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How to Choose Medical Software

image for Pornpak Khunatorn / Getty Images
Pornpak Khunatorn / Getty Images
  • Medical software consists primarily of practice management software and electronic medical records (EMR) systems.
  • These software solutions work in tandem to streamline both administrative and clinical tasks performed by healthcare organizations.
  • Choose your practice's medical software based on its pricing, ease of use, features, integrations and available tech support.
  • This article is for healthcare organization administrators or practice owners who are in the market for medical software.

Finding the right medical software – both electronic medical records (EMR) systems and medical practice management software – is an important task for every healthcare organization. For new practice owners, considering the options can be difficult, especially based on the number of medical software vendors out there.  

Medical practice management software not only includes your scheduling tools, which govern how you organize your patient appointments and keep track of which providers are booked at what times, but also helps your staff manage your billing cycle. EMR systems cover the clinical side of the house, allowing providers to document patient encounters, prescribe medication, order lab tests and review medical history.

To ensure your practice is successful, it's critical to choose the best software for your staff and workflow. In this guide, we'll examine what practice management systems do and walk you through the decision-making process.

Medical practice management software is designed to help medical facilities run more efficiently. It’s a technology solution that can be used for scheduling appointments, tracking appointment times, managing billing cycles and organizing patient information.

Medical practice management software is an essential component of any modern medical facility, as it allows healthcare organizations to stay organized and ensure high-level patient care. By consolidating all information related to patients and doctors into a single platform, medical professionals can easily navigate important details about patients and other information. Without this software, organizing any medical practice would be labor-intensive and subject to significant human error.

Key takeaway: Medical practice management software covers all the administrative tasks a healthcare organization requires.

Intuitive and effective practice management software is essential to a practice's workflow. These are some features to look out for and why they're important.

The most basic and arguably most important feature for medical practice management software is the ability to maintain up-to-date information on patients, including medical history, family history, medications, allergies and recent lab results.

You can also use medical practice management software to verify the status of a patient's insurance, confirming whether it is still active and estimating copayments, out-of-pocket expenses, and prior authorizations.

Most medical practice management software includes a calendar tool that allows front-office staff to schedule patients by location and provider, making it quick and easy to review patient information prior to a visit.

Good medical practice management software will allow you to process payments and record billing history all on one platform with built-in credit card processing capabilities. Front-office staff can capture out-of-pocket expenses upfront when a patient arrives for an appointment, and back-office staff can code claims for reimbursement and submit them to payers (such as insurance companies), managing those that are denied or rejected.

Clinicians and other medical professionals need patient data to be effective at their jobs. Medical practice management software allows you to generate important reports on your patients for other doctors. This can improve patient care and ensure your practice gives patients and doctors accurate, useful information.

Similarly, medical practice management software should be able to generate financial reports that help you track the profitability of your business. These reports include information like accounts receivable (A/R), the days claims spend in A/R, and total reimbursements versus expected reimbursements.

Key takeaway: Medical practice management software covers patient information tracking, billing and reporting, which are all key functions of running a healthcare business.

The first step in selecting practice management software is understanding what roles you need it to play. Here are a few of the benefits of having the software.       

Medical practice management software allows you to coordinate vital financial and logistical aspects of your practice, including scheduling, billing and financial analysis. Handling each of these functions in one piece of software helps your staff become nimbler and more organized.

Medical practice management software expedites tasks that could otherwise slow down your day-to-day operations. For example, a patient portal takes some of the burden off of your front desk, allowing patients to request appointments and fill out forms online. Appointment reminders reduce the number of no-shows, and insurance eligibility verification ensures a patient is covered for a provider's services before they arrive. The system that best matches your specialty and workflow will play a big role in your clinical and financial success.

Medical practice management software and electronic health records (EHR) systems, which cover clinical operations, should work together seamlessly. These two components of your practice's healthcare IT suite need to share a great deal of data, which is why many practice management software companies offer built-in electronic medical record (EMR) solutions.

