Management
Information System
Resource Tool
for
Behavioral Health Providers
July 5, 2006 Edition
漏 2006, Behavioral Health Collaborative Solutions
The Management Information System Resource Tool is intended to be a starting point
for organizations that are researching software applications with the intent of purchasing
a new system or upgrading an existing system. It is designed to provide a list of
software products used by behavioral health organizations that are known to the
authors, a list of the functions that should be considered in purchasing a software
product, and limited information about the functionality of each software product
included in the list. The Tool is not intended to be a fully comprehensive listing of all
software available to the behavioral healthcare industry and their functions, nor is it an
endorsement (either positive or negative) of any of the products listed.
When embarking on the process of looking for a software "system/application", it is
important to understand and be able to define exactly what "system" requirements or
functions are needed for your organization. Often behavioral health organizations have
unique programs and services, and have funding/data requirements that may tax even
the best software. Below are some basic guidelines to think about as your organization
begins the process of looking for a software application.
Size Matters:
The size and complexity of your organization will have a direct impact, both on what you
actually need and what you have to spend on a software application. Smaller
organizations with only a few users (or programs) can limit implementation and
infrastructure costs because they can operate with a few personal computers on a very
small network. As an organization grows in size and complexity, more staff members
need access to the software and also need software with greater functionality to perform
their job duties. This requires much more information system infrastructure, more
complex networking, communications between different sites, and processing power to
allow multi-user scalability.
The budget ranges below are general guidelines for the types of software and their
range of functionality that would be most appropriate for organizations of the stated
budget size. In general, 1-4% of the organization's annual budget is a good guideline for
the initial purchase price; therefore the range for a $10 million organization to consider
spending is $100,000 to $400,000, or $10,000 to $40,000 per million. Conversely,
organizations should not buy software that is priced well below these general
guidelines, or they risk purchasing an application that will not provide the functionality
necessary to address the complexity of their organization. Organizations that are close
to one end of the budget range may wish to move up or down in the recommended
software, depending upon anticipated growth and other factors.
A note of caution: while it may sound optimal to move quickly to an integrated clinical
record, most organization's first priority for software should be to manage billing,
scheduling and staff productivity effectively. Organizations without much information
system experience may be best served by implementing billing and scheduling first, with
any clinical record modules implemented in a subsequent phase.
7/5/2006
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1. Budget Less than $3 million. If your organization operates on an annual
budget of less than $3 million, you most likely will be looking at a "canned"
practice management software application that requires relatively lower
cost and resources to implement basic billing with a few additional
features. These applications give you basic functionality for very specific
needs such as scheduling, basic client information (enough to bill), service
recording and billing, consumer statements, and maybe some basic
reports. These typically provide no business/financial functionality,
(general ledger, payroll, etc.) These would need to be purchased
separately.
2. Budget of $3 - 7 million. An organization of this size may need additional
functionality above what a practice management package can offer. These
additional items could be more detailed enrollment or assessment
information about the consumer, data required by state payers to earn
grants or contracts, accounts receivable management, and electronic
medical record/treatment planning capabilities. Again, business/finance
software would most likely need to be purchased separately.
3. Budget Over $7 million. Any organization operating in the behavioral
healthcare field with an annual budget of $7 million or more is large and
must take a more holistic approach to their management information
system needs. A large behavioral healthcare organization must have
sound software applications implemented to deal with all the functions
required for day-to-day operations. This would include the ability to
respond to and deal with external data requirements and reporting, and
the ability to produce internal management reporting to provide the
necessary information for managing the organization. These system
applications would not only provide the functions listed above, but also
provide tools to allow an organization to obtain an electronic medical
record, provide dynamic system warnings when problems occur, provide
alerts indicating when action is required, etc. As a larger organization,
having a fully functional and integrated management information system is
the key to your success or failure in the future.
Integration
Some organizations consider buying "the best of breed" for each functional area, and
then trying to link this data together in some fashion. This usually tends to be very
expensive, and consumes more staff resources than might be necessary if a fully
comprehensive software package was used. This approach does give the organization
the best in each functional area, and with the right staffing resources, this can work well
for the organization. Most behavioral healthcare organizations have limited resources,
and often cannot afford the staffing to properly manage, maintain and provide training to
staff for multiple software applications.
