eClinicalWorks vs. Therap Electronic Health Records (EHR)

If you love clicking around in a pretty EMR all day long then this is the EMR for you. [However, I believe] if you are looking for efficiency and support, you should look elsewhere. [I feel] this is an EMR clearly designed by the tech world without much attention or care for those who use it and if you look at the reviews carefully you see that most of the people who love it are in IT.

Therap is best used by persons who primarily work on a computer. This would include administrative work and supervisors or direct care staff who work in a group environment and enter documentation on the computer. While there is minimal room to adjust any of the forms to reflect agency specific documentation, the form templates themselves offer flexibility within the template. The exception being that whatever standard one uses for measurement must be carried out throughout the form to which the measurement standard is attached. Much of the documentation entered into the system must occur in the browser making access through a mobile devise cumbersome. The daily documentation (ISP Programs, T-logs and MARS) are available on the mobile app itself and is pretty straight forward. In this regard persons who work in the field including any supervisory staff in the field can enter documentation easily on this app. There are significant limitations though in that there is no ability to save a return to a form and the default time out is 30 minutes.

Pros: EVV, all inclusive EHR including plans, documentation, forms, MAR and more, excellent reports to capture data across all documents, Ability to export reports by PDF and Excel, provides good training, feedback, and communicates disruptions to the system as well as a walk through of updates made to the system.

Cons: browser access is not mobile friendly, scheduling is cumbersome, inability to save as you go, inability to create plans for the same service year for multiple services, no time out warning on the mobile app.

Incentivized

• Access to patient's records - obvious lack of file and charts; transportable ; multi user synchronous access
• Produces clinical note as end product that is organized and "readable" as opposed to the gibberish output of many EMR's that look like a poorly formatted FORTRAN printouts

• Therap has some very nice reports to track billing, documentation, end user activities, and much more!
• Therap did not disappoint in a smooth EVV process.
• Therap's billing is program works quite well.
• The alerting system works very well particularly for alerting T-log entries (we use this for our incident reporting)
• To be fair, they have a number of documentation tools that are very helpful (seizure logs, food diary, medical appointments and so much more) on the browser version of the program.

Incentivized

• Meaningful Use Reports should be capturing data in real time and generated fairly quickly instead of the MAQ dashboard extraction process.
• Their support teams are not very helpful at certain topics such as the definition/logic of Meaningful Use calculations. These are generally difficult to determine but several cases in regards to Meaningful Use take several days before it gets addressed.
• Training videos would be helpful on their support website.

Incentivized

• We provide a number of services to the same individual. VA requires a separate plan (ISP) for each service. Therap only allows one plan that covers a specific date and will not permit overlap.
• Because we provide supplemental services, most of our employees are field workers and rely on a table to access the record and enter documentation. the mobile app is very limited in what the user can document (T-Logs, MARs, and ISP Data). The browser version is far to cumbersome to use on a tablet and only the browser version contains some of the other useful documentation tools.
• Employees cannot save and return to data that has been entered. It must be completed in one setting before timing out.
• The mobile app times out in 30 minutes without warning creating issues with documentation not being saved.
• Scheduling is a nightmare. It is cumbersome and difficult to navigate. It does not seamlessly roll schedules over. It is also impossible for management to adjust schedules when away from a computer as the browser version (required to change schedules) is not mobile friendly and difficult to navigate on a phone or tablet.
• There is no measure available to prevent 'clocking out" before documentation is entered. This can create a logistical and time consuming processes to reconcile the billing and pay.

Incentivized

If we had an option to easily switch to another EMR product we would. However, an EMR keeps you invested solidly in it - once you've started you're then going to be stuck with it. The investment into the data in the system are such that you have no real option to back out of what you are in and move into something else. Again, if we could, we would immediately move to another EMR. The ability to use it and be supported by the vendor has decreased nearly to the point of inability to use.

Incentivized

[In my opinion] the features allowed by the system are not designed for providers. [I think] the systems are inefficient, and new features tend to be "bolt on" features either as products purchased and added from other providers or simply a module created and strapped onto the software. There doesn't seem to be much idea around making things easier for the provider, though they like to state that provider burnout is something they are working on.

Incentivized

I often cannot assign a proper diagnosis under the assessment section; and as mentioned, sometimes (about once a month) the dictation just freezes because "the request has timed out" (even restarting the iPhone/ laptop does not help).

You put in support cases through a support portal. [I believe] for no apparent reason, the company decided that their support cannot have access to actual patient records and as a result, it's required that they have to connect remotely to a computer system in our network, and log in as one of our users to do anything. This also entails that they are completely incapable of diagnosing problems and require significant amounts of user input and time to try and begin any sort of work on the problems. [In my opinion] this takes away from patient care and other concerns. Also, while you can put in as detailed a ticket as you want, when you are called, you have to go over the ticket again, as they don't seem to read or care what you put in, as it's more important to them to go over everything in painful detail. Often times you must explain to the tech how the process works. In the past month, we were upgraded overnight with zero warning, which caused issues the following day as we had to update every single computer in our network (over 300) and it requires administrative privileges so couldn't be done by a user. This also doesn't update any information in the programs list, so there's no way to tell whether the update happened or not.

Incentivized

Paid for training, did not help. They trained prior to go-live, but it was so long ahead that users weren't able to function well when it actually happened, they seemed unable to provide adequate support. [In my experience] further support is typically very boilerplate, and is thus not useful, and has additional cost.

Incentivized

It's very important to limit your schedule during the weeks after go live but it is equally important to have a resource that is the lead at the practice that ensures that milestones are met leading up to the go-live date. Someone must be the point person at the practice otherwise milestones will be missed and the implementation will run into problems.

Incentivized

eClinicalWorks is above average for primary care outpatient services. It is not my favorite but it is not the worst either. ECW was selected by the group prior to my arrival so I cannot speak to why it was selected. I had an easy time adopting it but I have an extensive history of working with EMRs as a CMIO. As a company, they are constantly work to improve their product

Incentivized

The products that we have researched and used int he past are not listed as available options.

Lauris Online - completely customizable EHR system based on templates the agency uses. The process is cumbersome though in that each form has to be submitted to production with a wait time to go live up to 6 weeks. This can be challenging to business who have the ability to work on the fly and correct forms as they see fit. The reports are also challenging.

MITC - Capriccio Elite, LLC currently uses this program to supplement the pieces of Therap that do not work for us. This include a robust workforce management program (times sheet, clock in and out, documentation with ability to save, a number of alerts letting management know of no shows or late arrivals, completely mobile friendly, prohibits clocking out until documentation is complete, ease of use for administrators to make changes on a computer or mobile device.

Incentivized

• I will just share one area that our organization saw the ROI in a very short time period. That is the elimination of a dictation service for most of our specialty group doctors when we introducec Dragon Medical. This functionality brought a tangible benefit and a significant ROI in a short time period.

Incentivized

• The cost of the program is fantastic and doable for start up business to large operations
• Because of the price, it is easy to ignore Therap's deficits so long as there are other options available to fill in the gaps
• ROI on the time (= money) it takes to reenter information due to unannounced time outs creates dissatisfaction with the workforce and additional administrative time to walk through it
• ROI on time (= money) it takes to assure there is a match between clocking in and out and time entered on the billable documentation is pretty substantial. An agency can easily find itself under billing or over paying staff.

Incentivized