NextGen Practice Management is a medical practice management solution for physicians designed to automate routine tasks and enhance the patient experience. With the aim of simplifying the management of day-to-day tasks, NextGen Practice Management provides the tools to automate scheduling, billing, claims processing, and more through dynamic, customizable workflows.
With NextGen Practice Management users can configure workflows to both automate the backend workload for physicians and provide a more coordinated patient experience. Clinical and administrative tasks such as appointment scheduling, patient billing, claims status checking and processing, eligibility verification, and performance reporting can be automated for more efficient data entry and verification. Users can also set up business rules to trigger automatic actions when certain events occur, with alerts sent to designated staff in real time.
The NextGen Practice Management solution can be used across multiple locations to schedule appointments, clock patients in and out of appointments, and process payments electronically. In order to aid physicians with the claims process and reduce denials, NextGen Practice Management provides features such as electronic claims checking, automatic verification, and real-time eligibility checking, and alerts can be set up to notify staff when a claim becomes overdue. Data such as appointments and demographics can be accessed from all locations, while sensitive financial practice data can be kept private with customizable security settings.
In 2006, a 3rd party integrator (no longer in business) sold NextGen to our organization and since this was their first time installing it, the installation and configuration was barely implemented. To mitigate, in 2011, additional Practice Management training from NextGen and EHR Training/template development resources from Ciscon were engaged to review billing processes and create clinical workflows. Thanks to NextGen/Ciscon, we were able to launch the EHR in 2013. Since then, they have helped us make significant improvements to the clinical workflow (customizing templates) and billing processing. In 2016, the NextGen reports allowed us to start receiving CMS Meaningful Use/ACI incentive funds.
1. Highly configurable...an organization can develop/program/configure any template or drop-down list box to tailor it to their clinical staff!
2. Software includes everything a clinic/hospital needs...and with NextGen's MirthConnect product, any interface or integration to another system is possible and easy! Besides the EHR and Practice Management, NextGen provides a Patient Portal, ePrescribe capability, Rosetta and MirthConnect (allowing interfaces to any system like LabCorp, Quest, Immunization Registries.), and much more!
3. NextGen Support is awesome...and if there is a new staff member, just request Tier 2 or Tier 3 support techs so your challenges are addressed quickly by experts in every area of the product!
4. NextGen Training is helpful from knowledgeable and experienced staff who have worked in clinical and front office environments. For any upgrades or projects, or if you are brand new, leverage the advanced trainers for additional training for staff and learning how to utilize/configure the system by having them review your configuration.
5. NextGen Development and NextGen 3rd Party Integrators (like Ciscon) are amazing to work with...If you don't have time to develop templates or learn, contact them to obtain a quote. I have been most impressed with support team at Ciscon! They have been able to streamline Provider templates and save tons of clicks so the Providers just adore and appreciate the efforts! They were also able to train all the clinical staff on the new workflows.
Like any EHR (vs a paper chart), there are lots of clicks for the clinical staff members.
In addition, the graphical user interface was so new to staff, this caused delays in the encounters.
(To mitigate, we spent time, money, and effort on training users as well as building customized templates...This was worth every penny!)
We have about eight months into this software and are still struggling with very basic issues such as claims not making it to the carrier and reports not functioning to our (or our clients') level of expectation. I cannot report on many fields in the system and despite being told in the beginning that their reporting tool was being enhanced and we could report on individual fields, and spend additional money to export data so we could create our own reports.
Clients are increasingly frustrated with inability to get eligibility checks on many of their common carriers and to get anything much beyond just confirmation of coverage (not outline of actual benefits, etc.) Collections module is clunky and we have not found it to be effective.
On the upside, claims entry is fairly simple, and auto posting is a breeze, as is data entry of patient information.
Autoposting is fantastic. We find it does it correctly close to 100% of the time. When the system cannot effectively autopost, it "flags" the RA so that you can address it individually. When we initially converted, we found that importing patient demographics was refreshingly simple and something we could do on our own without additional costs.
Patient demographics are easy to enter and maintain.
Reporting is completely ineffective. Canned reports don't balance against each other, and it's hard to quantify values. Not much assistance from Customer Service, although they do try to be helpful.
EDI process has been nothing short of challenging. From enrollment issues in the beginning to claims submission and follow-up issues, we are finding as we work AR several months later we're still having issues with some of our claims from early on which can't seem to arrive at the payer, despite acceptance confirmation from Healthfusion/ENS. It's costing us hours of time on the phone and lost productivity. We also cannot actually see the acceptance reports and are told we can't have access to those because they're in larger batches, which again creates additional phone calls and work on our part.
