Practice Software and Technology, Part 2

As described in the previous installment in this series, the Practice Information Management System (PIMS) is the heartbeat of a practice. Every clinical and operational event runs through this regulator of a small business.

The Practice Building column is focused on building today’s veterinary practice. The series is dedicated to providing readers insight into issues and resources that support long-term practice growth. Previous articles have focused on areas of investment, lending and capital access, marketing and client communication tools, and service expansion.

Table 1 lists the PIMS platforms reviewed in Part 1; in this article, we continue our review of common systems and introduce a new set of emerging players, focusing on:

• Distinguishing features of each system
• Recent or upcoming innovations and improvements
• Common questions about current systems and migration to new technology.

IDEXX CORNERSTONE

Idexx Cornerstone (idexx.com/smallanimal/practice-management.html), owned by Idexx Laboratories of Portland, Maine, is marketed and sold as an integrated solution that solves the most important clinical and managerial needs of the private practice. In concert with other Idexx offerings, practices using Cornerstone have the ability to fully integrate the PIMS with external and internal laboratory diagnostic testing, diagnostic imaging equipment, client communication, and education services, as well as utilize a variety of marketing tools.

Technical Aspects

Cornerstone functions in a Windows environment that requires an operating system of Windows Vista to Windows 8.1, and the system can be configured to operate utilizing an onsite or offsite server. Cornerstone can also be configured to work with tablet devices, allowing practices flexibility when choosing equipment.

IDEXX recommends business class computers, printers, and peripherals, as well as high-speed wired connectivity, to ensure maximum performance. For more information on technical requirements, please see the Idexx Reference Library at idexx.com/smallanimal/practice-management.html.

System Hallmarks

In addition to well-known equipment integrations, Cornerstone offers several features that can help streamline workflow and improve patient management.

Compliance Assessment Tool. The Compliance Assessment Tool is an internal surveillance feature within Cornerstone that automatically alerts to gaps or opportunities in patient care. The tool may be utilized to:

• Screen recent visit dates for patients
• Identify additional care opportunities based on individual patient history
• Track services by the provider
• Financially quantify missed opportunities.

Enhanced Medical Notes. Operational bottlenecks in a practice are often related to errors caused by redundant or missed information. Cornerstone’s electronic medical notes system enables a practice to reduce errors through customizable templates that ensure consistency in medical records, and also features the ability to initiate diagnostic requests from within the workflow, including an automated process to capture services provided (including associated charges) and functionality to link medical information directly to the associated client’s take-home instructions.

Electronic Whiteboard. A real-time whiteboard enables a practice team to operate from a centralized directive in the hospital. The electronic whiteboard makes it easier for staff to track hospitalized patients and access patient information, and it allows a practice to customize or designate specific patient prompts, as well as predefine defaults for certain patient types.

Inventory Management. Through a partnership with MWI Veterinary Supply (mwivet.com), Cornerstone enables a practice to place MWI orders directly through Cornerstone, providing complete tracking of inventory from the original order through delivery to the pharmacy shelf.

Coming Attractions

The Idexx Pet Health Network is a proprietary client communication platform intended to reinforce a practice’s bond with their clients both during the examination room experience and between patient visits.

Subscribers can access a host of client communication and education tools, including:

• Automated appointment confirmations
• Client surveys
• In-room education materials
• Patient ID cards
• Personalized patient reminders
• Personalized pet pages
• Practice newsletters and online review campaigns.

More detailed information about Pet Heath Network Pro can be found at pethealthnetworkpro.com.

Idexx is also the owner of DVMax Veterinary Practice Management Software, a PIMS compatible with both Windows and Mac systems. DVMax is marketed as an innovative and user-friendly PIMS solution for practices looking to become paperless. For more information on DVMax, visit dvmax.com.

INTRAVET

IntraVet (intravet.com), owned by Patterson Veterinary, Inc in Devens, Massachusetts (pattersonvet.com), is marketed as an easy to use, paperless or paper-light PIMS solution. The platform is designed as a single source management solution (everything operates in or around the PIMS) through its numerous integrations with diagnostic technologies, highly competent inventory tracking capabilities, and a proprietary client communication library of services.

Technical Aspects

IntraVet can be used as a single or multi-user system, and is compatible with most Windows operating systems and with tablets and wireless networks. It can be deployed as an onsite server system or set up for offsite server hosting. According to the company, more than half of all users utilize IntraVet for their hardware and networking needs as a total PIMS package. More information on technical requirements can be found at intravet.com/SoftwareOverview/Hardware.

