Practice Management System Software
Far-reaching regulatory shifts at the federal level combined with advancements in technology and a changing patient population are just a few factors contributing to the rapid transformation of the U.S. healthcare system. As the industry evolves, the systems and processes utilized by practices and practitioners must also evolve in order to keep pace with the demands of today’s care continuum.
In such a dynamic healthcare environment, medical practice management software is essential in order to effectively and efficiently coordinate communications, transactions and interactions between patients, providers and systems. Various organizations nationwide have implemented practice management system software and achieved measurable, positive outcomes related to both patient care and the fiscal health of their practice.
But as with any new process or solution, the selection and implementation processes must be well-defined and informed in order for the system to be successful. This article will examine some best practices and key considerations for revenue cycle professionals in selecting medical practice management programs – from an initial concept and exploration to selection and implementation.
What is Practice Management?
Practice management is the process of “managing all business aspects of a medical practice including financials, human resources, information technology, compliance, marketing, and operations.”
What is Practice Management Software?
Medical practice management software is defined as “a category of healthcare software that deals with the day-to-day operations of a medical practice,” which includes “capturing patient demographics, scheduling appointments, maintaining lists of insurance payers, performing billing tasks, and generating reports.” Medical management systems often integrate with electronic medical records (EMR) or electronic health records (EHR) based on the practice’s needs.
Benefits and Advantages of Practice Management Software
Medical practice management software offers a host of benefits to practices.
- Perhaps the most widely-reported advantage is improved workflows and streamlined processes.
- Medical practice software provides a means of coordinating critical logistical and financial practice components, such as billing, scheduling and financial review and analysis.
- Streamlined processes and enhanced workflows help ensure a more efficient practice.
- A practice management system is an invaluable communications tool. The platforms utilized by most medical practice management software systems offer a patient portal, which allows physicians and medical staff to easily and quickly communicate with patients.
- This technology also allows providers to communicate with one another easily via mobile technology such as tablets.
- An additional efficiency and communication benefit is the ability to create and send bills or balance statements to patients, and calculate out-of-pocket costs in advance to help increase the likelihood that payments will be made at the point of care.
- A major factor that makes medical practice software attractive to providers is automation. For example, the patient portal functionality in a PMS can lessen the load on front desk staff and allow patients to schedule appointments and complete required forms online prior to their office visit.
The Roadmap to Success: Best Practices and Key Considerations
The successful launch of medical office software can only be achieved by following a sound process for evaluating potential solutions. Outlined below are 11 key considerations and best practices that providers should incorporate into their selection and implementation process.
Best Practice 1: Assemble a Practice Management System Team
The goal of any Practice Management System (PMS) initiative should be to better support and leverage the medical team and provide greater efficiency to existing processes and workflows. As such, the fit, practical application and effectiveness of a potential new system should be determined by the actual team members who will be utilizing and interfacing with the software. A PMS team of key stakeholders should include at least one representative from each function or discipline within the practice. While the composition of the team will vary based on office size and type, team members may include physicians, non-physician clinicians, practice administrators, registration staff, coding and billing team members.
A team-led process will help ensure the system selected is the best fit for the practice. Collaboration and buy-in from all of the practice areas impacted by a PMS also serves to expedite the process and helps avoid unnecessary costs and delays.
Best Practice 2: Analyze Existing Functions to Determine the Level of Support Needed
In order to make an informed decision regarding medical software, it is important to evaluate current patient management processes and the claims revenue cycle. This step is often best achieved by putting pen to paper – or fingers to keys – and mapping out current systems and processes. The map should include all points and interactions – from initial contact with a patient through follow-up appointments and reminders on outstanding payments.
By visually defining existing workflows, the PMS team will be able to determine what functions and processes the optimal medical office software should support.
Best Practice 3: Identify Key Deliverables and “Must Haves”
In his renowned book, “The 7 Habits of Highly Effective People,” author and leadership expert, Stephen Covey, advises “begin with the end in mind.” Beginning the selection process for a practice management system with a clear understanding of what it should deliver for the organization is perhaps the most critical step the journey.
The PMS team should help lead an organization-wide effort to identify the essential features and components a system must offer in order to effectively serve the practice and its patients.
But in order to arrive at a list of minimum requirements and criteria, it is important to know which questions to ask. Below are the top 10 questions to ask to ensure you are choosing the right medical billing software. Be sure to check out our previous “Top 10 Questions” post for a deeper dive into the key queries for the selection process.
1. How much do you want to spend on medical billing software?
2. Will you need to make an investment in hardware or infrastructure?
3. How will it work with your existing EHR system?
4. Do you have adequate in-house IT resources to support your medical billing software?
5. Is the billing software easy to use?
6. How long will it take to implement the system?
7. What type of training is available and will the training period fit your schedule?
8. What safeguards are in place to protect the security and integrity of your data?
9. Is there a robust reporting system?
10. Can the system be customized to your unique practice requirements?
Specific questions such as those outlined above will help define a list of essential features. The list should include some of the following components:
- Patient scheduling
- Appointment management
- Claims management
- Data analytics and reporting
- Patient portal/online access
- Mobile responsiveness
- Preference for server vs. web-based
Best Practice 4: Vet the Available Practice Management Software OptionsOnce the PMS team has established the checklist of “must haves,” it is time to begin researching available systems. As with any product or endeavor, a quick online search for key terms, such as “practice management solutions” will yield numerous results – some credible, and some less than capable. Thus, it is important to narrow the field and develop a short list of viable and legitimate options even before applying the criteria established by the PMS team. Ideally, no more than 10 and no less than three vendors should be selected to submit a formal proposal for the project.
