Software secrets revealed

Software for your practice is not an insignificant investment. It’s a big one. Not only that, software dictates how your practice will operate in the future. As a result, it can be overwhelming.

We spoke to technology experts to get their take on how practices should manage a software search and acquisition for their practice. We also learn some of the insider secrets that can help a clinician make the best decision possible for one of the most critical decisions for their operations.

“It's one of the biggest decisions you're going to make for your future as a group,” Mike Uretz, Executive Director of Dental Group Partners and founder and editorial director of DentalSoftwareAdvisor.com says. “If you do it wrong and get the wrong vendor and get the wrong software, there are a lot of bad repercussions.”

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Uretz helps group practices and DSOs find new software for their operations and has been for over 20 years. He says the software field in dentistry has evolved from straight practice management for operations in the past to including more robust clinical features and functionality today, including electronic health records and clinical analytics, which support improved patient care.

“It’s important that when we talk about looking for software we need to understand where healthcare and specifically dentistry is going. Do not just look at practice management functionality that supports administrative and financial areas but also look at the clinical applications,” Uretz says.

John Flucke, DDS and Technology Editor for DPR, believes that getting your staff involved is crucial to your process. You want their buy-in to any changes that occur in the software. You also want to ensure it does what they want, as well. Having the support of the team to make the change will make the integration and all the related pain points go smoother than if you surprise them with it.

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“Human beings don’t deal with change very well,” Dr. Flucke says. “Getting the staff involved in that and saying, ‘Yes we understand there's going to be some pain with this, but the long-term benefit for everybody involved,’ is going to be so much better.’”                                                                              

Beginning your search

Uretz says when you look at new software, there are many factors to consider. These include:

• The functionality: Does it do what I want it to do?

• The navigation and UI: Is it easy to use?

• Technical analysis: Does it use “scalable” state of the art or older technology?

• Implementation/training: Does the vendor have an implementation and training plan?

• Support: Do they have a support agreement that outlines remedies for you should their support be sub-par?

• Contract: Does it have your best interest at heart?

Dr. Flucke says to consider all the team’s needs when picking software for the functionality. For example, if you love the way it charts, but the accounting staff need reports the software can’t produce, it is not the right choice.

“You need to be aware of all those facets of it. Sometimes for doctors that can be hard,” Dr. Flucke says.

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Uretz says one of the significant areas he always considers is the technical analysis.

“You can have software that looks good to a layperson, like a dentist or an administrator, but the technology might be very old or proprietary. Also, it might not be scalable, and when you grow, you might be stuck with something bad technically five years from now,” Uretz explains.

In other words, he ensures that his clients don’t buy software that looks like a Ferrari but with the engine of a Volkswagen.

Implementation and training follow because none of the other things matter if it’s not installed correctly and your team doesn’t know how to use it. Plus, it can take a long time to get what you need. Uretz says it is vital to look at the software company’s implementation and training plans and ask about how they work.

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Support is another area Uretz says people sometimes neglect. However, it is critical because you need to know if you have a problem if there will be someone at the software company that is going to take care of it on a timely basis.

“When you are selecting software, look at the company, talk to references and find out how they support, as well as what guarantees there are,” Uretz says. “Find out how they support you when there is a problem.”

After you have considered all of these aspects, Uretz says the contract itself is essential. You have to make sure it includes all the right steps that are logical.

“Make sure it's a good fit,” Uretz says.

The decision process

Uretz works through this decision process a lot with clients. He starts with a needs requirement analysis. He talks with all the departments to determine what they need and how software features can help them. Uretz also has them list what they liked about what their previous software did. The result is a list of what the practice is looking for regarding features and functionality.

Dr. Flucke agrees that a needs analysis is key to the decision process. He advises doctors to consider all the factors of the software rather than the ones they like best.

“A lot of doctors get hung up on the clinical part of things, and I think that's good,” Dr. Flucke says, including himself in that group. “But sometimes doctors don't get hung up on the business side of things, and we need to pay attention to that as well.”

Related reading: Futureproofing your digital investment

Dr. Flucke encourages taking a detailed look at the competition by comparing and contrasting features. In particular, he says to see what you gain, but also what features you lose if you make a change.

“You sure don't want to have some function that somebody in the office really leans on and then suddenly have that function disappear because you need a change,” Dr. Flucke says.

Dr. Flucke also recommends making a list in these type of decision-making situations. Make a list of pros and cons for each system you have under consideration. Once you eliminate one of the options, re-do the list again for the remaining systems to narrow it down further.

“I would sit down and do the standard accounting chart where you just balance the credits and debits the pluses and minuses,” Dr. Flucke says. “It becomes much more black or white because you see everything.” 

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The next step per Uretz is a request for proposals (RFPs). Using the list from the needs analysis, ask vendors to tell you what they do and don’t have from the list. Then, you get a proposal from them in writing with all the details, including technical framework and the areas of training and support.

