NextGen is one of the nation's largest providers of medical software and is used by over 60,000 providers. They offer several different products to help practices and hospitals manage the financial, administrative, and clinical components of their businesses. NextGen has won many awards since their start in 1973, including repeated rankings on Forbes and BusinessWeek "top companies" lists. For example, in 2010 they were ranked #22 on Forbes Best 200 Small Companies in America.
NextGen Ambulatory EHR has received 2011/2012 CCHIT certification, as well as the important ONC-ATCB certification. This is required for physicians that want to receive Meaningful Use incentives outlined in the American Recovery and Reinvestment Act (ARRA). EHR software companies must meet a long list of feature and functional requirements to receive these certifications. So, pardon the jargon, but NextGen's Ambulatory EHR is a feature-rich system. It provides coding optimization and compliance (i.e. E&M coding advice), ePrescribing, lab integration, image management, and more.
NextGen Practice Management helps providers manage the financial and administrative aspects of their offices. It helps practices manage patient appointments, submit claims to payers and clearinghouses, verify patient eligibility, and more.
NextGen is designed for medium and large practices with 2 or more physicians, and is ideal for a few specialties, namely cardiology, ophthalmology and community health centers. In addition to their EHR and practice management system, NextGen offers revenue cycle management, health information exchange, and patient portal applications. They also provide EDI services and offer off-site data protection.
Daniel from EANW
Portfolio size: 101 or more users
Overall, once you get down the navigation, everything seems to flow pretty nicely. I gave this an 8/10 because there is a bit of a learning curve when it comes to this, and people who aren't as proficient with computers may struggle with learning how to navigate through the system.
Overall, the base programs of NextGen meet our functionality pretty perfectly. We are a multi-specialty Ophthalmology clinic. I gave this an 8/10 because some of the ancillary systems do not work as well as they could.
I believe that no EMR product is perfect. I would even go to say that there isn't one out there that will knock you off your feet. This is simply due to the fact that EMR companies are being forced to develop their products so quickly by the federal government that this comes to a sacrifice in overall quality. Simple as that.
I will nary give out a perfect score. But NextGen's customer support is usually spot on with response times. They also do a good job of opening WebExes in order to physically walk you through the issues or to allow you to walk them through the problem.
The product is all-encompassing. There are many EMR products on the market that only do one thing, such as keep a chart. NextGen not only does that, but they have an image control system and a check-in segment of their software. Each of these can be configured to communicate with one another.
I do not like it when you find an honest issue with the software. You've worked and worked, and you run into a system issue that should be easily fixable. Sometimes, this is a non-issue; just open a ticket (call tech support), someone will walk through it with you, usually via a WebEx, and your problem will be solved. The issue stems from when they are unable to solve your problem and they link your ticket number to a "Problem ID number," basically meaning, "We know and acknowledge that there is an issue here; we will update you when a future release fixes your issue". At this point, you are dead in the water waiting.
As a recommendation, I see a ton of reviews on this website probably stemming from doctors who are unable to cope with the fact that clicks and usability really depend on how proficient you are with a computer in general. These kinds of complaints are a pretty standard response to any computer-based program. You can't exactly blame the fridge when you put your glass under the water dispenser and get ice because you didn't press the button to change the output.
Carmen from Gerstein eye institute
Portfolio size: 6 to 10 users
I like that I can understand it and play around with it.
I use at at work to do my job, and it is user-friendly.
Overall, it's a good system and makes my job easier to do.
They are great. They respond quickly to issues and are always efficient.
It is user-friendly.
Sometimes it is slow, but overall, it's a good product that makes my job easier.
It is a good product that is easy to use and easy to understand.
Flora from Gerstein Eye Institute
Portfolio size: 11 to 20 users
There are many steps, and they have no flow. This makes training new employees difficult and requires too much time.
I need to be able to move quickly from patient to patient, and the software requires too much time.
The software is well-thought-out in regards to all fields required to keep a detailed medical record.
NextGen is always quick to respond to questions and concerns.
The software runs efficiently with few bugs
The software is difficult to navigate and includes many steps
Make sure the software fits in with your daily activities
Danelle from Gerstein Eye Institute
Portfolio size: 11 to 20 users
There are a lot of clicks to remember. Upgrades change often and things that are fixed in the upgrades cause other things to stop working.
Upgrades are released prior to testing functionality. They charge for upgrades when everything doesn't work properly. Their customer service team has no idea how to assist in workflow issues.
It's poorly designed. It does not help support meaningful use. Most templates will change the entire office workflow and delay in template pages adds time to each visit.
You must initiate a ticket for every instance. Then they transfer you to another team to handle your problem without going into detail and address the wrong problem.
It's an easy transition from EPM to EHR.
Everything else is awful. Templates are busy and slow. Customer service is slow and frustrating.
Test out the software before purchasing. Interact with workflow to ensure it will meet the needs of your practice.
Ara from Georgia Ophthalmologists
Portfolio size: 21 to 50 users
It is easy to use after you have been using it for several months.