A few tips and guidelines for choosing quality and practice-tested systems include:
- Look for products that have been accredited through the Practice Management System Accreditation Program (PMSAP)
- Read reviews and surveys on both the system and the vendor from independent review organizations and publications
- Word of mouth - recommendations from colleagues and fellow providers on their preferred medical office software often offer the most compelling and trusted insight into potential solutions
- Request demos of the systems to experience their interfaces and features firsthand
- Do not be afraid to ask for help - the complexity and nuances associated with selecting a practice management system can sometimes be overwhelming for practices and PMS teams. If significant doubts or questions arise, consider contracting with an experienced consultant to help guide the process and ensure the right questions are asked and all the necessary boxes are checked for your office’s specific needs.
Best Practice 5: Crunch the Numbers - Evaluate Cost and Estimate ROI
Calculating what the practice’s return on investment (ROI) will be before deciding to pursue medical office software is critical to success. Considering the ROI will help determine whether the investment of staff time, resources and money is worthwhile. A cost-benefit analysis can help make this determination by weighing factors such as:
- The potential costs of foregoing a practice management system
- The potential cost of failed implementation of the software
- The potential savings or increased revenue that could result from adopting a medical management system, such as increased reimbursements and reduced costs
Best Practice 6: Evaluate Interoperability and Integration of Systems
In today’s connected healthcare environment, system integration is critical. Medical practice software solutions must align with existing processes and procedures, and provide users with the ability to easily access and utilize data between workflows and programs. Without an integrated solution, staff members will waste time copying and pasting information and duplicating tasks.
Similarly, practice management system software must also talk to the practice’s electronic health records (EHR) system. Some medical management systems are integrated within an EHR as a component of the care platform, while others are designed to seamlessly interface. Regardless of which option your practice chooses, the ability to connect with your EHR is crucial to ensuring efficient communication both internally, and between care settings and providers.
Best Practice 7: See the Big PictureWhile the selection and launch phases are vitally important, the life of the practice management solution is only just beginning at implementation. It is important to consider the ongoing maintenance and continuing service needs of the system during the selection process in order to make an informed decision and commit to an arrangement that is manageable for your practice.
A few key questions to consider include:
- When/what does the renewal cycle look like?
- What will the setup/implementation process require (time, personnel, resources, etc.)?
- How much training will the system require, and does the vendor include training as part of the product’s contract/agreement?
- Is the solution scalable and capable of growing with your practice?
Best Practice 8: Look for a System that Works Both Like You and with You
Customization and flexibility are important considerations for any PMS team. Every practice differs when it comes to the functionality and features of medical office software and medical billing software. Some may require specific, non-standard reports; others may request a unique configuration of the system’s interface.
Some systems may meet all of your needs out-of-the-box, but if customization is important to you, be sure to weigh this factor in your evaluations of systems and vendors. As previously mentioned, it is important to define your organization’s must-haves early in the process as this will allow you to determine if your practice’s requirements and non-negotiables are standard or custom features.
Best Practice 9: Don’t Forget Compliance
Maintaining compliance is a constant priority for medical practices, so naturally the medical practice software selected should bolster your efforts toward healthcare compliance, rather than serve as a hindrance. Most systems are specifically designed to ensure compliance with healthcare mandates and regulatory requirements, such as the Health Insurance Portability and Accountability Act (HIPAA) rules, the HITECH Act and various provisions of the Patient Protection and Affordable Care Act. Be sure to ask how the solution you are vetting can help make the compliance process easier for your practice.
Best Practice 10: Float the RFP and Gather Responses
Once the list of potential practice management solutions has been winnowed down to a few front-runners, it is time to create a RFP (Request For Proposal) and contact your shortlisted vendors . While the makeup of the RFP will vary based on the organization’s size, needs and other practice-specific factors, all RFPs should include key elements, such as features, timeline, training and support required. You may also choose to provide vendors with your list of “must haves” as an attachment. By comparing the responses to your RFP, the PMS team will be able to determine the best overall fit for you practice. Responses should be carefully evaluated to determine which system provides the most ROI within the defined budget.
Best Practice 11: Choose for Best FitMedical offices considering a practice management solution must carefully weigh factors such as cost, functionality and integration. But while these factors are key determinants, the importance of user experience and overall fit must not be overlooked.
Ultimately, the best medical practice management system is the one that fits best in your practice and meets your organization’s specific needs. The solution that allows you to build on the processes that are working, and add efficiencies and fixes to the areas that are not, is a solution that will position you for success.
The Bottom Line
Practice Management System Software is essential technology for today’s healthcare practices. As outlined above, medical practice management programs offer a host of benefits to providers. But in order to realize the added efficiencies and improved patient outcomes of a practice management solution, careful consideration must be given to the selection and implementation process.
By following and adopting the best practices and key considerations outlined in this article, medical offices of all sizes and practice focuses will be prepared to select and implement a system that is the right fit.
The Practice Management People
At RevenueXL, practice management is what we do. We offer a completely customizable and flexible suite of billing and practice management tools you can configure to your unique practice needs. These tools are far from template or cookie-cutter – our systems are carefully designed to work with you and your workflows, not to replace them with something different, redundant and difficult to learn. You know what works for you and your practice – we simply help you do it faster and more efficiently, with fewer errors and less duplication of effort.Contact us today to schedule a live demo and discuss a custom solution for you practice.