7/5/2006
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When purchasing a fully comprehensive package, organizations need to consider what
functionality they are or are not willing to give up in each area in order to achieve full
integration of all their organizational processes.
Pricing
Cost is always a major consideration. Once you have identified the scope of
functionality your organization needs, you can begin to look at what different vendors
have to offer. Many of the practice management software applications that offer a more
narrow scope of functionality can be purchased "off the shelf" for a minimum
investment. Obviously, the larger your organization, and the more functionality the
organization desires, the larger the investment becomes. It is very important to
understand how each vendor prices their product. Several vendors price their
applications in pieces or "modules" such as: Clinical Module, Financial Module, Human
Resource Module, etc. Other vendors may give you a "total price" for all the functions
they offer, which may or may not be exactly comparable to another vendor. Other
vendors will offer a price based on the number of users the organization is planning on
using their system, and their "system" may or may not have all the features of another
vendor's product.
Implementation Resources.
Organizations should also understand that reducing costs for appropriate
implementation planning and staff training on the new system will limit the effectiveness
of the system, create a poor return on the investment made in purchasing the system,
and ultimately, may cause disaster. Horror stories about poorly functioning systems can
often be traced to poorly planned and resourced implementations. Most reputable
software vendors are very clear that part of the cost of the software includes training
and assistance with implementation. It is very difficult for any organization, large or
small, to use a product "out of the box" without training and thoughtful implementation.
Budgeting for implementation assistance from a consultant with experience in
behavioral healthcare and information technologies may be important for success for all
sized organizations: from those larger organizations with high complexity to small
organizations without internal information technology staff. Consultation should be used
to assist with planning, training, process flow and implementation.
Information and Functions
The list of functions below represents the type of information that can be captured and
tracked in a system along with functionality of the software. This list is intended to
provide the range of possible data and functions that may be available in software
products to assist organizations with comparing products with their needs and
resources. This list explains the categories included on the Product Grid.
7/5/2006
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00Client data
o Client billing data 00lient information required to submit electronic or
paper claims, such as name, address, identifying number, etc.
o Client clinical data 00ncludes information from an integrated clinical
component of the product, such as assessment scores, treatment plan
goals, or outcome data
o Other client data 00ncludes fields for information that may be required or
customized for submission to state payers for enrollment into publicly-
funded services. Examples include Federal Block grant data, family size,
and income level.
00Scheduling 00ncludes ability to electronically schedule multiple clinicians
o Link schedule to billing 00ncludes an automated link between the
schedule and billing once a service is confirmed.
00Authorization tracking 00ncludes the ability to enter the number of units or
services authorized and usage against those authorized units. Users should
investigate the functionality within this area depending upon the needs of their
environment. For example, if a payer authorizes 40 hours of therapy, either
individual, family or group, the ability of the software to track and count down
remaining services for purposes of monitoring usage of that authorization will
vary between products.
00Billing 00ill generate a paper or HIPAA compliant electronic claim for
professional services (837P). If an 837I is needed by the user for census-based
services, that functionality is not included in the grid and should be researched by
the user.
00A/R Management
o Tracking Aging of Unpaid Services
o Tracking Reasons for Denials
o Aged Receivable Report by Payer Source
00Reporting
o Basic00ncludes a "canned" set of reports
o Report writer00ncludes a feature that allows users to design some
customized reports
00Medical record 00ncludes an integrated medical record component. If a product
provides links to other software, such as Microsoft Word, for medical record
activities, that functionality is not included in this grid.
7/5/2006
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o Assessment 00ncludes a clinical assessment with some tailoring to the
agency's requirements
o Treatment plan 00ncludes a treatment plan with some tailoring to the
individual agency's requirements
o Progress/encounter notes 00ncludes the capacity for staff to enter
progress or encounter notes after a service has been delivered
00Compliance 00hree of the most common basic compliance issues associated
with billing are listed below along with potential system features that can help to
address the compliance issues. These features require a product that integrates
medical record and billing functions.
o Expired treatment plan 00roduces a report and/or prevents billing when
a treatment plan has expired
o Service on treatment plan 00revents billing a service that is not included
on a treatment plan
o Progress note present 00revents billing for a service if the progress note
has not been entered and "signed" by the clinician
00Financial
o General ledger
o Payroll
o Accounts Payable
o Financial Reporting
00Estimated costs 00ncludes costs for initial purchase and annual licensing or
maintenance costs. Does not include hardware or network costs.
