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.
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.