A Panel Discussion

Compiled by Rogena Schuyler Silverman

Rehab Management recently hosted a roundtable panel, featuring several key players in the practice management software industry. Among the topics discussed were the benefits, expectations, and drawbacks of electronic medical record-keeping systems.

Taking part in the discussion were: Nelson Aviles, PT, TherAssist; Bill Cummins, MS, CCC-SLP, product director of Connections Therapy Management, AccuMed Technology Solutions; Brad Dumke, CEO, The Rehab Documentation Company (ReDoc); Tom Fahey, president of Health Care Software; Ricky Gomez, vice president of sales and marketing, Planetrehab; Derek Greenwood, founder and CEO of EON Systems Inc; Jim Hammer, COO, Chart Links; Charles Lee, national director, sales, Raintree Systems Inc; Steve Mackie, president of GiftRAP Corporation; David McMullan, vice president of SourceMedical; Dan Morrill, president of Hands On Technology; Steve Petrie, founder and CEO of SpectraSoft; Jim Plymale, CEO of Clinicient; and Steven Presement, president of InTouch Practice Management Software.

Rehab Management (RM): What specific business areas should therapists evaluate when deciding on what software will help them the most in managing their practice?

Nelson Aviles: Since you said, “Therapists,” I’ll answer the electronic medical record. Obviously, the therapist represents the linchpin of the practice. An outstanding EMR allows therapists to access all patient information instantaneously, review past history, manage the PT’s objective data, and transfer data to required documents. Ideally, this frees up time for physical therapy care—which results in better patient outcomes. Keeping the patients and their physicians happy and referring others is in the best interest of your practice.

Bill Cummins: Therapists need rehab management software that keeps their practice organized, productive, and growing, not to mention compliant with regulatory changes. Depending on the specific market that the practice serves—outpatient, SNF, home health etc—a software shopper might be drawn to specific financial, clinical, or operational features. Instead, they need to select a nimble, well-rounded product that monitors scheduling, tracks productivity metrics, provides detailed reports, facilitates documentation, adapts to regulatory changes, and grows with you as your business expands into new markets.

Brad Dumke: Evaluate internal operations first to determine what the impediments are to achieving the organization’s full potential. Key areas to evaluate include compliance, underbilling, capacity management, and referral source management. Use the findings to define how you will measure success, and insist that your software vendors demonstrate how they can help you achieve your goals.

Software is simply a tool; a decent tool applied to a clear purpose will lead to success. Outstanding tools applied to an unclear purpose could fail.

Tom Fahey: Comprehensive functionality and ease of use are key components when evaluating software. The increase in the number of insured individuals will put a higher premium for software applications that add real value to a practice. The ability to back up care delivery, track productivity, automate insurance rules, and understand net revenue are vital to a clinic or an organization’s success. Technology, usability, and company longevity are other key factors that should be considered.

Ricky Gomez: Businesses should be keenly aware of the direct impact their software decision will have on their business, especially their efficiency. Complicated software directly translates to inefficiency, which means more time spent on the computer and less time with patients. Software should ultimately make the therapist and clinic more efficient, thus allowing the therapist to better treat patients and the owner/administrator to easily manage and hopefully grow their business.

Derek Greenwood: The therapist should evaluate what activity, if changed, will make the biggest difference in their practice. If you find yourself having to stay late at the office to finish documentation, look for software that provides fast, easy, and customizable notes. If it is getting paid, look for software with insurance follow-up.

Jim Hammer: Management. Will the software notify supervisors when documentation or charge tickets are incomplete? Compliance. Will the software flex to allow therapists to document according to personal preference while still ensuring compliance for the practice as a whole in the case of an audit? Reporting. Will the software include a business intelligence module so that insights (ie, productivity measures) can be gained from analyzing the stored data?

Charles Lee: Authorization management and referral tracking are two key areas that therapists should evaluate. In addition to these vital components, the ability to set up “business rule” alerts and task management capabilities is also crucial. Billing and collections components, as well as easy-to-run comprehensive reports, should also be available to maximize practice efficiency.