If you decide to keep your billing in-house instead of outsourcing it to a medical billing service, your practice management system will help ensure your claims are submitted to payers (such as insurance companies or Medicare) in a timely and proper manner. In tandem with a diligent staff, medical practice management systems can increase the number of claims that are accepted by payers on the first pass, quickly collecting reimbursements for services rendered.

Staff members can also use the software to respond to denials and rejections, generate financial reports, and pull data to analyze your practice's fiscal health. (Note that you'll also need a certified medical coder on staff if you intend to bill through your medical practice management system, especially with the recent change to ICD-10 and upcoming change to ICD-11 coding standards.)

A medical practice management system can also be a tool to generate and send patients their balance statements and to predetermine whether patients will owe anything out of pocket before their appointment, making it easier to collect payments at the point of care. Engaging patients and granting them influence in their healthcare is not only a priority in the evolving healthcare industry, it also makes for a better patient experience overall.

Additionally, patients can communicate directly with the practice and providers through a secure patient portal, many of which offer telemedicine capabilities. Patients can update their information in the portal, including their address, insurance information and preferred pharmacy. Practice staff can review and accept these changes prior to the patient's next appointment.

Key takeaway: Medical practice management software helps coordinate administrative operations, keep patients engaged with the practice and ensure the practice's financial performance is meeting expectations.

Electronic health records (EHR) systems, also known as electronic medical records (EMR) systems, are clinical software tools that help providers capture notes during a patient visit, prescribe medications, order lab tests, generate superbills that can be turned into claims by the billing team and monitor patient medical histories. They are distinct from but related to medical practice management software; these two types of software are typically integrated as a unified healthcare IT platform.

It is best to think about medical practice management software as the administrative tool for a healthcare organization, covering front-office tasks like setting appointments, verifying insurance eligibility, and updating patient demographics, as well as back-office tasks like medical coding and billing. In the middle is the EMR system, which communicates with the practice management software to display provider schedules and information about patients prior to a clinical encounter.

During the encounter, a clinician documents information about the patient and any diagnoses. Once the clinical documentation is complete and the patient encounter ends, the EMR system feeds that data back into the medical practice management software, allowing coders and billers to go to work.

Most healthcare organizations require both medical practice management software and an EMR system, and many vendors sell these software solutions as a package. Generally, the best option is to use unified EMR and medical practice management software from the same vendor, as these solutions are guaranteed to work well with one another. It is possible to connect software from different vendors via API, but this is only recommended in unique circumstances. See Business News Daily's best picks page for more information about the best EMR systems and medical practice management software.

Key takeaway: EMR systems work in tandem with medical practice management software to support clinical operations and track patients' medical histories over time.

While physicians rarely need to interact with their medical practice management software directly, it is an indispensable daily partner for staff members. Between engaging with patients and supporting your revenue cycle, the medical practice management system you choose plays a large role in the success or failure of your practice. When selecting medical practice management software, you should keep several important factors in mind.

The cost of any practice management system is highly variable depending on your needs, the features you select and the size of your practice. There are often hidden costs and optional features that could quickly increase the base price.

Generally, a unified medical practice management software and EMR system costs between $300 and $1,000 per provider per month, not including any setup fees, implementation costs or add-on feature fees. Some vendors include everything in a monthly subscription, while others offer a la carte menus of certain features or tiered pricing plans.

Go into the conversation with the vendor knowing what you need and what you don't. Your top priority through this process should be to obtain a written list of which features you will be getting for exactly what cost before you agree to partner with any vendor. Without clear, written confirmation, it can be tough to know what's included in the regular price and what costs extra, and you might end up paying an additional fee for a feature you could live without.

Implementing a new system and adapting to it is difficult enough as it is, so make sure ahead of time that the people who will be using the new software are comfortable navigating it. Everyone works differently, so consult your staff and include them in the decision-making process. They should at least be moderately comfortable with the system, and, ideally, the vendor will offer you a company representative to guide them through the learning curve.

