Practice Management Software Buyer's Guide

Managing a health practice is filled with many complexities and constantly moving pieces that must be perfectly organized and coordinated to run a smooth practice and serve patients with the highest standard of care.

Medical practices have a lot more at stake than other “offices” when it comes to administration because they aren’t simply dealing with products or paperwork alone, but human life. This makes administrative mistakes in this field much more costly than in other industries. 

86% of mistakes made in the healthcare industry are administrative, and preventable medical errors persist as the No. Three killer in the U.S. – third only to heart disease and cancer – claiming the lives of some 400,000 people each year.

-Healthcare Information and Management Systems Society 

Fortunately, there are powerful Practice Management software solutions (complete with EHR integration and medical billing functionality) to help streamline all the important administrative functions of a medical practice so you can focus on what matters most-your patients. 

This guide will help you understand what to look for in your perfect Practice Management system and offer helpful guidelines for choosing the best solution for your unique practice. 

There are many Practice Management software solutions available on the market. Many are customizable to the intricacies of different medical practices while others offer specialized tools and features dedicated to a particular type of mental or physical care.

Choosing the best Practice Management software for your unique practice may seem overwhelming unless you understand the top features and tools you should be looking for to better your practice’s administrative tasks and processes. 

• User-Friendly System Interface
• Electronic Claims
• Insurance Eligibility Verification
• Coding Converter
• Scheduling Tools (Patient and Staff)
• Integrated EHR
• Reporting and Analytics
• Customization Options
• Secure Mobile Access
• Revenue Cycle Management (RCM)
• Two-Way Communication with Patients and Staff
• Customer Support

The average organization spends about $20 in labor to file each paper document. The average health organization spends approximately $120 in labor searching for each misfiled document, and $220 for the re-creation of a document.

- PricewaterhouseCoopers

A poorly administrated medical practice can be harmful to patient care and accrue a lot of extra costs. Using a Practice Management solution can help ease these issues and also offer other practice-growing benefits such as:

• Minimize the time spent in managing patient records and charts.
• Increase the security, reliability, and accuracy of patient records and information.
• Improve patient data accessibility with easy to use records, charts, and information whenever needed during the course of a patient’s care.
• Eliminate, or drastically reduce, manual data entry to minimize mistakes due to human error.
• Reduce payment delays: the solution will check that all services and procedures are billed, minimize claim errors, and maintain an electronic record of bills and their lifecycles
• Spend less time collecting bills, and more time helping patients.
• Better handle coverage and reimbursement issues.
• Ensure compliance with government and industry regulations (and avoid hefty fines).
• Improve the quality of patient-physician interactions to boost patient loyalty.
• Streamline administration and management processes and reduce employee turnover.
• Run the practice more efficiently.

Historically, medical practice software fell into a few different categories: Practice Management, Electronic Health Records (EHR), and Medical Billing Software. While many software vendors still offer point solutions that practices can implement separately and integrate into all their other systems, there’s been a shift toward all-in-one solutions. Many practices, even small ones, are choosing to implement software systems that offer all the tools they need for administration, billing, and secure electronic health records storage.

Due to the advent of cloud-based practice management software, smaller practices can now afford to implement tools that they would have had to wait to use in the past. Cloud systems are more affordable and make compliance easier since they’re designed to all the regulations in the industry (and updated regularly at no cost to your practice outside of your monthly fee for using the software).

As a result, most of the leading Practice Management software vendors now offer completely integrated software systems that include tools for practice management, secure and compliant health record storage, and billing all in one easily accessible system. Depending on the size and needs of your practice, this may be the best solution overall for most practices, but it’s best to understand exactly what is offered in the solution you choose.

There are many great practice management software solutions on the market, which gives you options for your practice, but also makes the selection process a bit more complex and overwhelming. To add to the pressure, choosing the wrong solution could negatively impact the practice.

Since the medical practice management solution provider will work as a virtual partner for your practice, it is important to select a vendor that has a large user base. This gives you a greater guarantee that the vendor will continue to support, improve and upgrade your PM solution. A large user base also gives assurance that the vendor is financially stable, is likely to stay in business and will invest in its products and solutions.

Specialty-Specific Solutions

As you delve deeper, you will find that many solutions target a particular niche. There are a very large number of solutions that are built specifically to handle a certain kind of practice. It is but natural that these will perform better in their chosen domains, as compared to general-purpose solutions. If you do get a solution that claims to be built for your kind of practice, check if it ticks the following boxes:

• Does the solution understand what is unique to your specialty? How is this demonstrated? Does it offer the right reporting tools that will boost your practice's operations?
• Will the solution recognize the procedures your practice performs regularly? How detailed are the templates for these procedures? How advanced are the best practices it offers?
• If your practice involves multiple locations and inventory, can the solution handle these?

Ease of Use

There may be different views about what features are critical to your practice. What is critical to the front desk will naturally be different from what the physician values. A list of critical features will need to be created for each user type. In most cases, if you look hard enough you should be able to find solutions that satisfy most of these requirements.

