Help! Our EMR Is Driving Us Crazy!


So now that you’ve got the first year of “Meaningful Use” almost behind you, there have been the following painful discoveries:

  • “Meaningful Use” really means “Government Abuse” of your practice
  • Your EMR Software was written by programmers who have no idea how a real practice should function
  • Software solutions alone do not make a practice efficient or profitable
  • Everyone in your practice HATES your shiny new expensive software, especially the physicians

We believe that we have the solution for your buyer’s remorse! Let’s go over each of these points in detail before we explain how we can do better.

Meaningful Use Equals Government Abuse

My practice manager (who is also my Pediateq/PaperCutPro® partner) participates in some online listservs for practice managers. The recent chatter there is that now that the first year of ‘meaningful use’ is closing, it is time for all those who participated (i.e. taken the government’s incentive money) to belly up to the bar and provide all the reports that confirm they are in compliance. The other practice managers on the listserv were taken aback by the several hundred pages of regulations and numerous reports that the government required. The physicians simply took the government incentives to participate without carefully counting the costs.

If the full letter of the government regulations are not met, then the incentives will be collected by the government immediately. What physicians and practice managers have done in their limited focus on the government moneys is to willingly put the ring in their own nose by which the government will now dictate how they practice!

What is to be done! We strongly suggest that all physicians reconsider their decision to participate. We recommend they return the government funds immediately. Otherwise they will enjoy the tyranny of the governmental medicine, which will be ten times worse than corporate medicine for local practicing physicians. Painful as this step may be, if not done immediately physicians may never extricate themselves from the government gorilla if they continue on.

Do As I Say, Not As I Do!

Almost all practice management and electronic medical records software is written by non-medical programmers. Even if they have been involved in practice to some degree, they are not physicians or even practice managers. They have a poor understanding of office efficiency and do not design their solutions to improve the practice.

PaperCutPro® was written by me. I am an actively practicing Pediatrician with almost 30 years of experience in medicine and computers. My practice thrives because of my software solution. It is as important to me as it is to our clients that it always be the best. My practice is the proving ground for research and development as well as active care of my patients.

A Solution Is Not Only About Software

Early on when I and Linda Fabre, my practice manager and now partner in Pediateq consulting, began offering PaperCutPro®, it was obvious that software alone could not be the answer. Any practice that is successful and profitable must join good practice policies with good software. We only offer our software as part of our practice managing consulting services.

We expect anyone using our software and service to duplicate our practice success! We are successful and so we believe our clients will be successful. Not only will staff and physicians enjoy taking care of patients, but the practice will be more profitable without the government’s ‘meaningful use.’

“I Love This Software”

In our first beta test site, we installed the PaperCutPro® software and implemented the Pediateq practice policies. The new nurse practitioner coming to join that Pediatrician began training on the PaperCutPro. She had used it several years ago when she was previously employed with my former partner and me, though PaperCutPro® was not the powerhouse of features it is today. Much had been added since her previous experience.

Her first comments to me was that she loved the software! She too had the experience of several other EMR’s that had flooded the market because of the government’s meaningful use program. She too experienced buyer’s remorse of sorts and longed for what she had used before when she had worked for me.

Practice First, Profit Concerns Second

The breadth of features had so widened in my software, that that nurse practitioner was bowed over at how thoroughly she could document the patient exams. The ability for her to customize things with the new Template Manager is her favorite feature!

Supporting documentation is most critical to justify the charges behind the exam. PaperCutPro® makes this easy, quick, and rather painless. Changes to medical records are automatically documented in the exam’s change log. Charts to not have to be ‘checked out’ for use for that reason.

PaperCutPro® and Pediateq consulting is not just for Pediatricians! Because all of medicine uses the standard history and physical format, any primary care or specialty field will be well served by the software. Our consulting services are built on principles and policies that are applicable to all as well.

My practice manager tells me that our practice policies along with the PaperCutPro® software save us about $75,000 annually! That is real money compared to the government incentives. My focus is not on staying financially viable, but on the children I care for!

How You Can Get The Government Gorilla Out Of The Room!

Our Pediateq consulting services and PaperCutPro® software are available on a first-come first-served basis. We will provide client references as well. For an evaluation at no costs, please contact my office at 678-583-9071 and ask to speak with Linda Fabre. We can provide you with a tour of the facilities and to see the software and policies in action.

Clients need only provide the Macintosh hardware. We don’t use Windows for security and other reasons which we can discuss in detail when you tour.

