What Medical Software Do I Need for my Practice?

(This is the third in a series of four about how to open your medical practice. You can find Part One and Part Two here. This section focuses on medical software systems.)

You don’t have to understand code to buy software for your practice. That’s a technical function. You have to understand the business function. What do you need your medical software systems to do?

The whole point of technology is to facilitate business operations. You need an automated workflow for your office that is seamless.  When you’re considering specialized medical systems, they have to be able to talk to one other. Doing redundant data entry or finding workarounds add to the potential for error.

Your biggest software investments are for medical practice management and the EHR. They are two pieces of a single system that allows your practice to operate efficiently. Business administration and clinical care. The whole is greater than the sum of its parts.

Basic Business Applications

Choose the business software for your office – email, word documents, and spreadsheets. Few options are available -Microsoft Office 365 or you can try Free Office. You’ll need an accounting package for payroll and business billing; rent, utilities, etc.

Make sure you have good malware protection applications – don’t skimp. Hacked healthcare data is one of the hottest commodities on the market. System security has to be a priority. Write a clear system security SOP on how to govern internet use in the office. Write a clear system security SOP on how to govern internet use in the office. No one should access personal email or social media platforms on your system or your WiFi. We recommend new employees to read and sign it during onboarding.

Health Information Technology

Health IT’s goal is to improve quality of care, reduce errors and increase efficiency. Electronic records and systems would reduce costs and decrease paperwork. Though it may have reduced paper, the burden of documentation has shifted to digital. Health IT is a highly regulated group of systems that contain, control, and manage patient information.

  1. HIPAA

The Health Information Portability Accountability Act protects the privacy of patient health information. HIPAA controls how a patient’s information can be used or shared.

  1. HITECH

The Health Information Technology for Economic and Clinical Health Act is the enforcement arm of HIPAA. HITECH provides financial incentives to meet higher standards of security to deter hacking.

  1. MACRA

The Medicare Access & CHIP Reauthorization Act of 2015 regulates payments to doctors. Cost controls for Medicare Part B are also covered by MACRA.

The History

As web-based systems became the norm, the thinking on how to implement EHR systems shifted. Storing data on remote systems would encourage early adoption. Physicians could access or update patient information from any location. The records could be accessible to other medical professionals. EHR systems would eventually be more affordable for doctors.

President George W. Bush called for industry-wide adoption of EHR systems by 2014. This was followed by President Obama’s American Recovery and Reinvestment Act. It provided additional funding and incentives to medical professionals to adopt the mandate.

Medical Software:  Practice Management Systems

A Medical Practice Management System is manages the business side of your office. The automated system minimizes the administrative burden of handling patients and payment providers. It is not an EHR but does contain some medical information.

Most MPMS are remote systems – hosted online for remote access. Smaller practices can buy software and manage the system in house.

The advantages of MPMS include:

  • No redundant data entry
  • Business operations coordinated in one system
  • Operational efficiency
  • Automated insurance claims processing
  • Integration with EHR
  • Granular financial reports

An MPMS automates the following tasks.

Patient Data

MPMS captures a patient’s non-medical data. Name, email, phone, home address go into the system. The name of their employer and insurance provider is also input. If the system is remotely hosted, it can communicate with external systems. That connection automatically verifies a patient’s insurance eligibility status, co-pay, and deductible. Sharing that information with patients helps to avoid unpleasant surprises on their bills.

Patient Scheduling

This function reduces the office’s biggest administrative burden – patient appointments. The automated process reduces staff time spent booking and confirming appointments. Some systems allow patients to schedule their appointments online by choosing from open slots. (How many phone calls would this eliminate?) The flexibility reduces cancellations and rescheduling, leading to fewer unused slots. According to this graphic from Healthcare Innovation, unused appointments cost $150 billion a year.
infographic on the value of automated scheduling

Central Billing

Medical coding will still need to be done, but the MPMS automates the entire billing process. It captures the procedural cost and any upfront payments. The system can process credit cards to capture transactions at reception. Co-pays or other out of pocket costs feed into the MPMS. The system dynamically creates an invoice and sends it.

Generate Reports

An MPMS will provide instant visibility into your financial status. The system generates reports to show what’s working and what needs improvement. For example, the system could pull up the number of denied claims by a specific insurance vendor. Or look at how many “out of network” patients in the practice.

Questions to Consider:

  • How easy is the system to use?
  • Does it include a patient portal?
  • Is the system modular? (easily add-on additional functions or technology?)
  • Do you want patient self-scheduling?
  • How to keep patient contact information current?
  • How are denial of claims managed in the system?
  • Do they offer an EHR system?

Here is a tool comparing the top MPMS systems.

Electronic Health Records System (EHR)

The EHR captures a patient’s health information and chronicle their medical history. The system documents the physician’s orders and the patient’s results. All in all, the EHR replaces the paper trail with a digital trial.

Once the records are electronic, their value to the patient and physician increases. No more trying to track a paper trail. Everything is within a single system, from patient communications to decision support tools. This can reduce physician liabilities in the event of malpractice suits. Reports with sanitized data contribute to maintaining public health.