There are a few things that I wish I could do easier and not have to go through so many steps.
It is well-designed, it just isn't easy at first because its so many steps.
I wish that you could call someone for help. Having to put in support tickets is not user-friendly.
I like that it has many options. I also like the detail that you have to put into everything you do (i.e. from making an appointment to putting a note in the chart).
I wish that we were trained more one on one with a NextGen employee, not just sent on our own to do training.
Make sure you get more one on one training for employees.
Stacy from Georgia Ophthalmologists
Portfolio size: 21 to 50 users
The trainers make it more complicated than it needs to be.
It does what you need it to do. However, it's a lot more time spent clicking away.
Make sure you speak with every department in NextGen and get your information about printers, faxes etc. I had to replace every single printer and scanner, because after being told they would work, they didn't. This was one of the "misunderstandings" with the salesperson.
If you need help, prepare to wait two hours or two months for a response. And they are ticket-happy; they want to enter a ticket for everything.
My project manager has been wonderful. However, no matter how good she may be, she still has to go by the company's policies and procedures.
Customer service. The communication from the beginning with the salesperson wasn't good. I felt deceived by the way he sole me the product, but he later apologized for "misinforming" me. His mistake cost me a lot of money and many hours of work. Support is good at times, but other times, it takes weeks to hear back. Their accounts payable department has been horrendous! In the last year and a half, I've left at least ten messages for supervisors, and not one has ever called me back. Their invoices are always a month late, and then I receive it with a Past Due notice. It takes this department up to three months to reply to a simple invoice question, and it seems like nobody is in charge or cares.
If you are looking for a system that you feel the company helps you with at every step without charging training time every time you ask a question, Nextgen is not for you. If you do decide to go with them, make sure you are very persistent about what was supposed to be taught during the paid training time. I had issues where they didn't explain everything during the paid training time, and they wanted to charge me to answer a question because it required training. I told them their trainer should've discussed it during the eight hours they were training.
Tanay from GPCH
Specialty: Ob Gyn / women's health
Portfolio size: 11 to 20 users
It requires too many clicks; there are too many windows. The templates are busy.
The communication between its own products is poor. It seems they have tried to use traditional charts as a template, but they forgot to figure out how to make it simple, but they have worked very hard to make it very complicated.
It's a horribly designed product. Every time I use it, it reminds me of Windows 3.1.
The customer support for NextGen has poor response times and service.
I unfortunately have nothing good to say about this software.
The Physician side of the software is very poorly designed. It requires too many clicks and is not intuitive. I have used other outpatient and inpatient EMRs; by far, this is the worse one. My previous practice used Allscripts in outpatient and Eclypsis for inpatient. Both communicated with each other when it came to labs, etc. WIth NextGen, labs from inpatient will not enter outpatient. The order sets and templates are very busy. Furthermore, their tech support is extremely slow to respond and usually does not return with a solution in time. My staff hates dealing with them.
It is not worth the money. It is in no way a cheap option, and the amount of time you and your staff will spend using this software will result in money lost.
Sohail from Retina
Portfolio size: 6 to 10 users
It requires too many clicks to do anything. There are multiple windows to parse before data can be entered. Customer support is awful. The letter generating program is terrible.
It triples my work. The user interface makes my stomach hurt.
The product is head and shoulders above its nearest competitor in terms of its awfulness.
Tickets are not resolved promptly. The software is so bad and the company is so useless that we have hired an outside party to make modifications to make it less awful. And it still is terrible. And when the NextGen folks update the system, a lot of the modifications no longer work. It's one step forward, five steps back.
The billing staff tell me that the practice management module performs reasonably well.
It's counterintuitive, click intensive, and very slow. I'm in a busy ophthalmology clinic, and the software is the rate limiting step. Entering exam data is cumbersome. The notes that the system generates read very unprofessionally. Font changes and blocks of text which randomly go missing are par for the course. The simple process of adding a new diagnosis to a patient chart requires that I click three separate tabs, each of which says "add". I honestly hate this system. Stay away.
Talk to a physician who has used it. Don't be fooled by the positive reviews left by office managers, billers, or other non physicians. You'll be in the trenches with this monstrosity. It behooves you to talk to someone who's been there and done that. I've been there and it is a bad place.
Carey from Great Falls
Specialty: Family medicine
Portfolio size: 101 or more users
It is almost counterintuitive. Also, I generally have to pull up two instances at a time to do my job: one to view data and a second to write my note.
It is difficult to find the information I need and difficult to write orders (the format is, again, non-intuitive.)
I'm being redundant now, but it is difficult to use.
They're not there when we need them.
My experience is as a user of this system, which was chosen by hospital administration. I can't think of anything I like about it as a user but can't really address the vendor side other than to say our administration was disappointed in the lack of support. I guess I can also say that I was on call the first weekend after implementation, and that was my first experience with the system after training. The vendor had finished up during the week, and no one was available to help me on that first weekend as I struggled to take care of patients. I considered this product a real risk to the care of my patients then and still do now, even though I know it somewhat better.
