Practice Management Systems
Features That Will Save You Time
And Might Improve Your Bottom Line
Steven D. Atwood, M.D., FACP
satwood@pol.net
www.adultmedicine.com/presentations/practice-management-systems.ppt
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Practice Management Systems
Key Points for Today
1. What you need to know, not nice to know
2. What might separate the winners from the losers
3. Specific examples of how your PMS
can actually help you do your job or help
1. save time
2. improve efficiency
3. increase patient satisfaction
4. improve your bottom line
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Practice Management Systems
Key Sections for the Physician
1.
2.
3.
4.
5.
3
Scheduling / registration
Billing / accounting
Serving the patient
Which program
Where to get suggestions and specs
Practice Management Systems
Let’s Get To It
Scheduling
 Everyone Must Be Able to Schedule
nurse when telling coag results
 doc when telling patient to drop in

 See Schedule at Every Station and From Home
 30 Second Rule– Book Appointment in Seconds–
 patient name, doc, reason, when, done
 trim names selection to those that are relevant
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Practice Management Systems
See Schedule
Easy to Add or Change
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Practice Management Systems
Know key data before
the time is reserved
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Practice Management Systems
How much time,
which room
Robust detail
Bundled procedures
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Practice Management Systems
Are You Behind?
When Can You Get Back to the Hospital?
Helps to track when patients
Arrive
Roomed
Exit
No Show
Show the data by using
symbol, color, highlights
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Practice Management Systems
Seen and left
You are seeing now
e.g. 9am
and you
are behind
X No Show
Arrived
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Practice Management Systems
One Write, No Duplication
 Cut & Paste
 Drag & Drop
 Notes Everywhere
e.g. individual claims,
individual codes such as with prolonged detention
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Practice Management Systems
Cut and Paste or Drag and Drop
to any spot that week or in future months
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Practice Management Systems
Notes, Notes, Notes Everywhere
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Practice Management Systems
Archive the Inactive Data
No scrolling through 30 people with similar names
 Index patients by doctor or site
then use the list associated with this site etc.

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Practice Management Systems
Archive or leave out the data you don’t need
>>leave out patients not seen in 10 years
>>just your site’s patients--not entire system
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Practice Management Systems
Summary--Scheduling
1. Book an appointment in seconds
2. Anyone at any workstation can book the appointment
3. When locating the patient on your list, the list should
be trimmed to just your active patients—
not every patient who was ever entered into the database
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Practice Management Systems
Summary--Scheduling
4. Scheduler can easily see all the key data
as the appt. is made and as
you are working through the day’s schedule
5. Cut & Paste, Drag and Drop, one write system
6. Notes everywhere, appointments, insurance, bills
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Practice Management Systems
Billing
 Fee structure every insurance company
PAID vs. EXPECTED
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Practice Management Systems
Billing
Past
we used numerous fee schedules
generally a Medicare max allowed fee schedule
and a fee schedule for the rest of your practice
Now
generally all accounts assigned
but everyone has a different payment schedule
e.g. 1.6 x Medicare rate, no coverage for carve outs
another is 0.8 x Medicare rates
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Practice Management Systems
Billing
Paid
vs. Expected -
your computer should show you
the expected payment
as you enter payments
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Practice Management Systems
Billing

20
Paid vs. expected--see as you enter
Practice Management Systems
Billing

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charge vs. paid for each insurance company
Practice Management Systems
Billing
2. Export almost any field for report of data analysis
Best of Breed, not locked in
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Practice Management Systems
QUERIES

PMS is basically linked databases
the
setup is proprietary coding and formatting
you are locked in
when you buy it you might be married for life
because you might not be able to get your data
out if you switch to another program
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Practice Management Systems
QUERIES
PMS Design Linked Databases
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Practice Management Systems
QUERIES
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Practice Management Systems
QUERIES
Now
STANDARDS Provide the Connectivity
Between Programs
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
Not Locked In,
so Programs Compete on Performance

