Busy multi-specialty clinic needed to complete NextGen 5.9/8.4 upgrade.


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Protect patient data in our fully HIPAA compliant, secure EHR cloud with 99.999% (“five nines”) uptime and 35% better EHR performance than standalone hosting.

White Glove Support

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Attentive, hands-on support for all of your staff and physicians – keeping them productive and spending more time with your patients.


• Worry-free, on-time upgrade
• No impact to clinic operations and patient care
• Increased efficiency through new functionality
• Customized templates for unique practice needs

Horizon Eye Care, PA (Horizon) offers a full range of ophthalmology services including surgical & medical eye care. Formed in 1998, the multi-specialty clinic has six locations in and around Charlotte, North Carolina with over 200 employees including 20 physicians.

Horizon adopted the NextGen Electronic Practice Management (EPM) solution in 2012, and later added NextGen Electronic Health Records (EHR). Mai Smith, Director of Revenue Cycle Management, oversees EPM internal support at the clinic. Amy Brogdon, Clinical Manager, handles EHR internal support. Mai and Amy work closely together to ensure that Horizon is maximizing its NextGen EPM/EHR investment.

Savings and Security in the Cloud
ITelagen started providing NextGen EPM/EHR hosting and support for Horizon in 2013. Horizon counts on the high level of backup and redundancy that ITelagen hosting offers. “For a private practice, this would be a tremendous expense to do internally,” states Mai Smith. “We’d have to hire more people with technical expertise, plus purchase and upgrade our own hardware.”

ITelagen also ensures the security of Horizon’s confidential patient data in its HIPAA-compliant cloud. “In hindsight, choosing ITelagen to host our data was the best decision we could have made because of all the security issues happening now in healthcare,” says Amy Brogdon. “This would have been another huge expense for us to manage in-house.”

Upgrading to NextGen 5.9/8.4
Horizon decided to upgrade to 5.9/8.4 in Fall 2017, after learning about the new version at recent NextGen User Group Meetings. The clinic’s main upgrade objective was to take advantage of new MACRA and MIPS reporting features in the EHR and maximize reimbursement potential. On the EPM side, they wanted to access updated demographic views and new RTS functionality with additional patient eligibility information.

ITelagen and Horizon started planning for the 5.9/8.4 upgrade at the end of 2017. Since ITelagen led Horizon through prior upgrades, both organizations knew how to work together successfully. For the 5.9/8.4 upgrade, ITelagen added unique skills and expertise in three areas:

Custom Templates – as a multispecialty ophthalmology clinic, Horizon had approximately 80 customized templates to update and test before they were put into production. Ensuring the templates worked correctly in the test environment was essential for a successful upgrade.

“ITelagen helped with things that we couldn’t get to work in the test environment, and also got things to work the way we needed them to once they were in production,” said Amy. “For example, patient tracking utilities in the EHR are customized for our clinic’s specific needs. They weren’t tracking properly because the triggers weren’t set up correctly. ITelagen worked with us until they were functioning properly in the production database. We appreciate this level of personalized service.”

Robust Testing
ITelagen provided Horizon with complete release notes and a robust testing plan. These materials served as a roadmap to help Horizon ensure everything had been tested before it was put into production. ITelagen also did its own testing to confirm that the upgrade would go as smoothly as possible.

The upgrade was scheduled to take place from Saturday through Sunday morning to avoid any interruption to clinic operations. Amy, Mai and ITelagen spent Sunday testing the production environment to ensure it was working properly. “Our ITelagen project lead was there for us all day on Sunday,” said Mai. “We had constant emails and phone calls going back and forth as we tested everything to make sure doctors would be able to see patients on Monday morning.”

On Monday morning, the clinic opened on time and staff started using the system. When an issue or question popped up, ITelagen immediately researched it and followed through until it was resolved. “Anytime I had to submit a ticket, they called me back right away and we did a webinar to figure out what was wrong and how to get it working again,” shares Amy. “They actually listened to me to understand the issue instead of just talking over me.”

Mai adds that “ITelagen works hard to provide exactly what we need, and to provide it promptly. This is especially important in an upgrade situation where timing is critical. They have always been responsive to any issues we send their way. The communication between us is spot on.”

Horizon and ITelagen had weekly meetings during and immediately after the upgrade to discuss open items and ensure Horizon was satisfied with the results. Now, the meetings take place on a bi-weekly basis. They also have a monthly business strategy call to plan for the future, strengthening the partnership and alignment between the organizations.

System Improvements
Horizon is benefiting from improvements in the 5.9/8.4 release. The most popular ones with the staff so far are:
• Spell check functionality in the EHR
• Comprehensive patient demographic view, including insurance, in the EPM
• Fewer clicks required to get to different areas in the system
Going forward, ITelagen will continue to provide services, support and expertise to help Horizon achieve the best possible outcomes with NextGen EPM/EHR. “ITelagen acts as an extension of our clinic by providing valuable resources like hardware, software and personnel to support us,” concludes Amy. “It would be difficult for Horizon to have that level of infrastructure and expertise on our own as a private practice.”