: Day to Day… This depends on what your needs are. If you have a support contract with an OpenEMR expert, it can be very easy. This depends if your needs are already met.
3:Support wise if functions and features don’t work how long does it take for things to get fixed? Is there an actual paid support package?
This is an open-source community. If you experience a particular bug and need it fixed, you should hire a developer. You can report bugs in this forum, but there is no guarantee for a timeline fix. Sometimes its easy and it will be fixed right away or sometimes someone has a fix on a branch that has not been brought into the master branch. Other times you might want to hire a developer to assist.
4:Is it better to have a local installation of the server or go with AWS?
This depends on your needs. Personally, I think its much better to have a self-hosted server on-site and have a paid IT guy manage it. Some people are very much about the cloud, but if the Internet goes down, you lose access to your OpenEMR instance. In the case of a natural disaster (earthquake, hurricane, or other unpredictable natural / human caused disaster) keeping an instance in the cloud may prevent your access in the most dire situations. On the other hand, self contained servers brings other issues. I do recommend using AWS or GCP to back up your data.
5:How well does e-prescribe integrate? How is the submission to insurance companies?
There are services that are offered that offer e-prescribing. I am happy to discuss these with you. Out-of-the-box works well with Availity and Office Ally.
The thing to remember is that OpenEMR is an open-source project. I am happy to discuss more with you. Feel free to send me a PM and I can get you set up with a support contract and custom development, depending on your needs.
The most important thing to remember about open-source software is you are free to do with it as you wish. You can modify it, you can repackage it, you can use it for no cost, its yours. OpenEMR is powerful and its meaningful use certified (MU2). If you have a question you can ask it here in the forums and you will usually have a response within 24 - 48 hours, but if you want a guarantee of immediate help you will want to consider getting a support contract with someone.
The other thing to remember is that the folks that pay for fixes generally support contributing those fixes to the community. As OpenEMR evolves, so does your system. OpenEMR is a powerful solution and extremely cost-effective. We aren’t a billion dollar corporation, we are a community of developers consistently improving and modernizing a robust software solution.