Endocrinology Case Study

Decision for EMR

Why did you decide to use an EMR?

I decided to get an EMR 12-13 years ago, when Medicare said that if you didn’t write it down, then you didn’t do it, and if you didn’t do it, well then they wanted their money back! At this point it seemed like a good idea to purchase a good EMR. I looked into a variety of different EMRs and virtually everything was template-based, point and click EMRs. At that point, I discovered Praxis EMR, and it just fit.

Why did you choose Praxis?

Other EMRs were very confining in what you could and couldn’t do. I currently work in a 60-person group. A few years ago, they listened to our consultant and went with a template-based EMR, and I think they were sold a bill of goods. It just doesn’t work for me. After using Praxis, I’m used to more flexibility. When purchasing the template-based EMR, my group was shown a bunch of salesmen who gave pitches, showed what their EMRs could do, but didn’t show their flaws. I can currently use Praxis to do all sorts of flexible things, including using it with other EMRs and billing programs. Praxis is that good.

The Advantages of Praxis and Endocrinology

What are key benefits of using Praxis?

The key benefit is definitely the flexibility. You can create whatever you want on the fly, and then modify things easily. Additionally, there’s speed and ease of use. I’m in endocrinology. All of my evaluations and follow-ups go into Praxis. It’s easy for me to modify a history or assessment of a patient. During a physical exam, I do a single click to get through part of it. In other template-based systems, you would need to do all sorts of clicks to do a single, simple task. For example, if I wanted to write down the blood pressure, I might have to click the chest, then click the heart, then find blood pressure… With Praxis, it’s quick and easy to record the information that makes sense for what I want to do.

Additionally, sometimes I’m doing an exam, and an issue will come up that isn’t part of the original plan. For instance, if I’m evaluating someone’s thyroid, and I discover a heart murmur, I can easily right this down. In other systems, you would need to modify the template to do this, and to do THAT you need to be a programmer! With Praxis, I can easily make notes that might not be typical for a specific type of examination. I’m able to write down that heart murmur I discovered, and then the next time I see that patient, the heart murmur will be in their history and I’ll know to check it out.

Why is Praxis a good EMR for your specialty?

As an endocrinologist, I’m able to pull notes from others whenever I get a rare case or a case I haven’t seen before. If I were using the template-based EMR many of my colleagues use, I would have nowhere to begin, nothing I could easily modify. In Praxis, if I have a rare case, I can pull a previous case out of my network or out of the Knowledge Exchanger, modify it, save it, and then I have it for the future.

Why is Praxis well-suited for future use?

There are many challenges coming up, in the coming years, and Praxis is well situated to meet those challenges. One of the big ones is interoperability. Let’s say someone comes in and wants all your notes. Well, you can go into Praxis and print everything out as a PDF for a patient, and those can be imported into another record, or the notes can be given to someone and be read on any computer. Many other EMRs are very proprietary… you have to physically print out notes, or scan them in, you can’t put them into a PDF file, but rather some legacy file. With interoperability becoming such a large topic, it’s going to be important to be able to work with other programs, and this is something Praxis is well situated to do.

Have you interfaced Praxis with any Billing/Practice Management Systems?

There are sixty doctors in the clinic where I work. All of the other doctors use a different EMR, and we all use a central billing. I write all of my notes using Praxis, and then scan them into the other EMR. Praxis enables PDF or Word output that can be easily used for storing notes in other systems.

What features of Praxis have impressed you the most?

The customer support is great, especially LiveSupport. If I ever have a problem, LiveSupport is generally right there fixing it. In my clinic, which uses a different EMR, we’ve got ten people doing nothing but networking and running the EMR. I’m doing it myself. I’m able to do all my own support, and it’s outside of anything that those ten people spend their time doing.

Final Thoughts

I’ve been practicing for a long time, and I've seen records evolve from two line notes to four page type written stuff. With a lot of these EMRs, a lot of this stuff that is being generated, it's much worse than a two line note. It's impossible to find the information. Maybe the guy who generated it did it in a hurry and didn’t put a lot time into making sure the important stuff is in there, or that the important information is easy for you to see. Maybe they quickly clicked through all the templates. With Praxis, the note that you think of is the note that you create. It’s something that will be able to be read by anyone, and it’s not just what some programmer wants you to put in.

Praxis Electronic Medical Records (EMR) - Endocrinology Case Study

Physician Profile

Thomas Higgins, M.D.

Internal Medicine/Endocrinology

Boulder Medical Center

Boulder, CO



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