The choices of practice-management software that face the dentist are almost overwhelming. By taking the time to properly evaluate software, dentists can often avoid a costly, and ometimes exasperating, experience.
As we begin a new year, many offices choose to evaluate their current systems to decide if a change or “tune-up” is necessary. This is especially true of dental technology systems. Practices are moving toward a paperless or chartless concept, where records are kept in a digital format. The advantages of this type of system should be obvious to any practitioner. Data is easily available at any location, records never get lost, and clinical data can be manipulated to enhance the ability of the dentist and staff to diagnose and treat disease. While the hardware infrastructure is certainly important and must be chosen as the first step in a technology system upgrade, there is little doubt that the practice-management software is the one component that ties everything together. Every program has strengths and weaknesses, but dentists should try to choose a system based on two overriding principles: features and service/support.
Practice-management software features
The choices that face the dentist are almost overwhelming. Recent consolidations have reduced the major players in this area. The “Big Four,” as they are often referred to in online forums like Dental Town and the IDF, consist of Dentrix, Eaglesoft, PracticeWorks, and Softdent. Combined, these four programs account for at least 70 percent of the market by my estimation. However, there are certainly many smaller companies that have been around a long time and continue to produce excellent products. The trick, however, is to find the program that best meets your specific needs. As different systems are compared, one will see how certain features are handled better with one program than another. In other words, there is no one perfect program that is best for each individual dentist. There is not now - nor has there ever been - an answer to the question, “Which is the best program?” I recommend that you review independent studies and comparisons and ask colleagues for their opinions. Clinical Research Associates and Dental Equipment & Materials recently completed surveys evaluating most of the more popular programs, which should be helpful in the evaluation process. When comparing products, here are a few things to keep in mind:
You must involve your staff in this decision. As most dentists know, team members are the ones who interact daily with the software. Many dentists have admitted to me that they barely know how to turn on their computers, let alone understand a complex dental program. It is your team members who will be handling all of the administrative functions that the software handles. If they find the program difficult to use, it will be disastrous to your practice. Many dentists are fortunate enough to hire an office manager who has experience with dental software; someone like this can be an invaluable resource in determining the advantages of a particular program.
Every program has numerous bells and whistles, but most dentists end up using only a very small portion of these features. There are certain areas of practice-management programs that almost all offices use. These include, but are not limited to, patient registration, scheduling, treatment planning, insurance estimation and processing, recall patient management, and reports of practice parameters, such as production and collections.
That being said, there are many elements of modern software that should not be discounted. Dentrix, for example, has a direct link to Care Credit in its software, so that offices can determine a patient’s ability to finance expensive treatment almost instantaneously. Every practice is unique, so make a list of what’s important to you before starting to research different programs. Compare every program you evaluate using your list.
One effective method is to take either an existing patient or create an imaginary patient and see how the software tracks this person. In other words, create the patient record, schedule an appointment, create a treatment plan, post treatment to the account, create an insurance form, reschedule the patient, etc. In this way, you can compare apples to apples when evaluating the software. See how well the software can adapt to how you prefer to treat patients. Poorly designed software will force you to change how you practice and process patients, so you should avoid this at all costs.
Although most dental software today involves both administrative and clinical features, it is the administrative component that will often be the most important part. This does not mean, however, that the clinical functions are not important. The topic of integrating clinical data with practice-management systems is outside the scope of this article, but it is important that the software you purchase be capable of working with the software and hardware of high-tech products. Seamless integration gives your practice the ability to easily access both clinical and administrative data without needing to re-enter patient information in more than one location.
Training, service, and support
It is unfortunate that the most important factors in choosing a software package are usually given the least amount of consideration. Most dentists will spend hours evaluating software, choosing features, and looking at the price of the program, but they will scarcely think about the need for training and ongoing support.
Let’s start with training. There is no better way to ensure that your staff never adapts to a software program than to bypass proper training! Unfortunately, many dentists try to save money by justifying their decision not to spend money for onsite or classroom-based training.
Don’t make this mistake. Training is one of the best investments you can make. Dental software programs are complex; don’t let anyone tell you otherwise. Having everyone in the office (and, yes, that includes the doctor) up to speed on the software is crucial to ensure the software’s rapid integration into your practice.
Service and support is the other part of this equation. Many dentists make the mistake of looking at the price of the software and do not factor in the costs of ongoing support. I have seen support packages that are as low as a couple hundred dollars per year to packages that cost more than $5,000 per year. When choosing a support package, ask these questions:
• What are the hours for customer service?
• What other means of support - i.e., email, Web, fax, etc. - are offered?
• Are different levels of support plans offered?
• Is unlimited telephone support offered, or is it on a per-minute basis?
• How much support is included with the initial program purchase, and what will it cost to purchase additional years?
• Is on-site support offered?
• What are the qualifications of the support staff?
• How often is the program updated?
One important question to ask is how soon your call will be answered. Many practices have complained recently of the ever-increasing time that the office waits for a return call. Test this for yourself by trying to contact the companies’ support departments at different times of the week, such as Monday morning and Friday afternoon. Ask to see performance statistics, particularly the average on-hold time and average length of call. This information will give you an insight into what’s in store for you. Independent surveys (as I mentioned earlier) are also available that rate customer support for many different systems. Be sure to ask your colleagues to share their experiences with you.
As practices gravitate toward the chartless ideal, many dentists will come to realize that their current, outdated software is not up to the task. By taking the time to properly evaluate software, both from their current and long-term perspective, dentists can often avoid a costly, and sometimes exasperating, experience.
Where's the report?
Although finding a good product with excellent support is important, one of the most critical features is the ability to gather necessary data through the reporting features of the software. According to Linda Miles, a well-respected practice-management consultant, there are several key reports that should be easily generated from your software.
The five most important reports, in addition to gross and net production (to track write-offs) and collections, are:
Production activities report - Shows the mix of services and how many were done by each provider, with a tally of all providers compiled for the office as a whole.
New-patient tracking report - Shows the number of new patients, who or how they were referred, if they arrived as an emergency, whether they rescheduled for a comprehensive new-patient examination later, etc.
A/R aging report - Shows who owes the doctor money, and, more importantly, how old these balances are as a whole.
Recall tracking report - Since the hygiene department is the foundation for the entire practice, this report shows how many patients were seen in hygiene, the number due, and the very past due for the reactivation process to be done on an on-going basis each month.
Insurance tracking report - Shows when claims were filed, the number needing resubmission, those requiring individual consideration letters, and the follow-up record, whether done by the patient or the staff.
There are many other important reports such as the budget (estimated and actual); marketing tracking; lab tracking of how many veneers, crown-and-bridge, implants, etc., were done; and, last but not least, the referral report of where and when a patient is referred (this is good for follow-up). If the dentist is a specialist, she needs to know where all and the majority of patients are coming from.
Dr. Lavine practiced periodontics and implant dentistry for more than 10 years. He is the president of Dental Technology Consultants, a company that assists dentists in all phases of technology integration in the dental practice. He can be contacted by email at [email protected] or visit his Web site at www.thedigitaldentist.com.
