June 2002 Bulletin

Does your computer have a future?

Measuring your system’s long-term viability

By Ronald B. Sterling, CPA

The changes to technology are long overdue in the medical computing industry. Compliance with the Health Care Insurance Portability and Accountability Act (HIPAA) requirements is taxing less sophisticated systems and requiring massive changes to structures that many vendors cannot manage. Indeed, companies that can meet HIPAA changes have acquired companies that lacked the resources or technology bases to support HIPAA changes. What do these changes mean for your practice computer system.

What do these changes mean for your practice’s computer system?
Does your practice computer system have a future?

Consider the following issue: has vendor support degraded and/or dropped off?

You pay support fees to get access to the support staff as well as the right to install upgrades of the software. When access to the support staff drops, and/or new releases are few and far between, the company is either backing off from your product(s), or directing its focus elsewhere. For example, one vendor has not released a product update in over 30 months while other vendors have fired all but one or two support people for their products. In both cases, these moves are clear warnings that sticking with the product you rely on may not be a good long-term strategy for your practice.

Was the vendor sold to a companywith a competing product?

A number of practice management software companies have been acquired over the past few years. In each of these cases, a company with several product offerings will identify a "go forward" product that will be enhanced with new features and options. The remaining products are "legacy" products that do not have a future. If your requests for enhancements are answered with "your product can’t do that, but our product X could," you have a legacy system. An upgrade from your existing system to the vendor’s "go forward" product may be as expensive and complex as moving to a new system.

Does the vendor fail to implement true enhancements?

In order to meet the evolving needs of medical practices, products must be enhanced with new features and options. If your vendor releases new versions with mostly error fixes–("The A/R Detail Report will now balance to the A/R Summary Report")–then the product is not being adequately maintained. Vendors may cut back on enhancements due to development of a new replacement product, or preparing the company for sale to another party. What is the HIPAA product strategy?

Many software vendors have ill-defined HIPAA compliance plans and strategies. In some cases, vendors offer general commitments but fail to define the specific changes or costs. Complying with the HIPAA Privacy Regulations and supporting the HIPAA Transaction and Code Sets may require dramatic changes and enhancements to many software products. The cost of getting access to these enhancements may be significant if you are not covered by a support agreement or have a support agreement that predates HIPAA. Additionally, the upgrade and compliance with the HIPAA standards could require changes to your hardware and installation of additional workstations.

You should keep tabs on your vendor’s HIPAA compliance strategy and progress. If the company falls behind, do not be surprised if it discontinues the product or sells the company. Indeed, we saw several last-minute changes and problems when vendors had to upgrade their systems to manage the year 2000.

Be careful to monitor your current vendor to ensure that you make the right decision for your practice. If you need to move, you will want to consider all of your options.

Ronald B. Sterling, CPA, MBA, of Sterling Solutions, Silver Spring, MD, is a nationally recognized expert on electronic medical record and practice management systems. He can be reached at (301) 681-4247 or rbsterling@aol.com.

Computer Link welcomes suggestions about future topics for the column and questions about the use of computers in orthopaedic practice. Send your suggestions to the Bulletin at AAOS, 6300 N. River Rd., Rosemont, Ill. 60018.


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