Steve Mackie: Definitely mobility, as it increases efficiency paired with unwavering compliance and improved quality of patient care! Make sure your software facilitates the ability to multi-task and increase accuracy by enabling point of service entry. Rehab Optima ROX powered by GiftRAP does, plus it eliminates “wait until the end of day” patterns.

David McMullan: The key business areas that therapists and practice owners need to evaluate are: net revenue per visit—is their net revenue in line with similar practices in their region and market; average account receivable days and how does that break down by percentage into less than 30 days, 30 to 60 days, 60 to 90 days, and over 90 days; establish a good understanding of current costs: cost per visit, cost per patient, cost per FTE.

Dan Morrill: As a physical therapist in my own practice it is very important to monitor the efficiency of revenue management. Revenue cycle management involves appropriate referrals, effective scheduling, defensible documentation, billing, and collecting revenue. Each step is dependent on the other. Control of revenue cycle management is key to high-quality clinical practices. Great software can be the ultimate complement to an efficient and effective practice.

Steve Petrie: REVENUE! Many PTs tend to look at billing as the “money maker of the practice.” Yet a billing system can only submit claims for the work you’ve done. Real revenue comes from retaining patients, building a solid referral network, and boosting therapist productivity. If you focus on meeting the needs of patients, referring physicians, and your clinicians, you will create more work to bill.

Jim Plymale: No reentry of patient data for registration, scheduling, documentation, and billing; the ability to create Medicare-compliant documentation including automated support for PQRS; therapist ease of learning and productivity improvement; easy practice and therapist-level customization of documentation and correspondence templates; payor-specific, rules-driven charge capture that is integrated directly with billing for maximizing revenue; tools for collecting patient responsibility at the front desk; and customizable reporting and analytics with export to Excel.

Steve Presement: Aside from being able to handle electronic medical records, the number one question a therapist should be asking is, specifically, “How will this software add value to my practice, how will this software both help me grow and manage that growth.” All too often we speak to therapists so tunnel-visioned on the EMR piece that they lose sight of the value of having a good, integrated practice management software solution and how it can actually enhance their practice.

RM: Can the software integrate data from multiple clinics?

Aviles: Yes. TherAssist is designed to manage multisite clinics. Our program would allow you to manage sites separately yet still exchange patients between them. This can be done either with complete open access between clinics or with password protections. Reports can be accessed with site-specific criteria.

Cummins: Well-designed software enables multiple clinics from the same organization to access one centralized data warehouse enabling real-time aggregate reporting and data exchange between clinics. This is one significant benefit of Web-based rehab software and is a very cost-effective solution for businesses of any size.

Dumke: ReDoc Suite does support multiple sites within one organization, and can also integrate with other health care-related applications (such as clinical data repositories or longitudinal patient records). For example, a therapist can work at different sites on different days. Or a patient may show up at any site and receive good continuity of care, even if they’re treated by someone other than their primary therapist.

Fahey: Yes, HCS INTERACTANT™ provides a fully integrated, comprehensive system of clinical and financial applications designed for use by multisite, multiservice health care providers. This offers organizations the ability to provide uniformity across all sites for some features while at the same time allowing for differences among the sites for others.

Gomez: Planetrehab was originally created to manage multiple clinics from one central location. All clinics, regardless of location or size, can be managed from the designated management clinic. The owner/administrator can set company-wide policies, standardize documentation, access schedules, and run reports on a specific clinic and/or on the entire company.

Greenwood: EON Systems’ Digital Office can integrate data from multiple clinics or multiple businesses with multiple practitioners at multiple locations. There are over 140 practice management reports that can be done for all entities or for one. There is also a Query Manager for those ad hoc reports that are needed once in a while.

