Practice Management System Integration Question

By Sheldon Needle

Should you consider integrating your current Medical Practice Management System with a new EMR, or must you shift to an EMR that includes medical practice management functions?

Practices which are relatively new to software as a management tool sometimes do not realize the very different functions that a PMS (medical practice management system) and an EMR system offer:

A PMS is used for managing administrative, billing, scheduling, and budget related (financial) information, and an EMR is used for managing clinical, patient related information How feasible is it to integrate these two functions to produce reliable information for your practice, and to fulfill government reporting requirements.

Let us assume that you are a practice ahead of the wave, and you transitioned long ago to a medical billing software and medical scheduling system. You are very happy with it. It works for you and for your patients. Now the world, and the government, are at your door, and is pushing for a more total solution: an EMR / EHR.

Do you have to ditch the practice management system that you worked so hard to install and to customize to your needs and replace it with a total solution – an EMR that incorporates financial and billing capabilities? Or is there a way to keep you medical Practice Management System and integrate it safely with an EMR minus its billing and scheduling capabilities?

Here are some issues you must consider before you can answer this question:

1. Your Practice Management System is a business system, and your EMR will be essentially a clinical system (although a full EMR will include Practice Management functions). Unless you are looking for hardships, you need the 2 systems to talk to each other in a transparent manner, and you need the possible upgrades to work in tandem. One thing this might suggest: if you are interfacing a PMS with an EMR, you had best be dealing with well known systems that are very regularly upgraded, and whose
   interaction with other systems are constantly monitored.
2. A single database for financial and clinical patient data would, theoretically, provide the best and most reliable data-mining capabilities for your practice. But what if your Medical PMS is very effective? Perhaps you can live with the two databases, or you have a way to periodically reconcile the two databases. Or perhaps the functional users of your databases are so different that you can live with the minor incompatibilities? Evaluate these issues closely before making a decision. Don’t throw away the baby with the bathwater.
3. How will you meet reporting requirements? If your practice or facility would qualify for incentives from Medicare or Medicaid bonus payments, you must make sure that the reporting capabilities of your two systems, or the feed of one system to the other, would be able to furnish reports that would meet the American Recovery and Reinvestment Act (ARRA) HITECH reporting requirements.
   
4. Staffing: you must dedicate staff, and staff time, especially at the outset to managing the integration of data from a practice management system to an EMR / EHR. Someone must be in charge of both worrying about and converting data from one system to another, even if both systems theoretically support integration with each other.
5. Training: all employees who will be using both systems – especially the clinical people (doctors, nurses, PA, medical technicians) must receive decent training in the use of the systems, and in the ability to use both systems together.

Planning for such a conversion / data migration / functional integration is key to the success of making your new Electronic Health Records system work for your practice as a great helper, rather than as a hindrance. Making that initial investment of planning, time, and people will pay off in spades for your practice.

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