This system is completely non-intuitive and the most user-unfriendly software I've ever seen (and I used to be an engineer).
Have users evaluate the system before buying it, not just administrators.
Mona from Family Practice Associates
Date: September 2013
I am a nurse in a family practice, and using NextGen is my first experience in EHR. I was hired about a year after the system was installed, and replaced a nurse who retired because she just couldn't get used to the new EHR way of documenting. The other staff has told me that start up went fairly smoothly and that staff was available onsite for questions the first few days they were up and running, which was very helpful.
I do not feel that NextGen is hard to navigate. I was able to use the program on my own with very little help after only a weeks training, although there are many features that I am still discovering after 2.5 years of working with NextGen. My main complaint is its organizational layouts. The retrieval of information is my biggest challenge. I find it very difficult to find specific consult notes form specialists. Instead of notes categorized by specialty and date, they are only organized by date. I must sift through too many notes to find the one I am looking for, especially if the patient does not remember the time frame in which they were seen.
The same is true for labs and x-ray reports. The e-prescribing feature has many default dosing and instructional settings that are either incorrect or not often used. The process to change directions for a prescription is cumbersome and time consuming. We experience too much down time, with little explanation or time frame of when we will be up and running again. We are essentially crippled when the system goes down. We are unable to access any information which makes it nearly impossible to continue to see patients. Without the ability to review labs, immunizations, previous vitals,etc we cannot provide quality care. We have never been down for more than half the day, although that is still a lot of time, money and frustration wasted.
The IMO search diagnostic code search is supreme. I am able to find codes by providing symptoms, partial diagnoses, and partial codes. It has been a valuable tool. Our parent company has been researching new software, and some of the systems seem to be overly complicated compared to NextGen.
Amy from Covenant
Date: February 2013
I have worked with several different EMR systems but this one is the worst. It is completely inefficient and cumbersome to maneuver within the system. You have to memorize and remember all the millions of clicks to get anywhere. The templates that supposedly help "build your history" string along "sentences" that are non-sensical. There is a delay of 5-6 seconds between every screen and there are way too many screens. You cannot save a whole template. You must save every little piece as in "HPI" is one screen, "ROS" is another which becomes extremely tiresome and exhausting.
We were told that we would be up to full volume in 2 wks, but we are one month in (I'm actually 3 months) and nobody is even close to their full volume. The customer support is lacking a great deal in my experience as my "tap and go" has never worked and I've complained to multiple people, multiple times and nothing has been done to fix it.
The meaningful use instructions do not have anything to do with the diagnosis, so you have to go in and change each one and save it but it doesn't save the instructions for anything other than that diagnosis only. Example; if you pick dx 250.00 and write instructions, save them to your list and then pick dx 250.02 later, the system doesn't recognize that you have saved instructions for diabetes.
It takes forever to check labs and send results just because of the way it is set up so you have to scan through each little part individually and then go back to a different screen to write the results to the patient. If you forget any of it, you have to start over which becomes very frustrating quickly. The PAQ often sends the wrong results to the wrong doctor and it takes forever to first figure it out and then where to send it is complicated.
Jonathan from Chest Medicine Associates
Date: January 2013
I am a Pulmonologist in a busy private subspecialty practice. I have experience using several diffeent electronic health records. Our practice has been using the NextGen product for more than 7 years--so I can speak as a battle tested user of this product. There are certainly some advantages to using any decent electronic health record including access to outpatient records across campus, handling of phone calls, archiving of information, etc. However, the NexGen product has a long, long way to go to catch up. For communication with other physicians the product is atrocious. Computer generated notes are laden with typographical errors, grammatical errors, truncated sentences, and at times gross inaccuracies. For instance, our current template for physical examination puts no output into the office note for the pulmonary exam (and this is for a busy pulmonary practice!). Here is a recent example of text from a COPD follow up note template:
Reason(s) for Visit:
1. COPD - routine follow-up -The patient is seen in follow-up for COPD. The COPD - routine follow-up began since the last office visit. The COPD - routine follow-up has worsened. It occurs daily. The patient rates the severity of the symptoms as mildly severe. Symptom is aggravated by moderate activity. Symptoms relieved by resting and sitting. ....
On top of this there are nonsensical changes of font size and style in midsentence that make office documents look like ransom notes. I care about the quality of my written work, so I literally spend hours each, most of our template improvements are wiped out.
In my view, NextGen was clearly built first as a billing instrument, not as robust tool to promote all aspects of physician practice. The awards are certainly not for the quality of office notes or layout of screens for the enduser. Labs do not import into notes. Micro reports are difficult to read and necessitate scrolling through multiple windows. Data trending graphs are clunky, improperly scaled and often misplotted. As a practice group, we have tried to work with the NexGen programmers and have been very dissatisfied over 7 years with their lack of responsiveness and seeming inability to fix identified problems. Often when one problem is solved many more are created. As a result, our practice has invested a large amount of funding to support a local programmer to try to correct many of basic flaws in the software that should be part of the package out of the box. Unfortunately, with major system upgrades most of our template improvements have been wiped out.