August 2002

Decisions, Decisions!
Office Software: Your Guide to Smart Shopping
By Michael J. Koch, DC

Every month it seems there are new software offerings on the market. How can we be expected to keep up with it all - especially in light of all of the other tasks and learning we have to do?

What follows is a general overview of the newer generation of software that pertains to many doctors of chiropractic. Please note that while I may have my personal favorites, I've gone to great lengths to avoid mentioning specific products and brands. It’s important to do your research and choose what specific products are the right fit for your practice’s needs. (Another helpful resource is the Chiropractic Economics Software Directory & Resource Guide that appears on page 116.)

First, lets define the four basic divisions for chiropractic software usage:
• billing;
• report-writing,
• voice-recognition;
• office management and word-processing.

To say there is a plethora of choices, commonalities, prices, and distributors when it comes to office software is an understatement.
It seems we DCs are a frugal bunch and always want the cheapest things we can buy; we also tend to tell ourselves we will buy the better product or service “when we can afford it.” It’s been my experience that when that time actually does arrive, we would rather spend our money on items other than replacing, upgrading, and repairing the now broken-down and outdated products.

We then have to rush to find a quick - but not always an ideal - replacement. My best advice is to do some research regarding quality and functionality, and most times you will end up buying a near the top-of-the-line product or service, which will generally last longer and can be upgraded in the future as needed.

Here are some of the bells and whistles that can have an impact on software pricing:
• Versatility: Can it be upgraded or added to at a later date?
• User-friendliness: Is it easy to use and understand for the novice computer user, i.e., the newly hired CA, or maybe even you?
• Can it be “networked,” i.e., linked to other computers in your office as you grow?

The most important thing to remember about buying software is that the technical support is a key concern. If tech support is included in the purchase price for a certain amount of time, the software costs more upfront, but may cost less on an ongoing basis. If it is not included, any help or upgrades you might need or want could cost you in the future.

Some important technical support issues to investigate before buying include:
• Does the support include initial training? Will it be in your office or by phone?
• Is there beginner, intermediate, and advanced training included with the original price, or is it extra, and how much?
• Are service and tech support available 24 hours a day, during the hours you’re open, or only available 9-5 Pacific Time - and you’re on the opposite side of the country?
• Is support available to just the clinic owner, or to all staff?
• Is training of new hires included or extra?
• How many months of support and upgrades (new versions) are included with the initial purchase?
• How much is tech support per month thereafter? And how much per hour or session, if you do not choose to buy ongoing support?
• If you are a novice or intermediate user, my advice is to buy as many months of mid-line support as you can afford; it’s quite possible this move will save you major headaches in the future!

Here’s some more information on each general category of chiropractic software:
1. Billing software: This is software you use to bill and manage your accounts; it’s like ledger cards and a one-write system all in one. The more features, generally the more expensive the product will be. Increasingly,
electronic billing is a must for chiropractors. Your claims will get processed much, much faster when you use electronic billing. For example, Medicare won’t even look at a paper claim for six weeks, whereas electronic claims get processed and paid in a few days.

2. Report-writing: Whether pre-programmed macros, scanners, wands, or personal digital assistant systems (PDAs)/handhelds, they all are designed to make your job of reporting patient problems and solutions easier. Each year, technology advances, making software more sophisticated and easier to use, so don’t buy a used system. Some of the older systems are plagued with hardware and software conflicts that require spending more time than writing notes by hand. Most systems do save some time; you should allow about two to five minutes per patient visit to generate a computerized note.

What to look for in report-writing software:
• Compatibility with your computer.
• Portability: Can it move with you, or can you take it to and from home and work?
• Can it be networked on more than one computer, or do you have to pay extra for each one that uses it?
• Randomized text generation: Does it change the language so as not to appear “canned” on visits where there is little to no change in progress; does it make sense and read well?
• Learning curve: How much time does it take to get it up and running in your office with your level of computer and software skills: hours, days or months?
• Does it generate both SOAP notes and reports, or is it limited to one or the other?
• Last, but certainly not least, check several references (both novice and seasoned users) as to the ease of integration, customer service and help, upgrades, training, and ongoing support.

3. Voice-recognition: Ever since the character James T. Kirk addressed his computer in the first episode of “Star Trek,” the world has been enamored with the idea of voice recognition. Even though it’s 2002, the technology is still imperfect. The two top runners among the mass-marketed software are “Dragon Speak” and “Via Voice” - both say they can be up and running in a few minutes. While it’s true they initially get, “See the cat,” they can become quickly bogged down by advanced phrasing and professional terminology. They both require a great deal of RAM, generally do not network well, and do not interface well in real time with other memory-intensive word processors like Microsoft® Word.

If you’re still tempted to take the plunge into voice-recognition software, you should allow for the following:
• Buy the latest, most sophisticated version; with the medical dictionary included, you should budget about $800-$1,200.
• Make sure you have a minimum of 256K of RAM on the computer you’re dictating into.
• Buy a good “noise cancelling” microphone and digital recorder, for portability (usually included in the better packages).
• Run dual systems (the new one and the one you’re currently using) for at least 90 days, to allow for inevitable glitches.
• Do all of the dictating and then play back while transcribing, correcting the mistakes as you go; this trains the software to know your voice, style, and inflections for faster and better ongoing recognition.
• Be patient; there is a steep “learning” curve - for both you and the software.

4. Word-processing and office-management: This one is straightforward, without a doubt: you should stick with Microsoft Word (anything newer than the 95 version). This is by far the most popular and compatible word processor on the market, and with good reason.

The guidelines here will help you get started. Before you even start shopping, make a “wish list” of everything you are looking for in your software, and then narrow your list down to the products that best mesh with those wants and needs. Also, be sure to seek out advice from colleagues - both about what worked for them, and what didn’t. Before you know it, you’ll be on your way to a high-tech, highly functional computerized office!

Dr. Koch is a senior coach with Breakthrough Coaching. He can be reached at 800-723-8423, at info@mybreakthrough.com, or sign on to www.mybreakthrough.com