My Quest for Practice Management Software

• Patient Billing Programs by Dr. Judith Mazza, 5/19/97
  • I have tried a few. by Fred Sperry, L.I.C.S.W., 10/10/98
    
    

I have been searching for over two years for a comprehensive Practice Management system for a single provider Child and Adolescent Psychiatry practice. Managed Care has ravaged this practice and it is critical to find an automated solution to the overwhelming demands. After the two-plus years of investigating, I am no more further than I have ever been!

Civerpsych 2.0 was purchased. After an entire year, I now have the program running without runtime errors or internal data fragmentation. The program is full of potential, yet it takes a very obsessive individual who will commit to hours of tedious form building and field linking to tap that potential. One thing that I found problematic with Civerpsych 2.0 is the way data is accessed, manipulated and/or saved by the user. It involves a series of both mouse-driven as well as key stroke activity. When I tried to put the system into place temporarily, this constant swapping from mouse to keyboard created an observable (and frankly reported) level of stress for the office staff.

I could provide you with over a years worth of specific experiences with Civerpsych 2.0. However, I'll state two very important items for consideration. One, I have asked Civerex Systems (company which has produced Civerpsych 2.0) numerous times for a list of clinicians who are actively using their system. My request has been evaded and downright ignored. I cannot get a single clinician's name that is actively using this system to manage their practice. Secondly, the systems emphasis seems to be on the automation of clinical decision-making. I don't know what is typical, but I am not concerned with automating that function. The clinician functions in that role, and quite well. My concern is the management of information in an orderly way that allows a timely response to the demands of managed care entities and Insurance Carriers. Unless I've missed something, Civerpsych 2.0 cannot do this, yet. The staff at Civerex systems has come to know me well and I them. I cannot say enough good about those folks, but this, unfortunately is not reflected in the utility of their product.

Many collegues have opted to purchase Therapist's Helper. From what I have seen of this program, it is probably the best selection for a therapist's practice. It has numerous impressive features and seems to be quite a stable and well-supported product. However, I am leary about such a program for the psychiatrist's practice. There is consideration of the clinical impact of medication, but treatment planning seems to treat that element as an adjunct. Treatment goals for psychotropic therapy and those involved in psychotherapy are different enough to present some limitations for the physician user. The same is true for TheraScribe and Therabiller by John Wiley and sons. Another nicely organized, powerful program, but very limited in it's application for the physician.

Currently I am evaluating some comprehensive programs which are targeted to the medical practice. I am looking at CliniMed Practice Manager, MBA 7000-Ultra, and HBO and Company's Physician Office Manager. The system that we have used from the very beginning and has been an outstanding program, one that we have simply outgrown, is PBS (psychiatrist's billing system) 3.0 by Blumenthal. Dr Blumenthal has now released his PBS for Windows. I have examined a trial version but the limitations which we are faced with presently are not resolved in the windows version. I would highly recommend PBS to any mental health clinician, if your need is simply a reliable accounting/billing system that will track certification and allow electronic billing, then PBS is a cost-effective solution (and I get nothing to say that!). I believe it is slightly less, if not then comparable to Therapist's Helper.

It is hoped that more discussion will emerge about this aspect of mental health. Because, unfortunately, it is an enevidible reality of our future in this industry. Just before Human Affairs International was purchased by Magellan, they were unveiling their own Clinical Information System. This program was an attempt at providing computerized clinical review and care management. From what I could tell, it consisted of numerous assessment forms which were to be faxed directly into HAI's Computer network. The forms were similar to the scan-tron technology forms. Utilization decisions were made not by clinician reviewers, but as a result of templated algorhythms, which were produced by previous treatment outcomes data. This is the most frightening of possibilities, in my opinion. However, it is an inevidible evolution in managed care's grand quest to provide more for less.

I'll stop myself here. As you may well conclude, I am happy to see this forum I have felt very alone in this experience, but I knew that I couldn't be unique.

Thanks for hearing me!

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