Best of Breed may be easier to determine
 Export every field will help all this
Practice Management Systems
Billing
3. Modular not All-in-One
Off-the-Shell Software
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Practice Management Systems
Off the Shelf Software
vs.
All-in-One Package

Software doing majority of operations
for a large corporation
may have dozens of pull down menus
and take 3 days of training before you can use
e.g. IDX or similar software for large health systems
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Practice Management Systems
Off The Shelf Software
vs.
All-In-One Package
Separate
Programs or Discrete Modules
helps 1.) Training
2.) Security
3.) Upgrades
4.) Can Reduce Down Time
 Quicken $79 --bank activity and office expenses
 QuickPay $50 or QuickBooks $179 -- payroll
 HotFax --can fax any file as if you were printing it
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Practice Management Systems
Billing and Practice Management Software
Future Is Modular
 No All-in-One Program
Separate Program or Module for Each Part
e.g. EMR, Billing, Schedule, Ordering
 Now STANDARDS &
Ability to Import and Export data
can Provide the Connectivity Between Programs

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Practice Management Systems
Billing
4. Security specific for each section or each staff member
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Practice Management Systems
SECURITY
User ID, Password Too many programs
give full access to everything
 Station ID
after you log on
 Section Permission
e.g. Hospitalize Senator, only treating staff
have access to this patient’s tests

e.g. charge and collection for the day
not accessible by file room staff
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Practice Management Systems
Billing
5. Print-to-File vs. Programming an Interface
to transfer data between programs
Print-to-File rather than a printer
makes
report or papers go to a digital file
then can save it, send it, print it
or automatically add the data to a database
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Practice Management Systems
Print to File

Best thing since sliced bread
EG. 50 page AR report made in digital form
then save this file rather than paper
then send your satellite office(s) this via e-mail
rather than mailing or faxing 50 pages
 can use a claim clearinghouse &
NO INTERFACE PROGRAMMING NEEDED
your digital file fills in their database

Print to File—Data to Clearing House
e.g. Claims to a clearing house via the www
1. Generate HCFA type claims to Print
2. then you can Print to File so you can
save the printout and all it’s formatting
3. Send to your claim clearing house as file upload
4. Your clearing house can use this file and the
print layout to transfer this information to their
database
NO INTERFACE NEEDED-- NO MORE TYPING
PRINT TO FILE
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Practice Management Systems
PRINT TO FILE
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Practice Management Systems
PRINT TO FILE—can look like a HCFA
claim with just your data being displayed
Every letter and number
is exactly where it
would be on a claim
Thus a computer can
import the data
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Practice Management Systems
Print To File
Select printer then click print to file option
 Go to DOS prompt (in Windows>Accessories)
 Enter the command PRINT and file name e.g.


Then strike enter and your file prints
thus you can save anything you want to print
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Practice Management Systems
Print to File printer must be
connected by LPT-1 port
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Practice Management Systems
Summary Billing
1. Security specific for each section or each staff member
2. Fee structure every insurance company
PAID vs. EXPECTED
3. Export almost any field for report of data analysis
not locked in, Best of Breed
4. Modular not All-in-One
Off-the-Shell Software
5. Print to File vs. Interface programming
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Practice Management Systems
Physician in Back Office

Need a full current registration sheet or
face sheet right at your finger tips
insurance type may dictate where to go for tests
 insurance type may dictate which hospital to use
 insurance type may only cover certain meds

may need DOB
 may need SSN
 may need phone numbers for patient
 may need phone numbers for insurance company

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Practice Management Systems

Physician in Back Office
must be able to tag
individual data

then as a
batch you can
print
fax
reserve
reformat
Same as hold down Control then left click to
select desired data in MS Windows
progress notes
 claims to send
 schedule spots to reserve
 rooms or equipment to reserve

FAX

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If you can print it
you should also be able to fax it
Practice Management Systems
Send to fax machine rather than printer
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Practice Management Systems
Orders

prescriptions
goal is to order the right med quickly
formulary
 which med, which dose

