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Meaningful Health Care Informatics Blog

Mar 25 2012   8:37PM GMT

When is replacing a practice management system justified?



Posted by: RedaChouffani
PMS, Practice management, Practice management systems

As we look at the causes driving EHR adoption, there are many that immediately come to mind.  Providers are looking to improve care and patient safety, as well as get their piece of the EHR incentive program pie. There is also the movement toward paying for performance (P4P), reducing waste by eliminating paper records, and supporting access to health information from anywhere, at anytime. 

But for many physician groups, there is a significant impact on the organization from the practice management system standpoint that cannot be ignored.

There are many strong motives that drive the decision to replace a practice management system, including:

Revenue cycle management: Unfortunately not all PM software vendors provide tools and functionality to help improve and maintain a strong cash flow for practices.  Features such as automated statements, patient reminders, claims scrubbing prior to sending them to a clearinghouse, claim adjudication, as well as patient eligibility are all critical functionalities that should be present in a PM system.   In addition, PMS companies offer consulting services as well as billing services to help the organization further their success through their system.

Accuracy in reporting:  Since every practice has specific and unique requirements, it is very critical for a new PMS system to have accurate data in its reports.  Unfortunately while everyone does assume this being a must have in any PM system, it is not always the case.  The reporting side of these packages is also another critical piece for these systems.  All successful administrators and executives in the independent physician groups seek to use data to enable them to gauge how well the practice is performing and areas that many require improvements.

Flexibility and customization: When choosing a software solution, it is crucial that it be capable of adapting to a client’s unique requirements and workflows — not the other way around.  One size does not fit all, so a PMS must have the ability to be customized to the specific business needs and objectives of the practice. These features include:

  • Ability to require specific fields to be populated
  • Ability to create workflows and enforce them when registering patients and or scheduling surgeries
  • Ability to create custom fields
  • Access to the data dictionary to enable integration with any ad hoc in house applications
  • Allow for custom edits when it comes to claims scrubbing and patient registration

Scalability of the application: For some of the billing systems available in today’s market, there are still a few that struggle with scalability.  This comes at times as a result of the database backend that is used for many non-scalable applications.  In order to ensure a robust solution is implemented and is reliable for mid-size practices, this factor becomes very important.  There have been many cases where poor performance causes a significant loss of revenue and productivity, simply because the number of users on the system exceeds a 200.

Availability of good end user support:  For some organizations who rely heavily on vendor support, a high rating for customer support is extremely important. Others simply rely on internal resources for support, whether it is from an IT department or internal super users of the system to help deliver the necessary support.   Some vendors have been branded with having the worst support ever due to out of control growth, while others have seemed to sustain the same quality of support through the years regardless of growth rate. But nevertheless, support is an important aspect of a new PM application for organizations considering the switch.

While many organizations may not clearly identify with all of the reasons supporting the need for a complete PMS, the above list is usually a good starting point for consideration.  However, it is very crucial to properly assess all of the reasons for change, as switching is a a costly task, requiring not only some capital investment, but also the added stress and labor hours as part of the transition.  This means that just not liking the software may not be a sufficient reason to replace it.

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