Hammer: Yes. Chart Links allows multiple business entities to utilize the core software suite—keeping data separate per clinic—without a need to purchase additional software per facility. Chart Links also allows for multiple clinics to feed a single medical record if that is desired. This is often accomplished in multilocation or multiclinic environments.

Lee: Yes. Data from multiple clinics can be easily integrated and analyzed. Raintree has over 150 “out of the box” reports specifically tailored to physical therapy practices. The reports include graphing capabilities, and with the click of a mouse, the data can be exported to Excel.

Mackie: With Rehab Optima ROX, you get custom reporting empowerment for both large and small customers. You can create the reports you need, when you need them.

McMullan: Yes, our TherapySource software can easily manage enterprises that have multiple clinics operating in various locations throughout the United States. All of the data is accessible and integrated, which also allows for ease of use and provides powerful enterprise reporting.

Morrill: The software architecture determines how the data is structured and accessed. TheraOffice allows multiple clinics to combine or separate data. If issues are identified, it can help explore metrics to resolve issues. The purpose of integrated data is to quickly and precisely measure success, identify issues, and monitor trends as facilities attempt to reach their clinical and financial goals.

Petrie: Both our Web-based and traditional software solutions can centralize multiple clinics and break down data in reports by location, department, or therapist. However, we strongly encourage PTs to move to the Web. You eliminate the expense of servers, networking, and upfront software costs. You also enjoy free upgrades, free data backups, and free support. These benefits are all the more valuable for larger, multiclinic organizations.

Plymale: Yes, including support for multiple Tax-IDs. Any staff member can access all schedules, patient records and billing information for any number of clinics. All analysis can be broken down by clinic and, where applicable, therapist, referral source, payor, and patient.

Presement: InTouch is designed to handle everything from sole practitioners right up to national, multiclinic chains. Having the ability to compare individual clinic results or view the operation as a whole is integral to the value of any software package of this nature. Perhaps you bill centrally but schedule locally? Perhaps your user access rights vary from location to location? All of this needs to be considered when employing practice management software to encompass multiple locations.

RM: How safe is hosted data? What are the options for accessing data?

Aviles: Hosted data is very safe. Data is kept in a secure center with physical security measures (guards, reinforced walls, and limited access) and virtual security (encryption, firewalls, and off-site backup). Also, there are redundancies for everything. Think of an airliner—it might lose an engine, but the passengers would never know it. Moreover, hosted data resides and executes on our server. If a user’s laptop, Netbook, or tablet is stolen, the data is safe in our servers.

Cummins: During demos, practices in the market for software should review all data security measures the vendor has implemented. These include protection for software, hardware, and data transmission. With Web-based software that transmits data across the Internet, make sure to ask the vendor to explain the steps they take to encrypt and safeguard your data. Another consideration is the length of time they will store your data if you were to terminate service.

Dumke: Our data is owned by and hosted by our clients, and can be accessed via local area, wide area, or wireless networks. Data is encrypted between the server and client devices.

Fahey: With a proper service level agreement (SLA) in place, an organization’s hosted data is very secure. Application access is performed using a secure Internet connection from the clinic or office desktop computer. Hosting applications does represent a change versus hosting your own servers and business applications. There are distinct benefits to both means of deployment and should require a thorough due diligence before moving forward.

Gomez: We approach data safety in two ways: the security of the software and data, and the timeliness and totality of backups.

We employ two levels of log-ins to prevent unwanted access to the software and data. Each user’s log-in can be configured to allow full, limited, or no access to various parts of the software and data. Each level of access is determined by the owner/administrator.

One of the biggest threats to any business is the integrity of their data and the lack of a timely backup of their data. We use various techniques to back up data, and at the end of the day, a client has no less than six copies of their latest data and an option to back up their data to portable media, like CD, DVD, flash drive, portable hard drive, and so on. In fact, our clients synchronize their databases throughout the workday, thus creating a current backup of their data.

Greenwood: How dependable is your Internet connection? No connection; no data. The expense of “cloud computing” isn’t warranted. EON has a client whose old software ended up costing $1,200/month for hosted data as his files kept growing. On the other hand, a server has a one-time cost in the same range. We can do it, but we don’t recommend it.

