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by Gaby Loria,
Market Research Associate
Last Updated: November 24, 2015

Medical software includes a wide class of systems that manage the clinical and administrative functions of healthcare organizations. Systems have been tailored to automate just about every healthcare process, including billing, patient scheduling, creating and managing patient records, picture/image archiving, prescribing medication and more.

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In this guide we discuss the following:

Common Features of Medical Software
What Type of Buyer Are You?
Benefits of Medical Software
Important Considerations
Recent Events You Should Know About

Common Features of Medical Software

Electronic medical records Electronic medical record (EMR) or electronic health record (EHR) software assists in creating and storing digital patient records. Helps track patient notes, demographics, histories and medications. Features include e-prescribing, SOAP notes, E&M coding advice and more. EMRs may also provide lab integration, device integration, tablet support and voice recognition.
Medical billing Manages the creation of patient statements and submission of claims. Functions include coding, claim scrubbing, eligibility inquiry, electronic claim submission, payment posting and reporting.
Patient scheduling Automates the process of scheduling patient visits. Features include automated follow-ups, text message/phone/email reminders and multi-location support. Typically offered with billing in a practice management suite.
Radiology information systems Manages the operations and workflow of radiology imaging centers. Automates the process of storing, manipulating and distributing patient data and images.
Picture archiving and communications systems Manages the storage and retrieval of DICOM images (X-rays, CAT scans, MRIs etc.). Often used in conjunction with an RIS to execute the radiology workflow efficiently.
Medical accounting Automates accounting procedures for healthcare practices. Functions include A/R, A/P, general ledger, financial reporting and more.

What Type of Buyer Are You?

Most organizations we speak with are researching and evaluating medical software for one or more of the following reasons:

Transitioning from paper charts to digital records. “It’s raining paper” is the common cry we hear from paper-based practices. These buyers want to cut back on paper, improve office efficiency, reduce errors and run a more effective operation overall.

Replacing outdated software. This is a common scenario we hear from buyers. Their current system—whether it be a homegrown system or from a medical software vendor—is out of date and costly to maintain or update. They want a more modern system that is easier to use, meets federal requirements (e.g., ONC-ATCB certification) or that meets feature/functional needs.

Combining applications into an integrated suite. In many cases these practices have a hodgepodge of disparate applications, and as a result, find themselves doing double data entry and dealing with other inefficient workflows and processes. These organizations invest in integrated medical office management software—that is, integrated EMR, billing and scheduling applications—to centralize all information and functions in one place.

Implementing best-of-breed applications. Conversely, these buyers are focused on applications to address a specific need. Most often, buyers in this category are looking for a stand-alone billing, EMR, RIS or PACS system.

Pursuing federal incentives. We’re three years into the HITECH Act, and many physicians are replacing their EHR or purchasing one for the first time to meet federal requirements. In order to qualify for Medicare and Medicaid incentives, physicians—or more accurately, “eligible professionals”—must make “meaningful use” of a certified EHR. Providers have until 2015 to qualify, or they face penalties in the form of decreased reimbursements.

We should note that outpatient and inpatient organizations often have different feature/functional requirements. For example, inpatient care provider centers such as hospitals will require systems to support bed management, UB-04 billing and potentially long-term patient stays. Meanwhile, ambulatory care providers such as family medicine physicians and specialists will share common feature requirements to support “walk-in/walk-out” care.

Benefits of Medical Software

The general benefits of any medical system are improved quality of patient care, increased operational efficiency and improved practice profitability. These benefits are created by different applications and impact organizations in different ways. For example:

  • The automation of back-office operations streamlines administrative tasks associated with patient encounters, which may enable providers to spend more time with patients and hire fewer staff;
  • More accurate documentation of these encounters and a more organized claims submission process can lead to improved collections and
  • Automated alerts prompt providers with potential issues or risks, while automated reminders help patients return to the office when necessary, improving quality of care.

In addition to these general benefits, the major applications found in medical software each provide a host of specific benefits. For example, in 2014 we surveyed physicians about the benefits of electronic health records. They cited “easy access to records,” “more robust/legible records” and “drug interaction alerts” as the top advantages of using an EHR.

Important Considerations

Integrated suite vs. best-of-breed. When selecting a system, buyers will have the choice of implementing different applications for specific tasks, or a complete suite of tools to address all their needs. The key decision that most providers will need to make is whether to implement a standalone electronic medical records (EMR) system or replace an existing practice management system with a complete system. We hear from many buyers facing this decision as practice management systems have been ubiquitous since the 1990s and EMRs are increasing in adoption, primarily due to the HITECH Act.

Software-as-a-Service (SaaS). The trend toward cloud computing is impacting many industries, and healthcare is certainly one of them. Web-based, or SaaS, software offers several advantages such as lower upfront costs, reduced IT and support costs, remote accessibility and more. However, practices in rural settings may not have access to the broadband Internet necessary to efficiently run Web-based software. Moreover, Web-based systems may not support all the feature/functional needs of some practices with unique requirements.

Mobile computing. Going hand-in-hand with SaaS, healthcare providers are finding themselves increasingly on the go and accessing systems from multiple offices, home and mobile devices. Tablet (e.g., iPad) and smartphone support, including iPhones and Android phones, is increasingly common. If you will be accessing your software primarily from a mobile device, we suggest choosing a vendor that has developed a native app for your device, such as MediTouch’s iPad EMR.

ONC-ATCB certification. As most healthcare professionals are aware, the HITECH Act of 2009 requires the use of electronic medical records systems by 2015. Eligible professionals can subsequently qualify for up to $44,000 through the Medicare EHR Incentive Program or up to $63,750 through the Medicaid EHR Incentive Program. To qualify, they will need to demonstrate “meaningful use” of one of the ONC-ATCB certified EMRs.

Recent Events You Should Know About

ICD-10 implementation delayed until late 2015. With the passage of the Protecting Access to Medicare Act of 2014 in April 2014, Congress pushed back the implementation of ICD-10 codes until October 1, 2015. This is the second time the deadline to begin using the new codes has been postponed from the original October 2013 date.

Athenahealth acquires RazorInsights. In January 2015, ambulatory-focused EHR company Athenahealth purchased RazorInsights, a cloud-based EHR serving rural, critical access and community hospitals. This acquisition will expand Athena’s reach into the hospital EHR market beyond their current scope of 59,000 health care providers.

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