Medical software can vary in structure depending on the vendor, so it's imperative to know what your staff is looking for. For example, some systems use a central dashboard to organize the software's different features, while others employ a lot of dropdown menus and multiple popup windows. Knowing what is most effective for your practice's workflow is key to a successful transition. Any new system will naturally slow productivity a bit at first, but it shouldn't derail your entire practice.

You'll also want to ensure that the medical software you choose is widely used within your specialty. There are nuances to different specialties that a general medical system won't reflect, so you'll need to know whether the vendor took your specialty into consideration when designing the system. Otherwise, you might end up with a barebones system that is not optimal for the functions you require. A general practitioner's needs vary greatly from those of a dermatologist, for instance.

To find out just how well each company performs in that regard, it might be worth reaching out to other physicians you know in your field to ask how they like their practice management software.

Another huge consideration for your practice management software should be how well it will interface with the EMR system your practice uses, as well as the medical software used by other healthcare providers your patients visit. Interfacing is the capability of the two systems to communicate with one another and share relevant data.

Two systems that interface well reduce the time it takes you and your staff to enter and transfer data. If you're scheduling patients and recording demographic information, that data should automatically be entered into the EHR system when the patient comes in for a visit. Likewise, after a patient has been taken care of, the EHR system should automatically send the practice management system the relevant billing information based on the services provided. This should also apply to your communications with other practices, specialists and hospitals.

You'll want a medical software system that can create robust reports and analyze data, showing you exactly where your practice stands financially. Simply managing your revenue cycle is not enough for your practice to remain viable; detailed reports and analyses can go a long way in helping you project and even improve your cash flow. For example, you'll be able to identify which physicians are the most productive for your practice, or what neighborhoods most of your patients come from.

By identifying what works and what doesn't, you can keep your practice on a sure-footed path to success and profitability. If your medical software allows you to share those reports with other members of your practice electronically, that's even better.

Even if the system is incredibly easy to use, there will always be a learning curve. Also, consider the varying degrees of technical aptitude among your staff members. When your staff is adapting to a new piece of software, no matter how intuitive it is, they're going to need some guidance now and again. A truly committed vendor will offer comprehensive training, either onsite at your facility or one-on-one online.

It's important to receive a written breakdown of the training process the company offers and any additional costs for staff training during the implementation period. With good training, your staff will become accustomed to and comfortable with the practice management system quickly, and it will minimize the amount of productivity lost in the transition from your previous system.

Your vendor partner should be there for you when something goes wrong with the software. It's inevitable, as with all complex systems, that you will eventually encounter a problem, and the company should be available to help you recover from any issues. Further, if an issue arises on the vendor's end, you need to know that it'll be responsive and accountable for the error.

In some cases, a company might assign your practice a direct liaison. This is a useful resource for any practice, as this individual will be familiar with your particular system and the way your practice works. Other companies simply have a tech support call center; it might be more difficult to solve a problem if the person who takes the call is unfamiliar with your medical software platform's setup. Moreover, it's important to know whether support services operate 24/7 or if you can only contact tech assistance during normal business hours.

Key takeaway: Medical software platforms are sprawling systems that should be chosen based on cost, ease of use, features, integrations and interfacing, reporting capabilities, and available customer support.

Matt D'Angelo contributed to the reporting and writing in this article.

Adam Uzialko

Freelance editor at business.com. Responsible for managing freelance budget, editing freelance and contributor content, and drafting original articles. Also creates product and service reviews to assist business.com readers in buying decisions for their businesses. VP and co-founder of CannaContent, a digital marketing company dedicated to the cannabis, hemp, and CBD industries. Focused specifically on the content marketing arm of the company, creating blogs, press releases, and website copy for clients spanning the entire supply chain. Avid fan and indispensable ally of the feline species. Music lover, middling guitarist, and unprompted vocalist. Miniature painter who loves sci-fi and fantasy. Armchair political philosopher with a tendency to read old books written by men with unusually large beards. Ask me about all things writing!