FAX a Script--how do you sign
if digital signature not OK
vs. Voice Mail at Pharmacy
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Practice Management Systems
Forms
Scan the form
 Insert the file on a page as a background
 Overlay text boxes where the data goes
 Bookmark each box (control+F9)
 Jump box to box / bookmark to bookmark
(F11)

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Practice Management Systems
Any word processor & hopefully your PMS
can prepare and store any form
Start box 1
F11 to jump
to next field
bookmarks
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Practice Management Systems
Physician in Back Office

Email at every work station
internal network vs. entire web
inexpensive
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Practice Management Systems
Summary Physician Seeing Patients
1.
2.
3.
4.
5.
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Face sheet
Create batch for faxing or printing all at once
Fax directly without converting to paper
Outside forms become part of your program
Internal e-mail system
Practice Management Systems
What’s Out There
Selecting Your Practice Management System
How Many Different Programs
 List of Vendors
 Cost
 Features

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Practice Management Systems
PMS Vendors
List on Internet at
www.HIPAA.org/
pmsdirectory
about 110 listed
www.HealthCareInformatics.com/
issues/2002/10_02/spotlight.pdf
www.aafp.org/
9 rated
PreBuilt/fpnet_techguide.pdf
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Practice Management Systems
PMS Vendors
There are over 110 programs
perhaps ½ have ASP (web based) option
e.g.
Larger Systems
Smaller Offices
1. Medical Manager 1. Lytec
2. Millbrook
2. Medware
3. IDX
3. Medisoft
4. NextGen
4. E-MD
5. CompuMedic
5. FoxMed
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Practice Management Systems
PMS Purchase or Lease Prices
Varies by options—wide range
• Buy and own, then elective updates
• Yearly lease and required yearly updates
• Monthly lease per provider or per station
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Practice Management Systems
PMS Purchase or Lease Prices
perhaps
 $ 200
 $ 600-2000
 $ 7,000
 $15,000+
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Varies widely and changes
- many options
- must contact vendor
Medisoft
MedWare, Lytec
NextGen & per provider
IDX, Medical Manager
Practice Management Systems
Where to Go for Information
1. www.acponline.org/PMC/practice.htm
2.
3.
4.
5.
6.
7.
8.
www.ComputingForClinicians.com by ACP Fellow
www.aafp.org/practicemgt.xml
user comments
www.ctsguides.com/medical.asp
buy reviews
www.HealthComputing.com/KLAS
buy reviews
www.MGMA.com
members only
www.KnowledgeStorm.com needs free registration
www.CivicResearchInstitute.com/mi5.html
SUMMARY
on Leveraging Your Practice Management System
to Save You Time, Improve Efficiency,
and Improve Your Practice
1. Everyone Working with Patients can Schedule
and Has Access to Registration Data





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Just seconds to reserve an appointment
Need to know the health plan and contact numbers
Registration data effects your medications and tests
Old unused data to archives
MS Office type features—cut/paste, drag/drop, tag
Practice Management Systems
SUMMARY
on Leveraging Your Practice Management System
to Save You Time, Improve Efficiency,
and Improve Your Practice
2. Your software will serve you needs better
if you can easily import, export, and query
almost every field in the PMS



List of who is on a medication if a new alert
List and # of patients on a HMO
Export your data to your new software
3. Need ability to track expected payments for each
insurance company as the payment comes in
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Practice Management Systems
SUMMARY
on Leveraging Your Practice Management System
to Save You Time, Improve Efficiency,
and Improve Your Practice
4. Need ability to easily find, complete, and fax
paper –

e.g. Referral form–who, what, where, when, why
5. Inexpensive programs like Quicken can easily
manage key functions– Maybe everything in
one program is not a good idea
6. Every work station needs office e-mail
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Practice Management Systems
Questions
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Practice Management Systems
Practice Management Systems
Features That Will Save You Time
And Might Improve Your Bottom Line
Steven D. Atwood, M.D., FACP
satwood@pol.net
www.adultmedicine.com/presentations/practice-management-systems.ppt
61
Practice Management Systems