System Hallmarks

IntraVet offers several features intended to enhance practice efficiency and speed, and improve medical record accuracy and financial performance.

Flexibility. IntraVet can be utilized as a system driven by medical notes or invoices, and it offers the user the flexibility to track medical records in SOAP (subjective, objective, assessment, plan) format as well as nonformatted notation. The system can import and store scanned documents, digital images, and radiographs and offers several automated features, including updates of treatments and laboratory results to invoices and patient histories.

The Control Center. The Control Center operates as a hub for hospital workflow, acting as a live census for staff to access patient status (admitted, discharged, no shows, etc) and view real-time client balances. Functioning as a virtual whiteboard, the Control Center allows the practice team to operate from a real-time hospital monitoring system rather than the traditional whiteboard method of patient tracking.

Reporting Center. Users can create a variety of performance reports using the reporting tools, including real-time inventory analysis, provider reports, transaction reports, and financial/ accounting reports. Reports can be printed and/or exported to Microsoft Excel and QuickBooks.

Inventory Tracking. IntraVet offers a real-time inventory control system to track common inventory values, such as average cost, ratios of products bought and sold (inventory turnover), tax recording, controlled substance consumption and inventory, dispensing fees, and discounts. The system is also capable of generating reports for inventory consumption and quantities of products on hand, and can create reorder lists and purchase histories over time or by vendor.

Coming Attractions

Product Support. One differentiating feature of the IntraVet platform is Patterson’s significant investment in product training and support. When a practice purchases the IntraVet software, they automatically receive 90 days of intensive support. After 90 days, a practice may elect one of several different levels of support, from a basic support program to 24-hour/7-day support, utilizing phone, email, or remote access capabilities.

ePetHealth. ePetHealth is a proprietary suite of client communication and education tools that integrates fully with the IntraVet PIMS. ePetHealth is a client-centric tool offering clients access to the following:

• Client newsletters and surveys
• Electronic reminders
• Online articles and pet health videos
• Patterson DIA—diagnostic imaging atlas
• Online pet medical records.

To learn more, visit epethealth.com.

VIA INFORMATION SYSTEMS 

Information Systems (viainfosys.com), a VCA Antech Company, is marketed and sold as a user-friendly, workflow-oriented practice management solution. Operating since 1999, VIA offers many key features required for a paperless practice, including electronic medical records (EMR), patient schedulers, the ability to email direct from within the PIMS digital signature capture, and in-system payment processing.

Technical Aspects

VIA is a Microsoft Windows certified application that is compatible with Windows 7 and 8 Professional, Windows XP, Windows Server, and Windows Terminal Server. It is also compatible with Windows 8 Professional tablet computers, making it an option for practices interested in increasing staff mobility within the practice.

VIA is designed to be an onsite system, providing high-speed in-clinic access from workstations, desktops, wireless laptops, and tablets. The system is compatible with virtual private network (VPN) connections, allowing medical staff to remotely access medical records when away from the practice. For more information on hardware requirements, visit viainfosys.com/hardware.

System Hallmarks

VIA distinguishes itself from other PIMS through its own unique set of features intended to improve practice performance.

Flexible SOAP Templates. According to the company, VIA patient management templates were designed with the input of veterinarians, consultants, and key opinion leaders in the field of practice management. The system offers more than 25 built-in templates that can be utilized “as is” or customized to fit a specific practice’s needs.

Digital Whiteboard & Treatment Lists. VIA offers a central, real-time whiteboard that displays treatment lists, patient status, and an up-to-date financial balance for clients. Treatment flow sheets can be scheduled down to 10-minute intervals, allowing doctors increased flexibility in managing patients.

Mobile Accessibility. VIA Sync is a feature that houses the hospital database on a laptop so that mobile practitioners and house call veterinarians can access patient medical history, capture medical notes, and update client information and billing offline. Once returned to the practice, VIA Sync synchronizes the mobile computer to the hospital, updating changes to the hospital database.

On Demand Practice Analysis. VIA offers desktop dashboards that provide on-demand access to common practice performance metrics, including invoices created and/or pending, medical notes created and/or pending, laboratory order requisitions and results, and client recall reminders. Dashboard views can display total practice metrics or be drilled down to individual provider detail, which gives an enhanced view of individual provider metrics.