In 2015, I spent countless hours reviewing/sampling one EHR after another to find a good fit for what we needed/wanted in an EHR. We were moving from paper and wanted a cloud-based solution. As a dermatology office, we absolutely need the ability to document patient's skin findings on a diagram. HealthFusion was one of the few that gave this ability and even allowed us to upload our own images which we have designed for quick easy use. Most dermatologists will utilize a more derm-specific product such as Modernizing Medicine's EMA, PracticeStudio, etc, however, another criteria we wanted in our EHR was something that was truly platform-independent and browser-independent -- could work on a ChromeOS computer, a Mac, a Windows machine, Firefox, Safari, Chrome, Edge, Internet Explorer, etc. Again, MediTouch's HealthFusion EHR & Practice Management product provided this capability while other derm-specific products did not and continue not to. We also do our billing in-house and wanted a robust billing product. MediTouch is their own clearinghouse which is a big benefit so when there are issues, we don't hear from our vendor "Oh it's a problem with the Clearinghouse", instead MediTouch customer service tells us "Oh we need to fix that". Customer service is overall very good - it is here in the United States (Pacific Coast which is our local time zone) and available relatively quickly. So why not five stars? Well, the EHR itself is not designed very well for a specialty-specific practice like ours so we went through a process of customizing it for our needs. We are happy that customization was available however it was a daunting and time consuming process. While the EHR system allows for some meaningful use and PQRS measures it does NOT collect data for specialty-specific measures so it's basically useless for our PQRS/MU/MACRA reporting needs. Which is very unfortunate and might force us to move to a derm-specific product.
Platform-independent (works on ChromeOS, MacOS, iOS, Android, etc.)
Browser-independent (works in Chrome, Safari, Edge, Internet Explorer, Opera, etc)
Cloud-based with no need for specific hardware/software in-house.
Local to our time zone (Pacific) with U.S. based customer service
Clearinghouse is in-house with the vendor
Speed of operation - there have been moments when the cloud-based
Lack of specialty-specific Meaningful Use, PQRS, and MACRA measures
Need for heavy customization for the purposes of documenting specific scenarios (specialty or otherwise)
Extra components within standard documentation unnecessary for most specialties
Integration of PM and EHR could be a bit better
communicates with my billing company, but I could just fax a superbill just as easily. does insurance eligibility checks, does eRx (but is often difficult to find the pharmacy unless you know the exact zip code, sometimes doesn't find the pharmacy at all, like Safeway's)
Wow, there is so much not to like... Word searching for ICD10 codes, past medical history and problem lists returns hundreds of search items that have absolutely nothing to do with the words being searched. Also, if you enter the words out of the order in which they would appear, you will never find them. Social History is much more than whether a person drinks alcohol or smokes. There is no way to put in valuable details of a patient's social history and automatically include it in your notes. A lot gets lost by having to adhere to some stupid engineer's formatting. Same with past medical/surgical/obstetric histories-you cant add any valuable details to anything (like which knee was replaced and what happened after their concussion, etc). The charting is so useless that I have given up and gone back to paper charting. I start an encounter just to put my billing through. Health Maintenance: I can't enter that a patient refuses to do a colonoscopy or mammogram. All I can do is "disable" that patient from being counted for meaningful use. Poor formatting: while they tout being iPad friendly, each page has lots of unused space, so there is a lot of scrolling just to enter data or get to the save button (and if you don't press save, you lost it). More poor formatting: entering vitals->information is so spread out that it takes two screens to enter. AND peak flow is on the first screen while height and weight are on the second "additional information" screen. Which is more important? Also watch out for the backspace button, sometimes it works like you would expect, and other places you will get logged out and lose all of what you were doing.
It does have medical diagnostic tools like the Vanderbilt already included as well as an Asthma action plan/Asthma control test and several other questionnaires that are rather necessary in primary care as well as collates the information (i.e you can compare today's Vanderbilt score with their last Vanderbilt score without having to hunt down that note).
However, true to NextGen's form, the things that worked really, really well (like having the school physical form be automatically populated with the vaccines), they have somehow succeeded in completely screwing up, making the very, very few good things about NextGen a rapidly diminishing anomaly.
Where do I start??? Having to input data several different locations, it is SLOW and every single thing you want to do has to open a new window (read between the lines and understand that in an already slow program, every page you open has to load) and with all of the windows you open, there's no way to minimize them to go to another screen i.e you can't minimize the medications so that you can review the patient's last lipid panel, TSH, blood pressure, etc. You would have to close the medication module, open the orders module to review the lab then go back to the medication module and open it to make any medication changes. And if you want to make any medication changes or do any documentation at all, you have to have an open encounter and none of the encounters are labelled in any sort of orderly fashion so you have to open each encounter to find out where you put anything (again, think of each page having to load/open and taking 5-10 sec each).
