I have a bone to pick with many practice management systems. To me, they really don’t help medical practices manage clinics as businesses, but rather are designed with the intention to help a medical practice manage their “claims.” Which is fine, I guess. But if that is the case, then they should be called “claims submission” systems; not practice management systems.
It seems I’m not the only one that is dissatisfied with their practice management system. Physician Practice published results from a tech survey recently and they found that 54% of respondents didn’t think their PM system met their expectations. Here is the link. When pressed for more detail on what they sought, given multiple options, better reporting (62 percent) and more intuitive interface (55.8 percent) topped respondent’s wish list.
I suspect this is the reason why so many practices are poorly managed. It is not the doc’s or the managements fault, but rather poorly designed software that doesn’t provide pertinent information to make the right business decision.
I’ve put together a list of the 5 things I think that our practice management system ought to do in order to be able to call themselves, a practice management system.
1) Accounting Integration. It bothers me that we have to use another program like Quicken or Peachtree to do bookkeeping. Right now, our PM system doesn’t know how much money the practice has in the bank. And Quicken doesn’t know what our accounts receivables are. Seems to me that in order to truly be a “practice management” solution, the software ought to perform basic accounting functionality with ledgers, registers and financial statements, as well as perform financial analysis and competitive benchmarking, for example.
2) Business Management Integration. PM systems ought to show one’s business profit and loss reports and give you an overall snapshot of what’s coming in for the month, what’s going out, and what’s left in one’s accounts. Just like Quicken, the PM software ought to help us with money management, control costs and forecast revenue with business budgeting, profit and loss, track progress and goals. Fundamentally, it should tell me exactly where I’m making money and where I’m not.
3) Inventory Management / Bar Code Scanning. Imagine this scenario. One’s shipment of seasonal flu comes in and instead of counting them and then stuffing them in the fridge, we take a barcode gun, scan each box so the PM system knows how many flu shots we have in the fridge. Since the software knows how much we pay for each vaccine (thanks to the accounting and business management integration functionality), it can easily add up how much money we have tied in vaccine inventory at any given time. Every time a seasonal flu shot claim goes out, inventory is adjusted.
Every so often, we can run a vaccine reconciliation report (with the inventory management functionality included in the business management integration) to see how many vaccines we’ve given; which when subtracted to our inventory count, should match up with what we have left in the fridge. Boom! We now have done our vaccine reconciliation.
4) Merchant Services Integration. Considering how many transactions a busy medical office has with copayments, deductibles and balances, PM systems ought to make it easier to manage front office transactions than a traditional cash register. Furthermore, with integrated merchant services from the PM system, there shouldn’t be double-entry between one’s terminal and the software. And I shouldn’t need to buy or lease a separate terminal to take credit and debit cards. The integration would also allow payments to be posted automatically to patient’s ledger to eliminate double entry.
Additional features should include storing credit card information and emailing receipts. I’d love to be able to say to a person checking in, “I see you have a $35 copayment… would you like for me to put that on your Visa account ending in 1234 that we have on file? Oh, and ma’am…. here’s the receipt for you. I’ve also emailed you a copy for your records.”
Merchant services would also help with payment plans and recurring billing.
5) Patient Relationship Integration. What if, we could merge all the data from our EMR’s and our PM and use the data to get and keep satisfied customers? What if, we use all the data we have to create an overall strategy that enable us to learn more about our customers/patients/parents, thus developing a stronger, lasting relationship.
Just like Saleforce.com creates software to manage and nurture a company’s interactions with customers, PM systems (coupled with the EMR data), has the potential to help us track and manage our patients in a much more engaging way. Not only from clinical stand point but also from a marketing, customer service and support stand point.
For example, we document every single patient phone inquiry from parents. But I couldn’t tell you what are the 5 most common reason people call our office for. Let’s say parents call more often for feeding issues and questions. That would be helpful to know so we can address the issue and not have to answer that same question over and over again after they left the office. Or perhaps create a pamphlet that specifically address the most common issues. We transcribe each call; the data is in there. It just needs to be put into context.
Email and text message, and outbound reminder phone calls should also be part of the patient relationship integration functionality. But equally important is the data it collects. For example, is text messages or email messages more effective to reduce no-shows? Do people generally respond to a female voice or a male voice when reminding them of their appointments? This data, coupled with no-show data, could easily give you an idea which one of these methods are more effective.
There are hundreds, if not thousands of examples I could give on this topic alone.
Those are my top five, but why stop there? So I’ve put together a few more I’d like to include. What the heck!
6) Web Site Manager. Our website should not be a separate software entity. It should communicate with our PM system. If I can order a pizza from the local pizza joint on their webiste, I should be able to make an appointment online. I know there are many PM that allow this functionality, but they are still very limiting. Patient’s ought to be able to have access to view upcoming appointments, fill out forms, see treatment plans and account balances.
Patients should be able to get a copy of their EOB’s (we already scan all the EOB’s so the data is electronically stored) and their statements to make payments online. And those payments should automatically update the patient’s ledger.
7) NCOA Verification. Address verification should be a standard option that enables practices to check national databases to identify postal customers that have relocated. By comparing mailing lists against the database, it ensures the accurate delivery of patient statements and reduces undeliverable mail. The PM system should notify the practice in real-time when there is an address correction and update it in our PM’s patient files making manual updates a thing of the past.
8) On the job training. This one isn’t really a functionality of the system per se, but it would improve the functionality of the PM ten fold. Here it is, I would make every single PM developer, computer engineer and PM software designer that worked on our PM, work at least 6-months at our medical office doing front-desk work, doing billing type stuff, posting payments, submitting claims, working denials, running and reading reports, as well as data entry stuff like inputting demographics for 3 siblings with virtually the same demographic data 3 different times. Once an engineer really knows what it is like to post a gazillion claims a month, I’d bet there would be improvements to the PM system ASAP.
Oh, did I mention the PM should also continue doing all the stuff it does now?
I’ve heard many times (in fact, I’ve said it myself) that doctors are not good business people. But nobody agrees that doctors are dumb. Maybe, it is not that doc’s are not good business people, but rather the software tools they are given disable their ability to become smart business people. Even Warren Buffett couldn’t make wise choices about his business investments if he didn’t have the right information available to him.