Six Steps to Practice Management System Selection
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Get the Benefits of Automation
Physician practices can save significant time and expense by electronically performing routine administrative functions, such as verifying patient eligibility and contacting health insurers about the status of a claim. However, practices need the right technology to achieve these gains in efficiency. By selecting the right practice management system (PMS), practices can maximize the benefits of automation.
As with any major purchase, an initial investment of time and effort to research and evaluate options ensures that practices will choose a PMS product that best meets their needs. The six steps below outline how practices can systematically identify high-priority system features and functionalities for a new PMS and select the best technology fit to improve overall practice operations and compliance with electronic standards and operating rules.
STEP 1: Establish a PMS assessment team.
Building a team to assess what the right PMS is for the practice is critical. Staff involvement in evaluating the practice's needs ensures that the selected product will satisfy all users and be the most appropriate and cost-effective system for the practice. Furthermore, engaging key staff who use, interface with, or are directly impacted by the PMS will foster ownership of tasks that are necessary for day-to-day practice operations.
STEP 2: Analyze the patient management and claims revenue cycle.
The PMS assessment team should perform a comprehensive analysis of the practice's patient management workflow (from appointment scheduling to following up on late payment) and claims revenue cycle. Creating a detailed process map that captures the practice's workflow will provide a complete picture of the administrative functions that the ideal PMS should support. Maximizing the automation of the claims revenue cycle can dramatically reduce a practice's administrative costs and hassles while potentially increasing revenue.
STEP 3: Identify critical software functionality and features.
Based on the analysis of practice workflow and processes described in the previous step, practices can next identify the core features and functionalities needed for their PMS. One key factor to consider is software compliance with HIPAA electronic standard transactions, operating rules, and privacy and security requirements. The practice can then develop a checklist detailing the most important PMS features and functionalities to consider in product selection.
STEP 4: Research and compare PMS products.
Practices should next research and compare PMS products to find a system that is uniquely compatible to their needs. Practices may wish to start this process by checking to see if the product is accredited under the Practice Management System Accreditation Program (PMSAP; see www.ehnac.org/practice-management-system-accreditation-program) developed by the Electronic Healthcare Network Accreditation Commission (EHNAC) and the Workgroup for Electronic Data Interchange (WEDI). The PMSAP assesses a vendor's adherence to quality, privacy, and transactional and security standards. Practices may also wish to review vendor surveys from health information technology review organizations, network with similar physician practices for recommendations, visit vendor booths at trade shows, or engage a consultant to help find products that are the best potential matches for their needs.
STEP 5: Request and review formal requests for proposal (RFPs) from PMS vendors.
The practice should then create a formal RFP that outlines its requirements and specifications for a PMS. The RFP will include specific information vendors will need from the practice (e.g., practice size and specialty). In responding to the RFP, vendors will detail the functionalities and features of their product, as well as include pricing information. The RFP allows practices to gather the information needed to effectively compare vendors and select a PMS.
STEP 6: Select the PMS that best meets the practice's particular needs.
After a thorough review of all supporting documentation from the vendors, the practice can weigh each product's system features vs. costs and make a selection that will yield the most benefits. The practice can then implement the new system and reap the rewards of improved efficiency.
Additional Resources to Help with PMS Selection
Updated resources from the American Medical Association (AMA) can help practices looking to purchase a PMS – whether they are buying their first system or looking to switch to a different product. The AMA's "Selecting a Practice Management System Toolkit" includes a more detailed review of the six selection steps outlined above, as well as an archived webinar that walks through the decision-making process.
The toolkit also includes a PMS criteria checklist template that can be used as a starting point for assessing key PMS features and modified to reflect a practice's unique priorities and needs. An RFP template is also available to help practices solicit formal proposals from vendors. Visit www.ama-assn.org/go/pmsoftware to access these helpful resources and learn how to select a PMS that will streamline a practice's claims revenue cycle operations.