We provide the server hardware and get the initial practice clients set up. All practice data is hosted in our data center and all backups and updates are included in the monthly use fees. The monthly cost for Pediateq consulting and PaperCutPro® software is very reasonable and affordable at $1,200 for up to three providers (physicians, nurse practitioners, physicians assistants).

Warmest regards,

Ron Smith, MD

Say Hello to Logical Paperless Medical Records!


In this world of numerous EHR’s also known as electronic health records, PaperCutPro® stands out. It was the brainchild and creation of me, Ron Smith, MD. I’m an actively practicing Pediatrician with almost 30 years of practice experience. I live and work in Georgia.

I created, maintained, and developed solely as a database programmer who began working with databases in 1985. In 2000, I created and deployed the first iteration of PaperCutPro® as a networked solution designed not only to meet our EHR needs, but to link and network our several clinic locations.

At the end of 2009, PaperCutPro® in its 3rd iteration, was allowing my practice to accurately and easily record the complete medical records of over 33,000 patient visits in  a 12 month period in three clinic locations simultaneously. That is more than many local hospital emergency rooms saw in the same year. Continue reading

Proof and Pudding

That ever so cliche statement ‘the proof is in the pudding’ is, well… cliché!

Nevertheless, it is important to know that the software service that I’m selling is something that I live by. Our office uses PaperCutPr® and it is a testbed for new features, bug fixes and functionality testing. It is important to know that, unlike most other software offerings out there, PaperCutPro® was and is designed AND used in a REAL physicians office! So I think it is important to let you see my office where PaperCutPro® is in active use.

To that end enjoy this short tour of my office, Ron Smith MD Pediatrics and Adolescent Medicine PC. Pay attention to what you DON’T see. There is minimal clutter, smooth office flow design, and just a few legacy chart racks. Remember we see about 9,000 patient visits a year too and including me there are three full time providers in this space.

Video Tour

Why SAAS and Not Standard Licensing?

Most software models in the world are licensed. That means that they are owned by their creator or organization, and users purchase the right to use the software. Fees are one time purchases. Each feature upgrades to the software generally require an additional license purchase price, though often it is reduced. That policy does vary from company to company, but you should get the gist. The point is that if you want the latest and greatest version of the software, then you have to pay whatever applicable license fees that the software owner dictates. Software updates are generally scheduled on a routine basis to keep the company profits steady and the software ‘alive.’

SAAS, or Software As A Service, is based on a usage model and not a one time licensing model. You pay a modest fee every month for the usage of the software and/or services. If you want to quit using the software at any time then you can.

This has distinct advantages in Electronic Health Records software. Instead of a large hardware and software investment that could be $50K – $100K initially for the aver two provider practice, you can get started with say $5000 initial outlay and $1500 to $2000 a month for the usage of the software. Your hardware and software costs are reduced also because we provide all the server hardware and software, plus the software for the laptops and desktops which you will purchase to meet your specific office needs.

Let me share with you what I have in my office and you can judge for yourself. We see about 12,000 patient visits a year, have three front office staff each with desktops. We have a PediKey® Kiosk in the foyer for self-service checkin and medical record updating and a older laptop in the lab for the realtime lab instrument connections. My practice manager has a desktop in her office, I and my two nurse practitioners have laptops. There are 5 laptops in the nursing stations to cover nurse phone triage, nurse facilitator, and the nurse attendings for each provider.

My hardware investment excluding the database server, then is for 8 laptops, each about $1300 average, and 4 desktops each about $1300 to $1400 average. My hardware total is about $17,000. I use only and recommend only Macintosh hardware because of its reliability. I get about 6 years use out of a laptop, and 8 years on desktop units in my experience with Macintosh.

When you break that down it comes to about $2,800 per year hardware cost. It further breaks down to  about $233 per user per year. I’m basing that on a 6 year lifespan also.

Now what about the SAAS fees? These are assessed by provider, not total users. If you have one provider then it is $1,500 a month. Each provider is $500 more so that two is $2,000, three is $2,500, etc. For a single provider then the yearly cost is $18,000 for the SAAS fees. The first year with hardware outlays is the largest, but then year out for the next 6 years, the cost remains $18,000 a year paid monthly.

That includes ALL software updates and our hardware server and server and client database software usage and ongoing support. I modestly estimate the yearly savings is about $75,000. It could be more.

Our company site,, will have the full business end and detail how our management solution integrates PaperCutPro® so that you can get full use of the software… every part of it!