Hammer: Because Chart Links is primarily installed in hospital-affiliated outpatient facilities that don’t desire hosted solutions, our software is not currently available as a service.

Lee: Customer data hosted by Raintree is stored at state-of-the-art server facilities. The data is encrypted and placed on multiple servers for redundant backup. Customers can access their system remotely anywhere an Internet connection is available. The system is extremely fast. Therapists doing home-based therapy can even connect to the system using a wireless card on their laptop.

Mackie: Rehab Optima data is accessed through an encrypted SSL-based Web site from any Windows, Mac, or Linux computer or even through an Apple App. The databases are protected by the latest Cisco firewall advancements and Microsoft application technologies.

McMullan: We have thousands of therapy practices hosted on our network and in our data center. We take great lengths to ensure the safety of our client’s data. We provide complete data redundancy and both server monitoring and mirroring. This provides us with the ability to be back up in minutes and not days. We also provide daily and weekly database backups with full off-site disaster recovery. The data is accessible over any secure Internet connection.

Morrill: There is always risk in any software solution whether data resides on location or is hosted in the “cloud.” A well-designed data infrastructure plan decreases exposure and identifies risk. Another way to avoid risk is to learn more about your vendors (software developers, data centers, and hardware manufacturers). Learn as much as you can about their financial situations, operation history, and security history.

Petrie: Our Web-based solution uses the same encryption banks used to protect financial data. Then it is regularly backed up off-site. Compare that to data stored in-house, which is prone to security breaches, hard drive failure, PC theft, and more. You also maintain complete control over what data each user can access, whether it’s on a scheduling grid, a SOAP note, or a management report.

Plymale: Data is stored in a SAS 70 compliant data center with the highest standards for security. The data can be accessed securely via a secure client using a broadband connection. Data storage is fully redundant and automatically backed up to redundant data centers with off-site backup.

Presement: How would you feel if all of your clients’ data, all their personal details, were locked up in someone else’s office—an office that you could be cut off from at any time without notice? That is the issue with hosted data, you have no control over its access. What if you had a falling out with your software provider? What if they went out of business? All of your data, financial info, medical info, even something as basic as who is coming in for treatment—GONE. InTouch allows you to access all of your data remotely but still store it locally—you have control over your data, but can still get to it from anywhere. This is truly the best of both worlds.

RM: How easily can the system be updated as the practice changes and expands?

Aviles: Very easily. Users can add sites and resources on their own. All the content in TherAssist is user definable. They can create or modify additional disciplines, add exercises, and add templates or protocols completely independently. If they need additional user accounts, we add those within a day upon request.

Cummins: This is a major benefit of Web-based rehab software purchased through a monthly subscription. The subscription should include all system updates, including new features and regulatory changes, and the updates should be automatic, requiring little or no user involvement. Subscriptions also should allow an unlimited number of users in the practice to use the software on an unlimited number of computers.

Dumke: Licensing for additional users can be expanded with a single call and usually within 24 hours. Additional modules for scheduling, document scanning, and business intelligence analysis can also be added as the client’s needs grow and change.

Fahey: INTERACTANT is very easily updated as enhancements to the system are installed by the dedicated HCS Account Managers as part of the HCS ongoing support program. Your organization prioritizes a project’s importance to ensure that the HCS Account Manager is attending to needs according to specific requirements mandated by the organization. HCS does not subscribe to a traditional release methodology, and, therefore, organizations only install enhancements that are pertinent to them to make INTERACTANT better fit their specific needs.

HCS has developed all of its INTERACTANT Modules based on existing client input and requirements as well as the continuing evolution of the health care industry. HCS enjoys the major advantage of offering a complete range of software modules that support the clinical and financial activities of a health care facility.

