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Evaluating a Software Package

 Like with many decisions we make in life there are often tradeoffs associated with our choices; some are positive other are negative. Unfortunately, there is rarely a perfect choice.  Our job is to help you select a solution that would provide “the best value for the buck!” for your business.

Some of the questions you should be asking yourself are :

You must look at the needs of the practice, your budget and future goals, and then weigh them against what you already have and what other vendors offer.

You must evaluate the costs associated with the systems:

1. How much does it cost to maintain the system?
2. How much does a new software system and new hardware cost?
3. What are the annual maintenance and support charges going to be?
4. What is the cost of converting my data into a new system?
5. How much training is needed to ramp up the staff?

The following are some topics to consider when evaluating the option of making a change:

Is your existing vendor still in business or where they sold to a new vendor?
Large software distributors are purchasing other companies to gain their software source code while some are simply going out of business. A majority of the time, the product that was purchased is shelved within a year or two and limited or no enhancements are made to the product.

Do you want to create a best of breed solution or get all your software from one vendor? Some software distributors provide award-winning software applications while being staunchly proprietary where only the company's other software and peripherals will interact with the application. Can your current PMS integrate with an EMR system, Claims Management systems, hospitals or labs easily and at what cost? Can you transfer data to other applications easily such as Microsoft Word or Excel?

Did your existing vendor deliver on what he promised or were you misled?
Are you getting adequate support from the existing vendor or are they poor and non-responsive? Paying a yearly service-contract to your provider does not guarantee prompt service or an appropriate solution. Some service contracts require you to "take a number" and wait for the vendor to return your call, regardless of the current state of your system.  Is the vendor supportive and understanding of your needs as a practice?

Are the costs involved in maintaining the existing system including hardware, upgrades, support changes and staff training very expensive?
Do you continually add on functionality via modules at an extra cost or is additional functionality included at no cost via your support and maintenance dollars?

Does the product utilize newer technologies?
Technology changes at a rampant pace and newer products use this technology when creating systems. For example, many newer systems use industry-standard relational databases such as Oracle and SQL Server for easier reporting and efficiency. Windows applications are giving way to browser applications while system architectures are becoming in-tiered with easier integration, security and scalability.
Is an ASP (Internet Application Solution Provider) product better for you than a turnkey solution where you own and maintain the server/software?

Does the product really address the nuances of your specialty, size and workflow?
Each practice has a different set of steps to accomplish their work flow requirements. Choosing a software that addresses all of your daily needs while understanding its weaknesses is vital to service a larger patient load. A medical office is like any other business in that its purpose is to produce a profit while discovering ways to increase efficiency. Does your existing system provide the reports you need to manage your practice or are you spending too much time trying to create custom reports? Can your staff access insurance or medical websites to verify insurance or check claims status?

These are just some of the topics and issues to consider when evaluating whether to change software vendors or stick with your existing system.

Choosing a PMS or an EMR first
Before you chose a Practice Management System (PMS) you should first think about the Electronic Medical Records System (EMR); even if it is not in your immediate plans.   It's harder to find a strong EMR that will satisfy all the doctors in your practice than it is to find a strong PMS.  The worst-case scenario for your practice is to choose a PMS that might be good but offers a second-rate EMR. Implementing such a system might complicate integration with a different EMR down the road.  

Integrated package or best bread packages
Dealing with a single software vendor simplifies fixing responsibility and getting help when something doesn't work. In addition, it lowers cost of ownership because you are paying maintenance to a single vendor. Any integrated software package built around a core system does offer advantages. Its component programs can use a common logic to communicate back and forth with a common database, reducing processing time and opportunities for error. Its uniform look and feel at all workstations simplifies staff training. On the other hand, many integrated packages may have a good EMR but a second rate PMS or visa-versa. So, it is important to be aware of this issue while making your choice.  

Workflow
The system should allow for flexible workflow; features and functionality are no longer good enough as a selection criteria. The system should support workflow that create levels of efficiency and generate high levels of return on investment (ROI). In addition, it is very important to make sure that the new software package will improve and not “break” your current processes. In many cases practices follow a set of processes that are very unique to them.

ASP model
A sensible, low-cost way for cash-strapped small practices to acquire a first-class physician practice management system (PPMS) is to contract with an application service provider (ASP). With an ASP, the software that manages your data, as well as the data itself, resides on a computer owned and operated by the vendor. Because you're buying time on the vendor's server, your own hardware costs can be kept low (i.e., in the ASP model, you need only the "client" workstations, not the server). More important, the vendor provides all IT support--security safeguards, interfaces with payers, troubleshooting and automatic upgrades as needed.
Some practices decide they'll save money by owning the software they run. More often, doctors simply don't like having their practice's vital data residing at some distant location and being fully dependant on a third party to manage their data. In addition, having the ability to access your data would be fully dependant on the state of your internet connection and lose all access to your data when the internet is down. Also, uploading or downloading scanned documents tend to be slow, affecting productivity.

Software Features
Part of the software selection process is the software features.  Some features may be mandatory other may be optional.   Typically, the number of available features is proportional to the software license cost. 

Taking Advantage of the software features
ROI depends largely on whether your practice is flexible enough to take advantage of the all features that the software offers. We have seen in many instances practices utilizing very expensive and advance software packages at 30% of their capabilities.  

IIn our experience there are typically two reasons for that: 

First, regardless of how well the software performs its tasks, if your staff is not trained well and not focused on making the project successful, you will not be taking full advantage of the software; hence wasting money.
Second, many of the software features may sound great in theory, but may become too time consuming or unpractical to use while in a busy operating environment.

A new software implementation is often easier with a new practice versus a currently operating practice with many well established patients. Typically a new practice's staff is more receptive to a fresh work flow and associated work processes because they have not became accustomed to one system that they have used for many years.  With new practices, you also don’t have to worry about migrating your current patient database that has been faithfully built and maintained since the practice has opened.

Converting an operating practice from one software to another is more complicated.  The practice will typically first have to migrate their current patient demographic data and in some cases scan and import current patient charts. These necessary procedures create fears of data integrity issues and complete loss of information that might be relevant at a later point in time. This is also a time of frustration for your staff as they have to learn new keyboard shortcuts, additional options and data-entry procedures, and a general state of confusion for the first couple of weeks while they are learning the software.

Once you have identified your favorite software package, we strongly suggest the practice to install it and have a professional consultant test and train your staff within your work environment.   Software demos and salesman speeches are sometimes deceiving because you only hear the benefits for your practice, not the shortcomings of the software. Testing in a real production environment is the only way to insure that your practice is getting what it needs to perform at its peak.

Why work with a non-vendor specific company?