Based on the RFPs, Uretz has the team narrow down their options to the top two or three and has them schedule demonstrations. Here is where Uretz says the practice and groups make their biggest mistakes because they let the salespeople show them what the salespeople want them to see.

Instead, Uretz says it is vital for the practice or group to ask to see various features and functionality they need and just let the salespeople “drive” the demo. He recommends having people from all the departments present with specific tasks they want to see in the software to ensure the software does what the team at the practice wants it to do.

Dr. Flucke takes a different approach. He asks the reps to tell him why they have a better product than the other options. He also says you should contact your current company and let them know you are considering a change.“Theoretically, you might be looking for solutions that your system already offers, and you just don't know it,” Dr. Flucke says.

Related reading: Are dental software contracts rigged?

The last step is negotiating the contract between the top two software providers. Uretz says it is an excellent way to determine if the companies are going to work with you or not. From there, you can choose the proper vendor.

“People don’t like to do the work; they don’t like to spend the time,” Uretz says. “But these are the logical steps you take to get to a good decision.”

The secret to integration

Even though you might be integrating 3^rd party applications and devices in your initial implementation, it is critical to think ahead about what you might be integrating in the future. To prepare, Uretz recommends having a discussion about any future plans with your potential vendors to see if they can integrate everything you plan on adding. He also says talking to current users is a good idea, too.

Related: 5 tips for a successful software implementation

Uretz says many times, practices don’t plan enough ahead to see what their need might be after they implement the software. Imaging is an example. Some practices buy software knowing they will likely buy a new imaging device in a year, but do not check to make sure the vendor can interface with it and what the cost will be. Sometimes, this oversight can lead to extra unexpected expenses when it comes time to integrate after the original deal is inked. The more you know about what your needs might be in the future the better when negotiating your deal.

“When you are selecting software, try to think of everything you are going to do in the future to the extent you can,” Uretz says. “If you can, you are going to save yourself money and headache if you know ahead of time before you do the deal.”

Dr. Flucke agrees, adding that when you are planning a software change, be sure you know who makes your sensors. Sensors are intrinsically critical to the whole operation.

“There are certain sensors that just don't get along well with certain operating or certain practice operating systems, and you need to know that,” Dr. Flucke explains. “One of the things that I would do right out of the gate is that I would call the sensor company.”

Another area that is growing in practice software is the direct integration of electronic clearinghouse for claims processing. Some vendors have relationships that allow for payments processing for insurance claims to occur electronically. In other words, the software you buy integrates automatically with the clearinghouse interface, creating a seamless experience for the practice. However, Uretz says not all software companies have this level of integration with the clearinghouse, so you need to check with your vendor.

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Uretz says when it comes to integrating third-party systems into software, it is more easily done in the cloud. A number of third-party applications have emerged that handle such functions as social media, customer service, analytics, patient education and CRM (customer relationship management).

Dr. Flucke agrees that over the past five years, the cloud has gained traction over systems housed on servers in the practice. He thinks a couple of excellent benefits of a cloud-based system include no backups and fewer hardware compatibility issues because the interface is handled through a browser.

“From the standpoint of still using the old-fashioned client-server model that a lot of us are still on, you need to upgrade your stuff from time to time to stay current,” Dr. Flucke says.

In the past, Dr. Flucke says updating hardware was necessary from a memory standpoint. These days it is essential from a security standpoint.

“The operating systems keep evolving to keep the bad guys out of our networks and that requires you to update the operating system with all the security patches constantly, and that aspect does take advantage of the latest and greatest in hardware,” Dr. Flucke says.

Related: The pros and cons of the cloud: What every dentist needs to know

Networking is another critical consideration per Dr. Flucke. It would be best if you had the fastest cabling you can find, such as Category 6 Ethernet (Cat 6) to move your data and your images around efficiently.

“We're getting more and more stuff we have to move around our networks like Cone Beam imaging and things like that, and you don't want to wait five minutes for something to load when you can wait 15 seconds,” Dr. Flucke says.

Timing is everything when you go live with the new system, Dr. Flucke says. He suggests building a buffer to work out the kinks once you go live. Have the install on a Friday, so you have the weekend to tinker with everything or blocking out the first few appointments the next day after the install.

“I know you're going to leave some money in the production there, but come in and make sure everything works,” Dr. Flucke says. “The time to find out you can't take all the photos and your sensors don't work is not when the 8 a.m. patient is in the chair.”

Dr. Flucke also advises dentists to consider why they are making a change. If they aren’t gaining a ton of benefits to patient care, clinical outcomes, or operations efficiency, maybe table the move for the time being.

“If you are replacing things, look at improving things,” Dr. Flucke says. “Don’t replace things just for the sake of replacement.”