Advantages of the EHR:

  • Immediate access to patient records from any location
  • Improves quality of care
  • Secure patient communications
  • HIPAA-compliant
  • eSubscribing (no more faxing or squinting at handwriting)
  • Easy collaboration with other medical professionals
  • Simplifies referral process
  • Reduces prescription errors

Patient Information

The EHR collects baseline data on height, weight, vital signs during each patient visit. Family medical history, medications, and allergies are input. Substance abuse, use of tobacco products, and lifestyle behaviors are also incorporated. The reason for each visit is also captured, along with any patient-reported symptoms.

Patient Visits Chronology

Doctors enter their diagnosis, along with any tests, treatments, and medications. ePrescriptions come directly into the record. Lab test results and imaging from other radiology procedures are incorporated. The physician may make notes on the patient’s outlook or attitude. Over time, these records offer a lifetime of data.  It can be used to help researchers or public health professionals.

Clinical Decision Support (CDS)

The EHR comes with tools to help physicians make the best decisions for patient care. CDS-tools include built-in clinical care guidelines to support a more accurate diagnosis and treatment plan. The system alerts when the physician deviates from them. CDS tools reduce medical errors and improve patient safety. The system alerts when a medication the patient is allergic to is prescribed. It will also catch inappropriate dosages and dangerous drug interactions.

Accurate Billing

The EHR ensures that no visit, treatment, or test is missed when processing the insurance claim.  Ideally, the EHR is integrated with the MPMS. When the two systems can share data, there is one less step in the process. When a clinical visit is complete, the record goes for coding and automated claim processing.

An EHR isn’t optional but it does come with a hefty price tag. CMS is still offering financial incentives to help defray the implementation costs. The value of the EHR is undeniable some doctors struggle with time in front of the screen. But a new AI tool – Dragon Medical Advisor – is reducing the level of effort for doctors at Halifax Health. They report a 40% increase in physician engagement since the tool’s implementation.

  • How easy is the system to use?
  • What type of support do they offer?
  • Is there an audit trail?
  • Can data be imported or exported?
  • How are updates handled?
  • Has their system ever been hacked?
  • What is their policy for alerting customers in the event of a breach?
  • Do they also offer an MPMS?

Choosing the Right Systems

The first criteria in making your choice is the integration of the two systems. There is no point in having two separate medical information systems that can’t talk to one another. The MPMS handles the business end, the EHR handles the clinical end.  The patient ties the two together.

Have your questions ready. Think about what your practice will need. And don’t get flummoxed by technical jargon or ITspeak. If a system vendor can’t talk to you about the business value – they aren’t the right partner.

Always, always, always ask to see a demo. Better yet, ask for access to a “sandbox.” That’s a staging platform where you can use the system yourself. Any information you add is deleted within 24 hours.

Consider these factors when making your decision. (We based them on the assumption you use both applications. If not, apply them to an individual system.)

Ease of Use

When the user interface is complicated it’s less likely to be adopted. Granted people can be made to use it, but the opportunity for error increases. The system should be intuitive, easy to see each step and understand how they work together. Staff members who have to struggle with the system have a higher propensity for error. It’s reasonable to assume your data ends up inaccurate or obsolete.

Training

What type of training do they offer and how many sessions? The staff who use the MPMS won’t need training on the EHR. But they will need to know how to get data from the system. The physicians and nurse practitioners will need more than one session with the EHR. Do they offer self-paced sessions with flexibility for viewing?

Support

The level of support the vendor provides is crucial. There’s no time to wait to access data in a medical emergency. You want 24/7 phone support if the system goes down for any reason. You need a single point of contact for emergency support. Lesser support requests can be handled through an email ticket system.

A basic call center that is uninformed about managing medical systems is not a solution.

Cost

Budget is a big priority but don’t let the prices scare you. This is an investment in the efficiency of your operations. The right systems will reduce errors, improve patient experience and increase revenue.

Here is a comparison of MPMS systems that includes pricing. Be aware that more and more vendors are bundling the two systems to ensure integration.

It’s harder to find pricing on an EHR. The table below is part of a budget guide on EHR in Practice.

table of ehr costs

Before you get sticker shock, remember the CMS EHR financial incentives to help with the cost.

Factor in your Specialty

Every practice has different requirements. A doctor who does family medicine has very different requirements than an oncologist. This is not a one-size-fits-all purchase. A vanilla, out of the box application is not going to suit everyone’s needs. If you’re not sure how to couch this with the vendor, ask colleagues in the same field. They can give you feedback on the systems they use – pros and cons. It gives you a confident starting point.

System Structure

How easy is it to update the system? Is there a modular structure to add-on or extend the system?  Ask the vendor about the life expectancy of the system. It will need to be updated or replaced at some point and it’s important to get an idea of when.

Security Protocols

Has their system ever been breached? What is their policy on alerting customers? If they don’t have one, don’t work with them. Remember for a system to be HIPAA-compliant, you share responsibility for its security.

Don’t mess around with any vendor who has had issues in the past 5 years. Here’s the list of 2020 healthcare hacks and data breaches.

Buying Medical Software

Health IT has improved the capacity to collaborate, especially in hospitals and large medical groups. But technology changes quickly. With interoperability a priority, older applications may find it difficult to interact. There could be security risks when older systems try to engage with newer systems. Wearables, sensors, and other monitoring equipment need to securely feed data into the system.

Get your medical software systems in place now and plan for the next upgrade

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