00Number of users 00ndicates the maximum appropriate number of users. This
information is not included in the grid, but should be researched by the user
based on the nature of the product and operating environment. Vendors may be
optimistic about the number of possible users along with the hardware needs and
resulting speed of the system.
The Product Grid
The grid on the following page lists what information and/or functions are available for
each product based on the knowledge of the authors at the time of this publication and
may include representations from vendors of these products. Each information/function
7/5/2006
Page 6 of 8
area on the grid should be researched specifically by potential purchasers to ensure
accuracy at the time of purchase.
The grid is divided into two groups to indicate the nature of the software and its
corresponding cost. Group A represents larger, enterprise-wide application solutions
with primary markets of behavioral healthcare and human service organizations. The
majority of these vendors have a long history in the field and offer full functionality
across a broad spectrum of states, programs and services. Several include full
integration with complete business functionality while others focus on clinical service
delivery, requiring the additional purchase of business software. Generally, this group
would be the target for medium to larger organizations because of the broader
capabilities and higher cost. These systems require a large investment that generally
starts at $100,000 and can exceed $150,000 to $200,000. It is also important to
remember that additional investments are required for hardware and communication
equipment to implement these applications throughout the entire organization. Several
offer "web-based" ASP (Application Service Provider) versions of their product. These
can greatly reduce equipment and infrastructure costs for the organization. Many
vendors offer financing and leasing options to reduce the "upfront" cash investment.
Vendors listed in Group B are a collection of offerings referred to as "Practice
Management" products or software. These are developed with very specific functions
and can be purchased off-the-shelf. Because these applications are intended to be
"canned", and are less expensive, they do not have flexibility for any customization for
your organization's specific needs. Many are based on a medical practice office-based
environment adapted for behavioral healthcare. These products can range from an
application designed to run on a single personal computer (single user mode) to a
scalable application that can be networked and utilized by multiple users. For those that
claim to be multi-user, the optimal number of users should be researched as a part of
the purchase decision since many products may function poorly with a large number of
users. Some of these products focus on a very specific function like billing and have no
other capabilities. A number of these products are offered as a web-based ASP product
that only requires a personal computer and a reliable high-speed Internet connection.
Providers should be clear that the products in Group B are designed to meet specific
needs, and not intended to address the multiple information system needs of an
organization with a wide range of programs and services.
Information contained in the grid was obtained based on vendor-supplied information,
and the authors do not warrant the accuracy of specific items on the grid. The grid is
intended to offer general information about the systems, and functionality of each
system should be researched and confirmed prior to purchase.
7/5/2006
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Company:
Web Address
Price Range
Client Schedule Auth. Billing A/RBasicStateTXEMRFin.
Comments Characteristics
Data
Tracking
Mgnt. Reports Reports Plans
Group A
Anasazi Software, Inc.
anasazisoftware. com
Individualized Pricing
X
X
X
X
X
X
X
X
X
XComprehensive Behavioral Health Application
Askesis Development Group (PsychConsult) askesis.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
Comprehensive Clincial Operations
Defran Systems, Inc. (Evolv CS)
defran.com
Individualized Pricing
X
X
X
X
X
Web-Based, Human Service Application
Harmony Information Systems, Inc.
harmonyis.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
Web-Based, Comprehensive Behavioral Health Application
Health Care Software, Inc. (HCS)
hcsinteractant.com
Individualized Pricing
X
X
X
X
X
X
X
X
XWeb-Based ASP, Client Server, Comprehensive BH App.
