By Pascal Helou
New York, NY - Selecting medical practice software falls in the following categories:
o Someone (doctor, office managers) knows someone that has similar software and they “like” it.
o Vendors are invited to give proposals but the process of comparing the proposals is challenging at best. It is very difficult for non-area specific experts to be able to compare software features, technologies and price. Vendors will tend to give a low price for a basic solution but the real solution that the office will need may be multiples higher in final cost. They rope you in with a low price than add on fees dramatically once you are locked in.
o The doctor or office manager reads a glowing article on a software solution and decides to implement that solution based on the article written.
I have been in many situations where I was brought in to help resolve the result of poor decisions that have left practices in chaos with angry physicians, frustrated staff and unhappy patients after months of wasted efforts and at a tremendous cost leaving the practice worse off than they started! So how do you go about ensuring a successful selection of the right software for your medical practice?
Steering Committee
o A steering committee needs to be created that is accountable and is comprised of the best people from all areas of the practice.
o Each person is a stakeholder and represents a specific area of the business in the practice.
o The steering committee leadership needs to have deep technical, project management skills as well as a good understanding of the current work flow of the practice. They will rely on each of the stakeholders to properly define the needs and requirements of their areas.
o There has to be a commitment and practice management must make the team members available and dedicated for the process to work.
Defining goals and objectives
The process of selecting a practice software solution at this stage is more based on the business needs and politics than on technology.
o Indentify immediate and long term practice goals.
o Clearly outline the business goals and direction. This includes any planed new service offerings, any changes in reporting requirements, changes in office situations and a review of the current systems that are in use.
o Generate a document with clear goals and objectives, list of major features that are required, any specific technological limitations or requirements, list of systems that the new practice solution must be able to interface with, general timeframe and budget.
Performing an audit and mapping out workflows
Most software implementations fail because people throw money at a vendor who intern drops a solution into a practice with little training. This process is doomed to fail since even the best software cannot fix an inefficient or ineffective workflow!
Medical practices rely on information from many systems both internally and externally. Just adding technology will not necessarily improve your practice’s productivity. It has been shown that simply introducing new technology usually results in decreased productivity. The staff must maintain the current way they do their work while learning a new system. Adding new technology to an inefficient workflow does not result in efficiency gains.
It is amazing how many times people do things but no longer remember why they do those things. In one practice, one staff member was dedicated to filling out and processing certain paperwork that was sent to another department. The other department had changed their policies long time ago, failed to notify the other department and simply threw out the paper work! The best way is to map out the current workflow of all processes in the practice.
o Perform an audit trail of the patient encounter form as it travels throughout the office workflow.
o Document every system that provides or receives information from the patient encounter and the people involved.
o Document the workflows.
o Having a detailed map of each process, the people and systems they involved is critical to properly selecting the right software solution, maximizing efficiencies and ensuring a successful implementation.
Defining your system requirements
o Start by the things you can’t or don’t want to change such as the need to be able to interface with system A, B and C, the need for a multi-office solution or the need to support key business requirements.
o Reduce the number of vendors by the capabilities outlined in your requirements, by costs and by complexity.
o Call your colleagues with similar practices and see what they have done.
o Create an RFP (Request For Proposal) and distribute your request to the top vendors that have passed your initial minimum requirements.
System review and selection
o Start by eliminating any system that does not meet your system requirements. Many vendors will say that is planned in the next release. If it isn’t in the system now, don’t count on it being there any time soon or for free.
o The software must be able to work with existing systems.
o Many vendors promise that their system can interface to many systems. What is usually not disclosed is that this sometimes requires special programming and can be very expensive.
o Request a demonstration of the software once you have the vendor proposals. Make sure what is demonstrated is what you will be buying with all the features you will need and includes all costs. Many vendors show their top fully loaded application then sell you an entry version at a much lower cost to get you in the door. You end up spending so much more just to get to where you thought you had purchased.
o Each team member needs to review the software from their area’s perspective.
o A new process map needs to be created with the new system in mind so that each stakeholder can see how this will impact people’s tasks and ultimately show how the new software solution will streamline current workflows and result in new efficiencies.
o Try to visit an office that is similar in size and scope as yours that has the software you are looking to implement. Interview many people involved in the process and try to get as many lessons learned as possible.
o The final step is to select 3 top vendors and negotiate on price. Get everything in writing and do not accept any verbal promises.
Before signing a contract, closely review the contract with a technologist!!! I don’t know how many times I have reviewed contracts that were full of thousands of dollars in unnecessary line items. For every $100,000 contracts, at least 25% were things added that were not necessary for the success of the project. One client had a $25,000 option for an EMR solution that they had paid for as part of a much larger practice software package. I was doing an audit for the client when I made that discovery. They approached the vendor to implement that option. The vendor stated that since the software was purchased 3 years ago, the hardware and software has changed so much that it is now obsolete. It will cost them an additional $50,000 if they want the EMR option.
Conclusion
Selecting and implementing an EMR/Practice Management system is a complex undertaking that requires commitment from everyone that will be using the system. A committed steering committee is critical, clear objectives and goals, a detailed process map, workflows, system requirements are all critical to the proper selections of an EMR system. Keep in mind that more than 50% of EMR implementations fail because of improper technology selection, poor planning, lack of commitment and lack of training. One way to make sure your implementation is a success is to hire an independent third party technology consultant that is not associated with the vendor but is rather your hired technology expert. Their sole job is to make this a success while everyone else in the process has their real job to do as well. They will flush out which solution is best suited for your needs, project manage the implementation and keep the vendor honest. Their keys strengths are business and technology skills, strong project management and people skills. You can always contact us and we will be happy to give you a free consultation and or point you in the right direction!