In addition to having the dedicated Account Manager make any enhancements requested by the organization, there are other sources to add features to INTERACTANT. Our R&D team is constantly working on new applications and making improvements to the existing system. Enhancements that come from R&D are tested in-house and then released through Account or Project Managers to each client via meetings, e-mails, or the HCS Client Info Web site, which is an online forum designed exclusively for HCS clients, providing access to the most recent enhancements, R&D projects, upcoming events, contact information, and much more.

Gomez: As clinics are added, we simply create the database for the additional location and send the client a Planetrehab server. The client simply sets up the computer and connects it to the Internet, and they are ready to use the software.

Greenwood: An expanding practice is our specialty! We write efficient software that goes with the natural flow of the office, so expansion is expected. It has been proven time and again that our software makes it possible to service many more patients. When needed, increasing the number of users is just a phone call away.

Hammer: All functionality exists within the Chart Links core application suite so there are no updates required as a practice expands. Enhancements are delivered through product updates as they are released.

Lee: Updates, when available, can be easily downloaded from Raintree. We release a new version of Raintree each year. Clients on customer support are eligible to receive these upgrades for no charge. Raintree is extremely scalable. We have customers from a single location to those with over 300 sites.

Mackie: Rehab Optima ROX contains both corporation and facility level configurations, and payor-specific options. The facility level configurations allow the user to change specific practices from one facility to the next if desired. The payor plan configurations allow LCD assignment enforcement options along with the ability to assign CCI Edit check, 8-minute rule validations, and Part B Cap tracking by payor. The system is updated each time there are ICD9, Fee Schedule, CCI Edit, or FI/MAC Local Coverage Determinations updates.

McMullan: Our software was designed to accommodate growth and change in your practice. All of our clients add staff and locations on an ongoing basis simply and affordably. Our software is one of the key catalysts that allow our clients to grow the practice and add locations.

Morrill: Scalability is built into TheraOffice from single users to many users over multiple facilities. It can be updated using web updates or installed from a CD-ROM. TheraOffice also has the ability to add features and reports with a special “add-in manager” for downloadable content.

Petrie: Adding users or locations to our Web-based system is virtually instantaneous. When you expand to a new location, there’s no need to upgrade your server or add networking—all you need is an Internet connection.

Plymale: All system updates are automatically downloaded and installed when users log in. These updates are preannounced for significant changes, as well as an online system message notifying users when they log in, with online documentation and release notes. The system is designed to accommodate practice growth, with no limits to the number of clinics, users, patients, etc. It is also easy to customize according to types of practice—PT, OT, ST, and practice styles.

Presement: As mentioned earlier, our clients run the gamut from sole practitioner to multilocation national chain. InTouch is a fully scalable software solution that can grow with the practice—you do not have to throw out the baby with the bath water just because you add a discipline, a workstation, a therapist, or a location. Even if your system requires migration from a stand-alone workstation to a larger server, no problem—all of your history, all of your hard work, remains intact.

RM: How easily can software features be updated, added, or eliminated?

Aviles: Features, as I see it, are the functioning parts of the programs, not the content. There are a variety of features that users can turn on or off within the program. New features are always based on client needs and requests. For updating, when hosted, we add those for clients automatically without any involvement on their side. For local area networks (LAN) clients, since they have the server, usually it is a scheduled event.

Cummins: That depends on such factors as the technology the vendor is using to create their software, the size of the development team, and the complexity of the new feature. During a demo, ask the vendor how many software updates they have completed over the past year and review the pace at which new features are implemented. Also, make sure the software includes controls that allow you to turn these features on or off as desired.

Dumke: Many features can be hidden or exposed by the client’s system administrator. Much clinical content, for example, can be hidden or exposed depending on the patient mix of the organization. All clients are invited to suggest other feature enhancements based on how their clinical and business needs evolve over time, and features are added based on the assessed needs of the entire client base.