Medications: you have to associate a diagnosis with every single medication if you are a provider which is an awesome idea except that if you haven't previously entered that diagnosis, you can't actually save your medication and go back to it, you have to close out of the medication module, enter the diagnosis into the assessment and then go back into the medication module and re-enter all the same information again.
Labs: there is no way to save quick phrases or phrases you use frequently so that conveying test results is, on a great day, a lengthy and painful process. Also, if you want to know how your current lab value compares with the previous ones, you have to open up the patient's chart and go into the order module.
Entering orders: again, if the proper diagnosis isn't there, you can't save your work and open something quick to pop the diagnosis in, you have to lose all of your orders, "X" out of that screen, open up the assessment screen then go back to whichever area you were in (another lovely thing: everything is separated so putting in lab orders is separate from putting in diagnostic studies which is in a different tab than putting in referrals which is in a different tab than any clinic orders (like toradol, PPD, u/a, etc). Also, if you are ordering any sort of medication to be given in the clinic (like Toradol), if you forget to add that it's a medication, it deletes the order and you have to start all over.
Various names depending on the section: sometimes it's filed under Pulmonary, sometimes it's filed under Lung, sometimes it's filed under Respiratory...and the sections aren't in any kind of order either. The routine way physicians document an exam is starting with constitutional and working your way down. Nope. Not in Nextgen. The main page of the physical exam has One Page Exam, then constitutional, then diabetic foot exam, then ears, (separate from) nose/mouth/throat then neck/thyroid then breast (huh????) on down. However, if you open up a quick-note [great concept if it worked but the software doesn't actually recognize anything is in any particular field (i.e. HPI, Physical exam) and ROS doesn't even save...so if you try to calculate the code it always comes up as a 99212)] and you want to modify the exam at all (because if you go into the one page exam and enter anything, because it doesn't actually recognize there is data there, it deletes everything except what you've just entered) you go into the "Additional" tab where the headings are (I kid you not) Neck/Thyroid then Breast then Psych then Ears then Constitutional then Respiratory then Nose/Mouth/Throat then Musculoskeletal then One Page Exam then Cardiovascular then GU then Abdomen the Skin/Hair then Head/Face then Eyes then Lymphatic then Vascular then Extremities then Rectal then Back/Spine then Neurological and on... The ROS starts with Cardiovascular and marches on down to end with Respiratory and then Vascular and one might think it was alphabetical except Reproductive is sandwiched between Immunologic and Metabolic/Endocrine.
ROS: Since I brought up the review of systems, let's stop there for a moment. There are not things listed that a patient would say; they start out strong but then in Respiratory they include things like "Known TB exposure" (not really ROS but rather PMH or even HPI) and under Cardiovascular they include "Claudication" (not likely something a patient is going to complain about) and my personal favorite, under the female ROS is "Abnormal Pap smear." While there is the ability to pick "Other," most often the drop down menu that is supplied is a restatement of the things in the first menu so you have to hit escape and just type in your own words (or the patient's words).
And on top of all of this, it has the audacity to be glitchy. One of the things it does for me is, even when I've entered an assessment, sometimes it doesn't recognize that it's there and then tells me to enter an assessment...news flash: because of the way the software is set up, you can't enter a plan without an assessment there, so if I got to the screen where I could enter a plan...clearly there's an assessment there...however, you can't argue with a computer...
I titled this "I must be missing something" because if you go to their web page, they've got all these awards that they've won, etc and I just don't see how anyone could award them for anything. This software is abysmal at best and, if I leave my current place of employment it will be because of THIS. Not my boss, not the patients, not the money, the EHR. And this was adapted because the Illinois Primary Health Care Group that is over all of the FQHCs thought that this was the best option for Health centers that are taking care of a challenging population who needs things to be easier for them not more challenging. And with this software, I am more likely to miss things that need to be done because EVERYTHING is on a separate page and with 15 minute visits, who has time to do all that with a slow EHR???
Funny thing is, there's an update that may have fixed several of these issues but you can't task anymore so we can't upgrade. That would mean that every time you needed your nurse to do something, you couldn't send it to her, every time you wanted the front desk to schedule something you couldn't send it to them, every time you needed a follow up lab or test ordered, you couldn't send it to anyone to call the patient and do it. So either I'm missing something HUGE or the people who are evaluating NextGen and give it anything better than "Epic FAIL" are either working for the company or involved with someone who works for the company. My new analogy has become: if I did my job as well as they did theirs, I would be in prison for Manslaughter....
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