While every vendor will claim that its solution is easy to work with, it is important that you ask for working demos or a trial. Employees should get an opportunity to work with the solution, to see for themselves how intuitive and easy to use it really is.

Many vendors will promise extensive customization to meet your requirements. This is something you must approach with caution. Customizations make the solution more complex and will have an impact on upgrades and maintainability. Look for applications that meet most of your requirements right off the shelf. Unless your requirements are truly very complex, you should be able to find several solutions without requiring any major customization.

Scheduling and Appointments

This may appear to be a routine activity, but it impacts most aspects of a practice’s workflow. The scheduler should provide:

• the ability to accommodate multiple doctors, offices and equipment on the fly.
• the ability to overbook appointments, to account for cancellations and no-shows.
• the ability to check patient eligibility as the appointment is booked. The solution should check that the patient’s coverage is current and includes the requested procedures.
• a robust and intuitive patient portal: can your typical patient register and make appointments with ease? Does the portal send notifications and reminders to minimize no-shows? How easy is it for the patient to fill out forms online, prior to the appointment?

Compliance and Security

HIPAA compliance is mandatory. Check if the solution is fully compliant and ask for necessary certifications. ICD-10 code compliance is essential: no bills will get paid without it. If you are already using another medical application that will need to share data with your PM solution, Health Level 7 (HL7) compliance becomes necessary.

Data security is a critical requirement. SSL security is easy to confirm by checking that all web addresses used in the browser begin with an https rather than a simple http.

Yet another security requirement is met by defining user rights and access authorizations. The system must differentiate and understand the various roles and related tasks. This will ensure that users only have access to patient and clinic data they need to work with, and will minimize the amount and type of data that may be compromised in the event of a security breach.

Most modern systems allow users to connect anytime, from anywhere. Even this capability should be selectively enabled. While you may want to allow your physicians to remotely access patient records, paramedics and admin staff will not need this capability. Ensure that the system is capable of allowing global access to only a selected subset of users.

Reporting

Practice Management software solutions come with a large number of built-in reports. These are critical to the efficiency of the practice.

Meaningful reports need to measure the practice’s key performance indicators (KPIs), as well as industry-specific criteria. Reports can be customized: check if this is easy to do. If your practice already uses a third-party report generation tool, check if integration is easy to establish and if your report writing tool will continue to work as efficiently as before.

The administrative dashboard should be easy to set up and use, and give you access to all the information you need to run the practice efficiently.

As with most software solutions, practice management can be deployed on premises or in the cloud. There are advantages and disadvantages to each approach:

Cloud-based solutions:

• The application and data reside on servers in a data center (in some cases, some components of the application could be local).
• No additional hardware is required; any PC, laptop, tablet or smartphone that can connect to the Internet will do. This also ensures native support for mobile users and multiple locations.
• Payment is subscription based, usually monthly, depending on the number of users.
• Updates are automatic. The vendor continues to keep the system updated.
• The responsibility for system maintenance, HIPAA compliance, security and database management rests with the vendor.
• Uptime of the solution is guaranteed by the vendor (but check what the penalties are in the event the guarantee is not met).
• The system is dependent on the quality of the Internet connection. Alternative connectivity must be secured to keep the system up at all times.

On-premise solutions:

• All data is stored locally, giving better control over the solution.
• You can expect better performance (speed, load time, computing, etc.) since all data is available over the local network.
• Additional hardware needs to be procured (servers, firewalls, etc.).
• Security and compliance are your responsibility; specialist staff may need to be hired.
• Backup and management need to be handled on site.
• Multi-site implementations are complex to handle.
• Up-front costs are high; updates may have to be paid for and managed by your staff

In many cases, cloud-based systems offer solutions to work around situations where Internet connectivity is disrupted for some time. It is important to ask prospective vendors about their options.

The quality of training and support provided by the vendor is an important factor. This can be assessed by talking to other users of the system. Ask for references or visit locations where the solution is already in use, and ask:

• Is the vendor's support staff responsive?
• Is there a good escalation mechanism for any problems that cannot be solved readily?
• What is the quality of training provided?
• Has there been significant downtime?

In many cases, end-users will procure the solution via a reseller and not directly from the vendor. Check what the responsibilities of the reseller are. Who will provide setup, support, training and warranty? Check out the reputation of the reseller: you could have selected a great solution, but a reseller who is not as responsive as you want.

When buying a practice management solution, the key considerations are:

• Establish a specific list of required features and compare vendors accordingly.
• Make sure the solution can handle your kind of practice and/or specialty.
• Check for ease of use, and robust and efficient appointment scheduling and management.
• Look carefully at reporting features: the tool should help you boost the practice’s performance across functions.
• Confirm compliance and security.
• Make sure enough support and training are provided by the vendor.
• Decide which deployment best fits your practice’s operations.
• Keep customizations limited; every customization will make it more difficult to manage upgrades and maintain the solution.
• Validate the vendor's reputation: you are looking for a partner who will work hard to make your solution a success.