In the summer of 2002 our three-neurosurgeon practice was faced with the task of upgrading our practice management software to meet the new requirements of the Health Insurance Portability and Accountability Act. I had recently joined the practice after completing my residency, and in my spare time I spent a great deal of time researching electronic medical records and practice management software packages. I was surprised at how difficult it was to find detailed and unbiased information. This article summarizes my experience and hopefully will provide you with some useful information if you are facing a similar situation.
The best resource that I found is the American Association of Family Physician’s Technology Guide https://www.aafp.org/techguide.xml). The AAFP and Microsoft worked together to identify practice management software that could accomplish a set of tasks that are fundamental to the business activities of a solo or small-group family practice. The software needed to be well designed and technically robust, as well as developed and supported by a company that could continue to support the product in the future.
AAFP’s Review
The AAFP’s review identified 11 vendors with products that use a Microsoft operating system and database. Of these, nine vendors agreed to participate:
- Compusense, Inc. (now A4 Health Systems (https://www.compusenseinc.com)
- e-MDs (https://www.e-mds.com)
- Greenway Medical Technologies, Inc.(https://www.greenwaymedical.com)
- nInfoSys, Inc. (https://www.infosysusa.com)
- MedStar Systems, LLC (https://www.medstarsystems.com)
- Millbrook Corporation (https://www.millbrook.com)
- NextGen Healthcare Information Systems, Inc. (http:www.nextgen.com)
- PerfectPractice. MD (https://www.perfectpractice.md)
- Visionary Medical Systems, Inc.(https://www.visionarymed.com)
Each company’s software package underwent an extensive evaluation of its functional capabilities, technical performance, financial stability of the parent company, and finally, the satisfaction of the customers who actually use the product. The functional capabilities were assessed by identifying the presence or absence of 57 criteria deemed to be essential to the day-to-day management of a practice. Very little variation was found among the products.
The technical aspects of each software package were assessed by a team from Microsoft that analyzed the design, architecture, scalability and reliability of the software. The team identified 58 criteria and ranked the products based on these criteria. There was significant variation in the scores, with Greenway’s PrimePractice scoring the highest and MedStar System’s MedStar software scoring the lowest.
The financial stability of each company was evaluated by an independent auditor. NextGen ranked the highest while e-MDs ranked the lowest. An assessment of customer satisfaction was attempted, but there was such a low response rate that it was difficult to draw any conclusions; thus, that data was not included in the final rankings.
An overall score was given, and based on this evaluation, four companies scored above 75 on a scale of 0 to 100 (with 100 ranking the highest): Compusense, Greenway, Millbrook, and NextGen.
Applying AAFP’s Findings in Our Search
The daily volume of patients in a neurosurgeon’s office is certainly less than that of aa family physician’s office, and therefore we suspected that any product that would perform well in that setting would perform well in ours. We invited the top two vendors, as well as the vendor of our existing software, for an in-office demonstration. Each of the companies provided a return on investment (ROI) analysis that indicated how much money would be made (or saved) by using their product. In addition each of the companies offered to provide training as well as data migration services.
All of the software packages we tested performed well, and in the end we chose the one that seemed to be the best fit for us, Greenway’s PrimeSuite. (PrimeSuite incorporates both PrimePractice, the practice management module, and PrimeChart, the electronic medical record module.)
As a side note, another factor played an important role in our decision to go ahead with the purchase. There is a little-publicized part of the Sept. 11 economic stimulus package, Tax Code 179, that accelerates the depreciation and thus the write-off of technology purchases https://www.irs.gov/formspubs/page/0,,id=12910,00.html).
It took almost eight months from the time we identified that we needed to upgrade our computer system to the time that the new system was implemented. So far we have been very pleased with PrimeSuite. The technical support has been excellent and there really have not been any problems. We are about to go live with the electronic medical records module, and we are particularly interested in seeing if the ROI predictions materialize and improve our bottom line.
Paul J. Houle, MD, is a neurosurgeon with Neurosurgeons of Cape Cod in Hyannis, Mass., [email protected].