We are neither the Light nor the Message ~ We are the Messengers

The Physician's Dilemma Simplified

Which is better: an integrated practice management software suite or an amalgam of solutions from separate vendors? Here's our answer.

Author: John Macikowski (Oct 25, 2006)

In this article we answer the following question:

Should you run your practice with one of the new integrated Windows Practice Management Software Suites or try to "mix and match" so called best of breed solutions from different vendors in an attempt to find a more customized fit for your practice?

Much debate has been waged over this question. The first option is a completely integrated Practice Management (PM) and Electronic Medical Records (EMR) solution. The second option is a solution that (purportedly) encompasses "best of breed" functionality for your particular specialty by combining two or more solutions from different software vendors.

I recommend the fully integrated solution for most Clinical environments.

The Advantages

With over 20 years experience in the computer industry, I have come to learn that integrated solutions generally offer a number of significant advantages over those involving two or more products from different — and in some cases competing — vendors.

A total integrated solution can empower your office with the tools it needs to meet growing compliancy demands, improve profitability, and enhance your patient care. The EMR should streamline and digitize all aspects of the documentation of patient care, while your integrated PM system can best facilitate the use of that digitized data with the requirements of billing, claims, collections, imaging, lab results, prescribing, referrals, reports, scheduling, and other clinical and practice procedures. And don't forget about the need to be HIPAA compliant. Other specific advantages are the higher level of connectivity across locations and staff, plus the scalability that an integrated solution provides.

All of the above assumes, of course, that you do not already have either a PM system or EMR system that functions perfectly and is fully integrated within your practice workflow as a legacy system. If you do have such a system in place, the question is a little more complex, as you have more variables to consider.

When considering a non-integrated solution, it pays to keep in mind that it's much easier to transfer billing data to new software than ERM data.

On the other hand, the EMR side is where you really need a reliable and state-of-the-art solution. Billing errors can be resolved; mistakes in patient care can have catastrophic results.

Cross-Platform Solutions

Issues become even more complicated if you are dealing with cross-platform solutions. In this situation, I recommend you “bite the bullet” and consolidate to a single platform and integrated EMR/PM software. The savings (due to system uptime, lack of interoperability issues, and the centralization of your IT resources) will more than make up for the initial capital outlay and training investment. You have to keep in mind that the relationship between clinical processes, business processes and billing is getting tighter all the time, not less defined.

Cost and Other Factors

Fortunately, one of the key advantages of an integrated EMR/PM system is often its cost — both the initial investment as well as the total cost of ownership (TCO).

But remember, while cost is important, it should not be the driving consideration. Rich features, ease of use, and after-sale support are all equally important. Other considerations are having the proper IT infrastructure in place to provide a stable environment for the software package that you are using and having a properly trained staff.

Consider the following: Most companies advocating the "mix and match" approach simply don't have integrated solutions. And most companies offering integrated solutions don't unbundle their software suites and market the programs separately — even though they could make more money doing so. It's not rocket science to see which is the better path.

Microsoft as Model

To better understand the issues discussed here, consider Microsoft Office.

In the early days of computing, there were no integrated office suites. People used different programs from different vendors for their business applications. Some examples: VisiCalc or Lotus 1-2-3 for spreadsheets; Word Perfect or WordStar for word processing; dBase or Paradox for database management; Eudora or Netscape for e-mail; and ACT or GoldMine for contact management. When data from one application needed to be exported and then imported into another, someone from Tech Support got a call.

Then Microsoft came up with a radical idea: Why not take all these disparate programs and integrate them into one comprehensive and smoothly operating suite of programs for business users?

Initially, there were few takers. After all, people were quite happy with (and, in some cases, nearly married to) the standalone products they had come to know. Why on earth would you want to compromise on some of the features and functionality you had come to depend on simply for better interoperability and reliability?

That was then...

Today, Microsoft Office is by far the most dominant business application suite in the world, and millions of business professionals have come to understand — and experience first-hand — how a fully-integrated office solution can positively impact business productivity, operations, overhead, and support.


Absent a compelling reason to take the "mix and match" approach to your PM/EMR systems, an integrated Windows Practice Management Software Suite will probably be your best bet.

John Macikowski is an Information Technology Consultant who has over 20 years in the IT industry working with solutions providers.