For a medical practice, EHR may be important -- but practice management is essential.
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Practice management and electronic health record (EHR) systems are increasingly intertwined and often packaged together, but there is one big distinction between them: While many medical practices adopted EHR in search of government incentives, they adopted practice management software for their own purposes. This is the software they use to run their business -- scheduling appointments, registering patients, submitting claims, and getting paid.
Practice management may not be sexy, but we couldn't help noticing our last roundup of medical practice management products remains one of InformationWeek Healthcare's most popular features, two years after it was published, and outpacing many articles on EHR and other newfangled healthcare software.
Ideally, EHR and practice management systems work together so that patient registrations become patient health records, and the diagnosis recorded into the EHR turns into a properly coded insurance claim. Increasingly, they are modules within a software suite rather than independent products. Practices that are in the market for a new suite may start out thinking about EHR, given the regulatory push and other changes in the market, but the strength of the underlying business system often makes or breaks the suite. Where practices are looking to switch systems, the change is as likely to be motivated by the weakness of the practice management functionality accompanying the EHR as it is by the EHR functionality per se.
The nature of practice management is also changing, given that Medicare and private payers are trying to shift away from pay-per-procedure billing to paying for "value," meaning incentives for providing better care efficiently. Just how complete that shift will be remains to be seen, but it means providers must gather and track different metrics and bill according to novel formulas. At the same time, the proliferation of high-deductible insurance plans, like those commonly offered through Obamacare health insurance exchanges, means that consumers are responsible for a bigger share of the healthcare bill. That means practice management must put a bigger emphasis on consumer collections, which used to be a relatively minor portion of a healthcare business compared with insurance claims processing.
This report is based in part on the Best in KLAS ratings from KLAS Research, which reflect customer satisfaction with health IT products as measured by a survey of healthcare organizations. KLAS segments its findings based on the size of practices participating in the survey, specifically the number of physicians in the practice. There is some overlap with the adjacent category of revenue cycle management, which is the process of tracking insurance claims and resubmitting and tweaking them until they get paid. Practices that don't want the hassle can outsource all or part of that process.
Athenahealth's AthenaCollector is the top-ranked product in all but the 75+ physician segment, where it does not yet have enough market presence to register in the KLAS survey. Athenahealth offers a cloud software suite bundled with an outsourced revenue cycle management service, making the software the front end to a business service that handles many of the complexities of claims coding, submission, and follow-up until payment.
Epic, the dominant enterprise system for hospitals, mirrors that performance by ranking No. 1 for practices with more than 75 physicians and not ranking at all below that level.
The table below shows the KLAS rankings for the leading vendors in practice management, some of whom compete with more than one product in the category.
Table 1: KLAS Ratings: Practice Management
# of Doctors
* Not rated (didn't meet KLAS minimum requirement for survey responses)
On the following pages, we present more detail about the distinguishing characteristics of leading practice management systems, with an emphasis on those that serve midsized to large practices. We've also included a couple of choices from the ranks of up-and-coming and niche vendors. Another good tool for sorting through the choices is the Practice Management Toolkit created by the American Medical Association and the Medical Group Management Association.
David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013) and ... View Full Bio