If the staff is the soul of a veterinary practice, the practice management software is its heart, because fully integrated PM software touches every aspect of the practice and unites the clinical and business sides. “Other than the people, there is nothing more important to a practice [than its PM software],” said William J. Griffin, VMD, CEO and medical director of the Regional Veterinary Emergency & Specialty Center in Turnersville, N.J. “If you have a rock-solid practice management software that is fully functional, then you will have an efficient team. “Our software program is the core of our business and the core of our standards of care, because everything goes to the medical record,” Griffin continued. “It becomes central to everything we do, from the medicine to the business. And it does all the reporting of our finances.” In the course of a day, a clinic’s practice management software generates thousands of pieces of client information, medical information and business information. The PM system must collect this data and present it to the practice in a way that enables veterinary staff to practice good medicine and practice owners to make their businesses profitable. Yet, as an overall expenditure, a PM software system is a relatively inexpensive investment—from about $10,000 to $30,000 for a basic program. Dr. Griffin, who uses the Cornerstone Practice Management System by Idexx Laboratories of Westbrook, Maine, converted to a paperless practice several years ago. He considers his practice “power users” of the software, using just about every aspect and feature, which he tailored to fit his 24/7 practice. Although most veterinary practices today have a PM system, many are not power users like Griffin. That’s OK, say experts from the leading veterinary software providers, because a good system grows with the practice. “Software systems have a range of capabilities that meet various practice styles,” explained Ron Detjen, president of Impromed LLC of Oshkosh, Wis., which produces Infinity and other product lines. “A good software allows the veterinarian to choose what works best for that practice. The software should allow the veterinarian to expand the software capabilities as the practice becomes more comfortable with the features it is using.” Features That Veterinarians Wish For Although all the practices Veterinary Practice News interviewed are happy with their software and complimentary about the education and service their vendors provide, they have developed a wish list for features. Even more seamless integration from one module to the other was high on everyone’s list. They would like to see an automatic interface with their distributors, so they can keep less inventory. This would enable them to automatically contact the distributor, order a product and send it to the client’s home from the veterinarian. Separate companies now offer this service, they said, but the percentage they charge is too high. Another automatic interface that veterinarians would like to see is a link to pet insurance companies. They would send a bill directly to the pet insurance company and be reimbursed directly, so that the client doesn’t have to pay the entire bill up front. The rationale: Some clients might choose an expensive procedure if they saw the immediate insurance discount, instead of having to pay the bill up front and wait to be reimbursed. Currently all pet insurance companies require that veterinarians be paid up front, and they reimburse the client allowable amounts. Veterinarians suggested that PM software companies take a cue from dentists, who have great client communications tools. One feature they liked was kiosks in the waiting room that allow patients to update their personal information, which would automatically update the medical record. A communication area that is being ignored, they said, is practice-to-practice communication. Most of the time, they have to fax records, tests, referrals, etc. Doesn’t it make sense, they ask, to send that information electronically? The focus for many practices is demonstrating their value to clients. Veterinarians are looking for options that not only strengthen their businesses, but that create long-term loyalty and more trusting clients who are willing to accept the veterinarian’s recommendations. Today’s practice management software helps them do this. This movement toward expanding capabilities is the trend software companies are seeing. Robin Brown, director of training and communications at McAllister Software Systems LLC of Piedmont, Mo., which makes the AVImark software, said that practices are taking advantage of more features than ever before. “They are beginning to realize that savings in time and costs come with better software utilization,” she said. “For example, some of our veterinarians can now see additional patients each day because they spend less time pulling paper files, and they have automated other routine tasks.” Andrew Knupp, marketing manager of the Cornerstone Product Line, said the economy has helped drive this trend. “We have seen a marked increase in interest and recognition of the practice management system as a tool that can drive growth within a practice,” Knupp said. “A practice management system is one of those tools that can help you show the value of the services that you provide. We are seeing an increased interest in some of the more value-added features and those that optimize how a practice operates. Veterinarians are using the next layers of the system, if you will.” The biggest advanced feature that is growing in popularity is electronic medical records. Griffin said fully integrated electronic medical records improve every other feature of the PM software, such as capturing lost charges. Other popular features are data analysis tools and those that integrate various aspects of the practice, such as the lab, to assure that the front desk captures lost charges. This integration was a key component for David Wright, DVM, owner of three Tennessee practices, including Collierville Pet Hospital. Wright’s fourth practice is scheduled to open in September 2012. “We have a central server, so the complete medical record of every client is available at every location,” said Dr. Wright, who uses AVImark. For example, say a client uses a hospital close to home but wants to pick up a medication at a different hospital that is near the client’s job. The second hospital would be able to accommodate that client because it has instant access to the patient’s medical records. In addition, veterinarians can check any medical record, lab report or radiograph anytime, anywhere. “There is no way to capture all your missed charges if you are not paperless,” Wright said. One estimate is that practices lose about $5,200 per month per full-time veterinarian in lost charges. “Anything you capture goes right to the bottom line, because you already provided that service,” he said. If the staff provides a service and does not bill the client, the practice has paid staff time and overhead, as well as materials, without compensation. “The practice management system also increases our productivity, because we are not tracking down transaction errors,” added Alanda Higgins, CVT, practice manager at East Lake Hospital for Animals in Danville, Ill., which uses Infinity. Electronic whiteboards increase productivity, help staff practice better medicine, and make sure charges are not lost. Just about every practice uses a dry white eraser board in the hospital that lists hospitalized patients and any care or medication they need throughout the day. Staffs check them throughout the day to meet patient needs. The electronic whiteboard does the same thing, except it is proactive—alerting staff when a patient needs care. The electronic program requires staff to interact and let the whiteboard know the task was done. This captures the charge and ensures that clients are billed. Client communication tools are very important, said Higgins. “We do search and sorts to find clients that are not compliant with heartworm preventive, for instance, or find patients that are overdue for vaccinations, and then prompt these people with phone calls. We also e-mail clients through it.” Some Features of PM Software Accounts receivable After-care instructions for clients Billing Boarding/grooming Capture lost charges Client-patient database Client communications Client reminders Electronic medical records Electronic whiteboards Financial reports Inventory control Lab integration Radiology integration Scheduling Smartphone apps Staff reports Standards of care protocols Track associates’ work Practices are using their communication tools to send automatic reminders on invoices, e-mails and texting. An area that is growing in popularity is mobile apps for smartphones, tablets and iPads. Companies either have applications or are developing them. There are applications that enable clients to schedule appointments or contact the practice. There are also apps that enable veterinarians to check medical records. Veterinarians can use mobile apps to download radiographs or lab reports to a tablet, iPad or computer screen in the treatment room to show the client what is going on with her pet. Inventory management is becoming very important, the software company representatives said. “Solid inventory management provides an opportunity,” said Knupp. “Veterinarians have a lot of money tied up in inventory. Tight management of those dollars is critical to running an efficient, well-managed business or practice.” When veterinarians use advanced features, they not only save time and money, these features can help them practice better medicine by more effectively educating clients, obtaining test results more quickly, and documenting patient conditions more fully, said Brown. “We spent a lot of money on the servers and the network, but we make up for it multifold, because of the efficiencies, charge capture, the number of patients we can see and the higher quality of medical care we can deliver,” said Griffin.
