For Clinicians The Practice Handbook

Choosing Practice Management System Software (PMS)

Choosing the best Practice Management System or software (PMS) is an important decision for all doctors, dentists, clinics and hospitals working in private practice. Read through to find out independent expert advice from one of our partners, Jane from Designated Group

What is Cloud Based Practice Management Software?

A cloud-based software program is any program that runs on the internet. The alternative to cloud-based is server based. There are pros and cons of each approach but in Jane’s experience in the private medical sector she would suggest that most doctors and clinics use a cloud-based PMS solution. The exception would be a large healthcare company or series of hospitals with their own in-house IT department who would be able to cope with the demands of running a server-based solution.

Cloud based software can be accessed from anywhere that has access to the internet, so can be used in different hospitals, clinics, working from home and whilst travelling. But there is a downside that if there is no internet access then some services may be limited depending on your provider. With almost infinite connectivity available nowadays, it is rare a PMS will ‘go down’ like old server based systems can.

A server-based solution requires you to invest capital in a server and have a physical place to store it safely and securely. You will be responsible for your own backups, security and disaster recovery plans.

If you own your server and it fails, then it will take critical time to repair or even replace, with disastrous potential for your clinic. Over time a server-based solution will be cheaper for multi-location clinics, but it definitely requires substantially more effort and up-front capital. 

Cloud-based solutions are generally more reliable and have a greater percentage of “uptime”

Over a longer period of time a cloud-based solution may seem to be more expensive, but most doctors are prepared to pay more for greater availability especially when working in a real-time environment like private practice.

Security and adherence to the GDPR legislation are crucial considerations. Having a server-based solution ensures your patient data is held within your own clinic and not shared with any third parties and is therefore more secure. But ensuring data is secure is a considerable and complex responsibility and not to be taken lightly. On balance it would seem to be preferable to use cloud-based software, but you must ensure the supplier has taken all of the necessary actions to ensure that data is secure and GDPR compliant on your behalf as data controller.

A good PMS will offer two factor authentications, and will have extensive conditions on controlling sensitive patient data

Scalability in Practice Management Systems

Scalability comes in two different respects. Firstly, ensure the PMS software allows enough storage to maintain patient notes and correspondence for a growing number of patients. This is especially important in a specialty where lots of images need to be stored. 

The other manner in which a clinic may scale is in terms of the number of consultants working within that clinic. Some software is better suited to this type of environment than others so this is definitely an important factor to consider if you are choosing software for your growing clinic.

Cost is important. Some PMS systems allow multiple users as part of the subscription or licence fee, but others will charge per user. This is key as the cost of multiple users can become significant. A consultant will need access to their PMS and will potentially also need to grant access to their Medical PA, typist and billing company. If you are being charged on a per user basis, these can snowball over the course of a year.

calendar scheduling

What Are Must-Have Functionalities in Practice Management Software?

The most important functions to explore thoroughly are those that you will use regularly. On a daily basis you will be checking your clinic lists and patient correspondence. Good PM software makes this quick and easy with minimal “clicks”. During your clinics you will want to move quickly from one letter or set of results to the next and also from one patient to another.

When you are choosing software, you should definitely ask for statistics on speed and reliability including the percentage of “uptime”.

Another important aspect for all medical practitioners is the ability to dictate letters and results and ensure these are securely made available to your medical secretary or typist ready for transcription.

Once the letters are typed you want to use a process, managed by your PMS to allow you to check new letters, approve them and flag back to your secretary that they are ready to be sent to the patient or clinician. The PMS should also allow for the letters to be sent easily by secure email. To check that the PMS you are considering is fit for purpose in this regard, you may want to involve your medical PA or typist in the decision-making process.

When working in private practice obviously the ability to invoice patients easily and accurately is fundamental.

Your PMS should allow your medical PA to take immediate payment of invoices via integration with a credit card company. The management of credit control is also key, and a good PMS will be set up to ensure that this is easy to manage. 

Electronic billing is now commonplace, and a good PMS will be integrated with the Healthcode system to allow immediate, electronic communication of invoices. You should also look for functionality that allow you to pull off reports relating to invoicing including aged debt. To help you manage credit control your PMS should allow you to set up a system of reminders to send to patients to chase unpaid bills or short falls.

Obviously, you have a choice to manage invoicing and credit control in house or outsource to a specialist billing company. If your preference is to manage this in house, then it is more important for your PMS to have very strong functionality.

A good PMS will also offer users the option to use an App and this can be incredibly powerful. An app allows you to access your PMS easily from your phone or tablet and can be a life saver on a busy day. An app should ideally allow you to access your clinic list, patient contact details and patient correspondence.

Most private practitioners will regularly perform lab tests and most good PMS systems allow for tests to be requested via the PMS and for the results to be automatically received into the PMS and stored in the patient notes. This functionality saves time but also helps to ensure that all lab tests are received in a timely manner and nothing is missed.

Many doctors are offering video consultations to patients and some PMS systems have the capability for this built in.