Fahey: Enhancements are easily updated, added, or eliminated as support is provided by a dedicated HCS Account Manager who is responsible for addressing state and federally mandated regulatory billing requirements as well as organization-requested changes. The benefits this dedicated Account Manager brings to our client organizations are multiple: The System Is Enhanced Daily—Based on the prioritization established by the organization, any modification requested from the organization is maintained by HCS for the full term of the relationship. The System Is Adaptable—Starting with the detailed systems review and continuing with assignment of the dedicated Account Manager, the system reflects modifications needed to meet client-specific requirements. The client prioritizes an enhancement’s importance, and installation occurs at the direction of your organization to ensure that the Account Manager is attending to your needs in the proper manner.

HCS asks the organization to prioritize the modification’s importance to ensure that the Account Manager is attending to those needs in the proper manner and at your instruction and requirements.

Gomez: We are the developers of our software, so we have complete control over the functions and what is incorporated into the software. We strive to stay abreast of latest trends in the physical and occupational therapy market and incorporate the latest features that our clients need. Our clients are our main source for additions to our software. When a client requests a new feature or suggests a way to improve our software, we consult with them and other clients and implement the new features and/or changes. And we never charge for updates or upgrades to the software. We update all installations once a week (on Sundays), so every client has the latest version.

Greenwood: Updates and upgrades are easily done by download over the Internet or in the case where a doctor has a slow or no Internet connection, it can be done through the mail on CD.

Hammer: Easily. The features in Chart Links are modular. That means, per user role, certain features can be allowed or hidden as needed.

Lee: The program is designed for easy updating and modification. All aspects related to a clinic’s operation, “business rule triggers,” workflows, and alerts can be easily modified by our customers. Raintree comes with comprehensive clinical documentation templates for PT, OT, and SLP. The program also features template building tools wherein customers can add their own forms.

Mackie: Features and modules are easily activated or eliminated at the customer’s request. These features can be activated or inactivated for one or all of the sites in your site portfolio.

McMullan: At no additional cost to our clients, we provide regular software upgrades and enhancements to our product. This includes all regulatory changes that occur on an annual basis and new clinical practice trends for providing quality patient care. All of software features are configurable so that any practice or facility can use all or only a select few of the features that they want to enable.

Morrill: Software changes are also dependent on the software architecture and the ability to update software coding. TheraOffice can be updated with web updates that can download and install automatically. In 2011, Hands on Technology will release a Web version of TheraOffice that will use the latest development tools to offer a Web experience that will look and feel more like a traditional desktop program.

Petrie: Our Web-based system is upgraded and enhanced continuously. Once it is uploaded to our Web server, it’s automatically on your browser. There is no longer any need to reinstall software on every machine each time you receive an update.

Plymale: The system has user-definable security groups that include system administrator roles. The administrator has the ability to control access to features as well as predefined libraries of documentation picklists, forms, templates, reports, and printing formats of documents that can be easily customized. Once updated by the administrator, all changes are immediately available to all users without re-deployment.

Presement: InTouch comes in one flavor—all features are enabled, all functions are available; you are not purchasing modules, it comes complete right from the start. However, you may not want some of your staff using certain features, which is why our security settings let you decide who can see what, who can do what, and who can print which reports—right down to the therapist level and for each of your locations.

RM: What are the biggest mistakes that should be avoided when choosing practice management software?

Aviles: Taking a short view. When considering software, there is a need to address a short-term issue for sure, but what about the next stage in the progression of your practice? Can the program or vendor address future needs, even ones you may not have anticipated? Choose a program that can provide functionality across your clinic, even if your need now is only for documentation. Choose a vendor that has a proven record of development.

Cummins: The biggest mistake is rushing into something. If you do not give the product a thorough review, you might be surprised later. Watch out for long-term commitments and costly upfront license fees, which can lock you into using a software application that does not truly meet your needs. Give yourself plenty of time for the demo, and ask plenty of questions. You want to come away from the decision confident of having acquired a valuable asset for your organization.