Coming Attractions

Multiple Location Capabilities. VIA Business Center utilizes enterprise level functionality that enables centralized management and access to client records, patient records, and schedules for hospitals with multiple locations. The system allows an owner/manager to manage inventory centrally but track usage by location, eliminate duplication of patient charts between locations, utilize common coding in all locations, and report and analyze practice performance individually or aggregated to all locations.

Emergency Room, Specialty, & Referral Hospital Software. VIA provides features and functions intended to support specialty and emergency practice workflows. These include specialty and emergency room specific SOAP note templates, flexibility to track numerous providers per case, advanced inventory integration with the Cubex inventory control cabinet system, and ability to track caseload and revenue volume by referral source.

Cost of Implementation

Cornerstone, Intravet, and VIA are all configurable systems based on the individual needs of a practice. Therefore, the required investment will vary significantly among practices based on the number of workstations deployed, inclusion or exclusion of hardware, networking services, and the quantity of training and support required to effectively launch the system into a practice.

New PIMS Products

Several new entrants to the PIMS marketplace are bringing new innovations and improvements to the way veterinary practices operate.

BeeFree Vet (beefreesoftware.com)
Although new to the U.S. market, BeeFree Vet is a cloud-based PIMS that has been used by practices in the United Kingdom and Australia for more than 7 years. As a cloud-based PIMS, it can be utilized on computers, tablets, and smartphones with an Internet connection.

BeeFree Vet offers several intriguing features, such as a real-time scheduler for clients, individualized doctor portals, and an internal electronic reminder system.

Rx Works (rxworks.com)

Rx Works has been providing PIMS to the veterinary world since 1988. The Rx Practice+ platform utilizes the medical record as the driver for all workflow features, tying all invoicing, reminders, and other patient features to specific medical inputs.

Rx Works utilizes a proactive approach to patient reminders, automatically following up with clients who do not respond and tracking reminder efficacy and response rates by the method they were delivered (email, text, or print).

Onward Vet (onwardvet.com)

Onward Vet is marketed as a cloud- and web-based paperless software product that offers practices an easy-to-use PIMS that simplifies common tasks of keeping records, tracking patient progress, and supporting ongoing hospital operations. As a cloud-based solution, Onward Vet is not dependent on specific hardware requirements and offers users technical flexibility with only a limited investment. The system offers many features of larger systems, including EMR, inventory tracking, performance reporting, and digital whiteboards.

ezyVet (ezyvet.com)

ezyVet was founded in 2006 as a cloud-based PIMS solution. The PIMS is constructed on open source technologies (unique for veterinary PIMS) that are freely available for the public to view, edit, and redistribute. ezyVet has 2-way integration to share data with Xero (xero.com/us), a leading provider of cloud-based accounting software that improves management efficiency. The system offers many features of other PIMS, including appointment calendars, laboratory integrations, and patient reminder systems.

Which System Is Right for Me?

Making the jump to a new PIMS is a big decision for any practice. Beyond the system itself, any conversion requires hours of time and financial resources associated with potential hardware and networking investments, data conversion processing, staff training, installation, and troubleshooting once a system is launched. If you are thinking about making a switch in your PIMS, consider the following questions and what’s right for your specific situation.

1. What’s most important to me? Do you want a system that’s economical, feature driven, user-friendly, and/or mobile capable? Each PIMS offers a host of features, but no PIMS offers all of them.
2. What features will my staff use most often? You might be excited about a new platform, but is your team likely to appreciate and utilize a digital whiteboard? Will that make your day run smoother or add frustration to what you’re already doing?
3. What am I willing to invest? Making a PIMS change is a financial investment regardless of the system you choose. Are you better off purchasing an off-the-shelf solution with unlimited licenses, a cloud-based solution, or a scalable system that charges by the number of workstations?
4. Do I want a cloud-based or server-based system? The most important part of any PIMS is where it stores your practice data. Each PIMS is different in its data storage capabilities, including:
   • Local servers (server is onsite at your hospital)
   • Offsite servers (workstations are at your hospital, but the server that houses data is off site in another specialized facility)
   • Cloud-based solutions (practice data is housed in the cloud and accessible from many locations).

Summary

The veterinary PIMS market is dynamic, with established brands constantly evolving their individual products and new technologies emerging that challenge the norm. Each system is different in its technology, key clinical features, integrations, and accessibility, which offers practices and their teams numerous options for choosing a solution that best fits their individual needs.

Key to Terms

DIA = diagnostic imaging atlas; EMR = electronic medical records; PIMS = practice information management system; SOAP = subjective, objective, assessment, plan; VPN = virtual private network