Online booking is already well established and popular across many industry sectors and we have every reason to believe that it will also be welcomed by patients booking private medical appointments. Some PMS systems already offer online booking but if they don’t currently, expect them to have it in their road map. Not being able to offer online booking will prove to be a significant disadvantage.

Doctify also has a booking system set up for our specialists, and Video Consultations. Find out more here

You will want to ensure that you have good support for your PMS both for yourself and your team members. When you are choosing software you will be dealing with the sales team, but once you sign the contract you will be introduced to the support team and the quality of their service will have a big impact on your practice, either good or bad.

Investigate the support offered prior to signing on the dotted line. If you are already established in private practice, then you may well have data to transfer from an existing system onto your chosen PMS system. You will need to understand how this data transfer will take place and the costs associated with it. Some providers will do this free of charge, but others will charge.

Equally important is training for you and your team members. A good PMS will be designed in a manner that means it is fairly intuitive to use, but there will be functionality that you will not benefit from if you are not given adequate training at the start. It would also be good to know that additional training on specific functionality is available at a later date too as you develop your practice. It is natural that once you are familiar with the basics that you will want to explore additional functionality.

The issue of data protection and security is a great concern. Any personal data being sent from one party to another is a potential risk. A better solution for data security will come from the provision of a “Patient portal” from your PMS. In this model, the patient will login into their own private portal to access letters and results therefore eliminating the need to transmit personal data.

And finally, with regard to your choice of supplier, it is important to be certain that the company has a stable and a strong financial situation. You are making a long-term decision and need to feel reassured that your supplier has a long-term future.

There’s so many systems to choose from, how do I choose the right one?

It is well worth investing considerable time and effort into choosing the right PMS system for your requirements. Once you are using a PMS, the thought of moving all of your data to a new system will feel incredibly daunting and you will want to avoid doing so. You will need to explore each PMS and measure its suitability against what is important to you, so it is a personal decision, but you can also get some valuable insight from others who have made similar decisions.

Ideally, you would talk to other doctors, clinic and practice managers, who have recently made a choice of PMS, so they are well informed regarding what is currently available on the market. Be careful when talking to doctors who made their choice a few years ago as they may be missing out on some of the newer developments such as online booking.

Talk to other users such as Medical PA’s. They are using the systems day in day out and will have very strong opinions on the various systems available.

Each PMS supplier will have glowing testimonials and case studies on their website which are useful, but I would also ask to speak to current users directly for each PMS.

You can search for reviews of each PMS via Google. Software review websites are becoming more and more popular by the day so it’s definitely worth checking.

Also ask your potential supplier about User groups and forums. If these are well established, then there is a strong suggestion that this is a company that listens to their customers and takes on board their suggestions, so a very good sign.

Ask for a free trial before you sign up. A free trial will be limited as you will not want to spend a lot of time entering data, but it would be worth entering a few clinics lists, patient letters and using the software in different locations to check speed, functionality, and integration opportunities.

Be prepared for every eventuality. If you choose a PMS and decide after six months that its not right for you, what would your options be? Do you have to sign for a full year or is it a rolling monthly contract? Would your provider make you data available in a format that is easy to upload to a new PMS system? How long would they take to do this and how much would they charge for doing so? At the very least this will give you piece of mind

Are integrations with other software important?

Some PMS systems have a lot of functionality built-in, but others prefer integrations with other software. Again, each approach has its pros and cons but either works well in general. Built-in functionality is simple and easy. Integrations mean you are able to choose the best in class software for your needs.

Dictation and transcription are important aspects of a PMS solution.

Some systems have in built functionality for dictation, transcription and secure email but others require the use of integrated software.

It is important to understand the way a PMS works to ensure that the functionality you need is in built but if not that the integrations with leading software are well established.

Ensure it meets your requirements in terms of reporting and financial management. Most PMS systems offer a level of reporting that allows you to review your financial data and your practice financial performance. Clearly your income data will be very detailed as all of the invoicing information will be available.

Some PMS systems offer the option to track practice outgoings and perform bank reconciliations. If this is the case, then you may have the option to pull off useful reports such as your profit and loss. Other PMS systems will integrate with well known finance software packages and this may prove to be a better option for you, particularly as it may make the process for your bookkeeper and accountant more efficient.

In summary, choosing a PMS is an important decision that will affect the long-term development of your practice. It is a decision that is unique to you, but you can definitely learn a great deal from others working in a similar environment and by doing thorough due diligence.

Jane Braithwaite is managing director of Designated Medical, which she founded in 2013 having worked in private healthcare for many years. Her objective is to help doctors and clinics establish, grow and develop their private practices. Designated Medical offers business services for private consultants, including medical secretary support, book-keeping and marketing. You can contact Jane directly at jane@designatedgroup.com

‘The Designated Team and Emma have been fantastic and professional at all times, I would not hesitate to recommend their services.’

Richard Lee, Consultant Opthamalogist.

Great service and great operational interface for a busy doctor! Very pleased with the quick response and my PA Emma – via Designated Medical – is not 5-stars, she is 6-stars!!!!

Marcus Harbord, Consultant Gastroenterologist