Practice Management Changes During EHR Implementation

EHR vendor simplifyMD has a really interesting post up that looks at what happens with Practice Management software when purchasing an EHR. In the post, they look at the results from a survey done by AC Group of 1,447 practices from November 2011 to March 2012. Here are some of the most interesting findings:

86% of Large Practices Keep Their PM When Purchasing a New EHR

88% of Smaller Practices Replace Their PM When Purchasing a New EHR

81% of Smaller Practices Hurt Their Revenue Stream by Implementing a New PM

Only 4% of Large Practices Felt an Impact to Their Revenue Stream

It tells a really interesting story about the impact of replacing your practice management system during an EHR implementation. I’ve seen the difference in choices made by small practices versus large practices first hand.

This issue is a crazy one because in the time I’ve been writing about EMR software, I’ve seen it flip flop multiple times. When I first started blogging about EMR, everyone wanted to keep their practice management software and just integrate it with their new EMR. Then, it quickly became that everyone wanted an integrated Practice Management and EMR. The above survey results seem to indicate that many clinics should consider going back to the old model of keeping their existing PM.

Full Disclosure: simplifyMD is an advertiser on EMR and EHR, but they didn’t ask me to post about it. I just found the data interesting.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • The trend I see these days is hospitals out buying up practices and forcing them to use the hospital system, and from what I’ve seen and heard, the hospital systems are feature rich for institutional billing, but fall short when you want to have those same nice features on the professional billing side of things are just plain missing.

  • Jay,
    Good point. I should have pointed out that trend and how it impacts revenues as well. Thanks for adding to the conversation.

  • On this point – I do beg to differ with you John.

    Smaller Ambulatory Practices with 1 or few physicians – are better off having a comprehensive EHR with Practice Management system. This is for multiple reasons.

    As you may have already know – if EHR and PMS are from two different vendors, in most cases they would not be interfaced and manual process comes into play. W/ new patients and Patient Demography this results in dual data entry and prone to errors.

    Secondly, its not a closed loop system; and for all you know there could be 45 encounters and there might be only 43 claims that are sent out. There is no automated reconciling process.

    Practices will have to continue to print super bills and pass it on to their billers. In todays billing requirements for indicating eRx, etc., – now this will also have to be indicated on the superbill.

    And the small office will have to deal with 2 different vendors for the same business process including the upgrades (such as the recent 5010).

    And not to mention the additional charges for system maintenance, upgrades and support. And finally the additional monthly charges that they may end up paying for the clearing house. These can easily add upto $600 or more per month.

    I do agree with you that there is a disruption to the cash flow; revenue is not altered but cash flow can suffer.

    To make this disruption as low key as possible, we do advise the practices to take baby steps and continue to use the old PMS for the following 3 to 6 months depending on specialty.

    In the meanwhile, the billing is submitted from the new system starting with a handful of claims and make sure that the system is registered right with the commercial payers. Within a week, you will get to know the status of claims. Over the following 2 to 3 weeks, majority of the commercial claims are transmitted from the new system, while Medicare and Medicaid claims go through the old system. This gives the practices time to register with Medicare and Medicaid with the new system which takes 2 to 4 weeks. Following this a hard cut off date is set for Medicare/aid claims and ERAs are switched to the new system as well.

    The practices continue to run the old system till such time the claims are flushed through which might take upto 6 months and/or more.

    Generally, if the implementation is planned – the disruption to cashflow will be less than two weeks.

    Cheers and thanks for opening up an interesting topic.

  • Anthony,
    I love when people differ with me. Makes for a more interesting conversation.

    I don’t agree with your assumption that having a separate PM from your EHR means that they’re not connected. That’s true in some cases, but in many cases there’s a really tight interface between separate vendors.

    I guess I’d say that I’m not necessarily arguing for or against keeping them separate or combined. I’m just say that it’s worth considering the impact on revenue if you do choose to switch. I think many will find that it’s not worth it to switch their PM when they have one that’s working well.

  • There is a wrong assumption here that all Practice Management Systems are created equal. Most “Comprehensive EHRs” today started as a PM or EHR and then just added the other component to jump on the MU bandwagon. A good EHR does not necessarily have a good PM and vice versa. The article doesn’t clarify the reasons for the drop in revenue. The decision to keep the existing PM or move to a new one should be based on the features of PM, NOT on the EHR. If you really like your existing PM and EHR vendor can’t integrate with it, it is time to look at an other EHR. That is definitely trouble in near future. On the other hand, if your existing PM can’t integrate with an EHR the provider likes – it is time to look for a new PM (which could be part of the new EHR or integrated with the EHR). I agree with John that it is a completely wrong assumption that PM and EHR from separate vendors cannot be connected tightly.

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