The medical software market is very large (1,000+ vendors) and complex. Vendors have customized applications for just about every provider designation (MD, DO, OD, DC, PT, PhD, LSCW, etc.) and type of provider organization, including outpatient, inpatient, and home health care. Years of development and company consolidation have led to a daunting market. We have written this buyer’s guide to help visitors understand how the medical software market breaks down and how they can identify the systems that best meet their needs.
Here’s what we’ll cover:
What Is Medical Software?
Deployment Strategies
Application Categories
What Type of Buyer Are You?
Market Forces and Trends
Benefits & Potential Issues
What is Medical Software?
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. Since different specialists have unique requirements, software companies address the different needs through both broad and narrowly-focused solutions.
Deployment Strategies
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 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 (PM) system with a complete EMR and PM program. 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 ARRA HITECH Act of 2009. It is important to note that many vendors offer applications in more than one category, and that the lines between many categories have become blurred.
Application Categories
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Electronic Medical Records |
Assists in creating and storing digital patient records. Helps track patient notes, demographics, histories, and medications. Functions include e-prescribing, lab integration, device integration, tablet support, and voice recognition. Example vendors include GE Centricity, AllScripts, and eClinicalWorks. |
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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. Example vendors include AdvancedMD, HealthFusion, and LeonardoMD. |
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Patient Scheduling |
Used to automate 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. Example vendors include AllegianceMD, NueMD and MedLedger. |
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Radiology Information Systems |
Manages the operations and workflow of radiology imaging centers. Automates the process of storing, manipulating, and distributing patient data and images. Example vendors include RISynergy and Medics RIS/PACS. |
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Picture Archiving and Communications Systems |
Manages the storage and retrieval of DICOM images (X-Rays, CAT scans, MRIs, etc.). Often used in conjunction with a RIS to execute the radiology workflow efficiently. Example vendors include Medics RIS/PACS and Sage Intergy. |
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Medical Accounting |
Automates accounting procedures for healthcare practices. Functions include A/R, A/P, general ledger, and financial reporting. Example vendors include Microsoft Dynamics GP, Epicor, and Sage MAS 90/200. |
What Type of Buyer Are You?
Before evaluating software and queueing up a formal comparison, you’ll want to make sure you know what type of buyer category you belong in. We have found that almost all buyers fall into one of the following four categories:
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Integrated suite buyers. These organizations are investing in software to manage two or more aspects of providing patient care in one single system. Most commonly, these buyers are looking for integrated EMR, billing, and scheduling systems.
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Best-of-breed buyers. These buyers are focused on applications to address a specific need. Most often, buyers in this category are looking for a billing, EMR, RIS, or PACS system.
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Outpatient organizations. Ambulatory care providers such as family medicine physicians and specialists will share common feature requirements to support “walk-in/walk-out” care. They are usually looking for EMR, practice management systems, or both.
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Inpatient organizations. While similar in scope to systems designed for outpatient care, inpatient care provider centers such as hospitals will require systems to support bed management, UB-04 billing, and potentially long-term patient stays.
Market Trends You Should Understand
Buyers should keep the following trends in mind when researching software. How a vendor fits within these trends could have a big impact on its viability.
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Software-as-a-Service (SaaS). The trend towards cloud computing is impacting many industries, and healthcare is certainly one of them. Providers are beginning to show increasing affinity towards the lower upfront costs, monthly pricing model, lack of IT infrastructure, and remote accessibility associated with web-based applications.
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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. iPad and iPhone support are becoming increasingly common.
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ONC certification. As most healthcare professionals are aware, the HITECH Act of 2009 requires the use of electronic medical records systems by 2015. Eligible providers can subsequently qualify for $44,000 in stimulus funds by demonstrating “meaningful use” of ONC-ATCB certified EMRs. This ONC-ATCB certification is going to be nearly essential for EMR vendors to survive, unless their target customers will not qualify for stimulus funds.
Benefits & Potential Issues
The primary benefits of any medical system are to increase efficiency, improve collections, or improve the quality of patient care. These benefits are created by different applications and impact organizations in different ways. Increased back-office efficiency streamlines administrative tasks associated with patient encounters, enabling providers to see more patients and hire fewer staff. More rigorous documentation of these encounters and a more organized claims submission process lead to increased collections. Automated alerts prompt providers with potential issues or risks, while automated reminders help patients return to the office when necessary.
While most systems are expensive, the high costs of delivering improper care or delaying receivables can often justify the investment. While trends such as software-as-a-service help make purchasing software a bit easier, government stimulus funds are providing a lot of the necessary funding to cover the costs of implementing most systems.
Have an opinion on this guide? Email the authors. We appreciate the feedback.