Dumke: The first leads back to question #1; begin with the end in mind and know how to measure success. That will guide good decisions both in product selection and during implementation. Second, recognize that adopting new software is NOT a technical project. It is a human project that needs to focus on managing the fear, uncertainty, and doubt that come with changes to workflow. Strong internal leadership and good communication of goals and plans to the staff are imperative.

Fahey: In certain cases, organizations believe the hype and the promise of future software offerings. Providers should base their decisions on current functionality and track record performed for other similar organizations. Once a decision is made, your entire organization should jump on board and dedicate time and effort toward the project to ensure its success and long-lasting benefit to the organization moving forward.

Gomez: Not looking at all the various software options can mean purchasing software that may not ultimately be the best fit for a company. Buyers should be willing to investigate and evaluate the different products on the market and not immediately discount software because of price or uniqueness of the product.

Greenwood: Getting software that is not going to solve the problems of your office. EON does a free public service webinar, “How to Evaluate Software for Your Practice in the New EHR World,” with very specific information about this. It is not about EON’s products, but how to find the right software for you.

Hammer: Avoid buying software that functions well in a controlled demonstration but not in a real-life therapy workflow. Conduct a site visit—if not two or three. Observe how the software functions. You should interview therapists, schedulers, and billers who use the software every day.

Lee: Practice owners should avoid opting for a lesser system that their clinic can outgrow. Not all solutions have the depth that is necessary to scale up when a practice expands. All software programs look good in a 60-minute demo. The differences between the systems only become apparent when digging deep and asking detailed questions. Also, practice owners should choose a fully integrated practice management solution over one integrating two or more vendors.

Mackie: Allowing your decision to be affected by price and not doing the proper due diligence to reveal how value supersedes price. By making a decision on the software product alone and not taking the time to explore and understand the character of the company your business will be relying on for years to come.

McMullan: Practices need to be careful when choosing a practice management in the following areas. 1) You get what you pay for—don’t focus only on price! It is more important to focus on a reliable return on investment (ROI) model using your own practice’s costs. Low-priced software vendors that remain unprofitable are prone to going out of business, and leave you searching again for a new practice management system. 2) Software Not Built for Therapy—if it was not designed for outpatient rehabilitation it will not work well for your practice. There are several key criteria and operational work flows that are unique to outpatient rehabilitation that a physician or hospital system will not be able to accommodate effectively either now or in the future. 3) Undervaluing the importance of quality and comprehensive training. Far too often, decision-makers cut cost by minimizing essential practice management software training, which results in underutilized and ineffective use of the software application. 4) Make sure to check references, and particularly beyond the references provided to you by the software vendor.

Morrill: Failure to develop internal processes and practices for your business is the largest mistake practices make when selecting software. Do not let software companies define your business processes unless it is clear that they will increase efficiency, improve revenue management, and help you achieve clinical excellence. Our best clients utilize TheraOffice to support and monitor their own business principles and operating plans.

Petrie: Focus on the solution, not the software. Instead of asking vendors if they have a certain feature, ask: “How can you fill our open slots?” or “What can you do to reduce denials?” Now the vendor—who may have spent years solving the same problem you’re facing now—can show you solutions you didn’t anticipate. And that leads to a bigger return on your investment.

Plymale: Don’t underestimate the impact of change on staff. Realize you will have to proactively plan and manage change. Don’t underinvest in training. Give your staff adequate time to learn the new system. Wherever possible, try to get the major product components, such as scheduling, documentation, and billing, from a single provider. This reduces your vulnerability to “buck passing.”

Plan ahead for changes to clearinghouses to ensure that changes in systems do not interrupt cash flow.

Presement: There are two pitfalls to avoid. #1) Don’t give a lot of cash to a stranger. Unless someone is prepared to give you back your upfront payment if you are unhappy, walkaway. #2) Don’t get tunnel-visioned into buying an EMR system, what you need is a practice management solution that will add value to your practice and #3) Involve both clinical and administration staff in your decision—everyone in your clinic needs to live with your software choice for potentially many years to come.