Lavender & Wyatt Systems, Inc. (Essentia) lwsi.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
XComprehensive/Fully Integrated Enterprise Application
Netsmart Technologies, Inc. (CSM- CMHC) ntst.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
XComprehensive Behavioral Health Application
NextGen
nextgen.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
Comprehensive Medical Service Application
Qualifacts Systems, Inc.
qualifacts.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
Web-Based, ASP Only
Sequest Technologies, Inc. (TIER)
sequest.net
Individualized Pricing
X
X
X
X
X
X
"Clinical Records System"
The Echo Group
echoman.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
Comprehensive Enterprise Application
UNI/CARE Systems, Inc.
unicaresys.com
Individualized Pricing
X
X
X
X
X
X
X
X
X
Comprehensive Behavioral Health Application
Group B
CIS (Kenneth Young/IL Only)
$50,000 to $60,000
X
X
X
X
X
X
X
Plus Monthly Fee $1,000 - $2,000
Civerex - Civer Psych
civerex.com
$1,700 per user
X
X
X
X
X
ClaimTrak Systems, Inc.
claimtrak.com
$50,000
X
X
X
X
X
X
X
X
Client Server & ASP Options, Can Purchase Modules
Psych Advantage (Compulink)
advantagesoftware.com
$3,500 to $6,500/5 user
X
X
X
X
X
X
X
X
XPractice Management Package- Scalable
Core Solutions, Inc. (Web Care 3.0)
coresolutionsinc.com
$36,000 for 20 users
X
X
X
X
X
Web Based Application & ASP, Focus on SA and MR
Easy Billing System
easybillingsoftw are.com
$2,148 to $7,334
X
X
X
X
X
Billing Application Only
Esteam
esteam.net
$60,000+
X
X
X
X
X
X
X
X
Web-Based:Internally Hosted, Agencies > 8 Million Budget
EZ Claim
ezclaim.com
<$1,000
X
X
X
Billing Application Only
Foothold Technology, Inc. (AWARDS)
footholdtechnology.com
$1,100 to $2,200/Mo
X
X
X
X
X
X
X
XASP Only, One Time Set-Up Fee $7,500 Plus Monthly Fee
Handel Information Technologies (RiteTrack) handelit.com
$52,500 to $195,000
X
X
X
X
X
X
X
X
Comprehesive Human Services Product
Hill Associates Health Mngt. Systems
hill-associates. com
$30,000 for 3 Users
X
X
X
X
X
X
X
X
Additional Users: $1,500 per Work Station
Intergy Practice
emdeonps.com
Individualized Pricing
X
X
X
X
X
X
X
X
PM: Priced by Provider Drs. $12,500, Others $1,000 Each
Inventive Software Solutions
inventivesoftware.net
X
X
X
X
X
Focus on Custom Design and Development
Kaleidacare
kaleidacare.com
$400/mo for 50 users
X
X
X
X
X
ASP Only, Focus on Care Management, Set-up Fee $3,500
LYTECS
completemedicalbilling.com
$5,000 to $20,000
X
X
X
X
X
Small Medical Practice Software
Med Ware
medware.com
$2,500
X
X
X
X
Practice Management App./Small Practice, not Scalable
MedAssist
inservio.com
X
X
X
X
X
X
Medical Practice Management Application
Medez (Integrated Software Solutions)
emedez.com
$10,000 for 5 users
X
X
X
X
X
Have Behavioral Health Specific Product
NDC Medisoft
completemedicalbilling.com
$1,074 to $7,798
X
X
X
X
Medical Practice Management Application
Misys Healthcare Systems
misyshealthcaresystems.com
$15,000/Initial Single Provider
X
X
X
X
X
X
Practice Mgnt. Application: Individual Pricing Single Provider
MS* Health Software
mshealth.com
$11,495 to $69,995
X
X
X
X
X
X
X
X
Client Server Based, Only Behavioral Health
Payerpath, Inc.
payerpath.com
$49/per Mo/Per Provider
X
X
X
Web-Based ASP Clearinghouse with Billing & Claims Mgnt.
Practice Management Technologies
pmtechweb.com
$12,000 to $14,000 for 10 users
X
X
X
X
X
X
X
X
Michigan Only:Larger users (CMH: $125,000)
PsyTech Solutions, Inc. (Epitomax)
psytechsolutions.net
25-50 Users/$2,000-$3,000/Mo
X
X
X
X
X
Web-Based ASP or Installed on your Own Server
Raintree Systems, Inc.
raintreeinc.com
X
X
X
X
X
X
X
Web-Based, ASP or Installed on your Own Server
ScerIS, Inc.
sceris.com
$4,000 to 100,000
X
X
X
X
EMR: Document Management:Pricing on concurrent users
Shrink Rapt
shrinkrapt.com
$635 to $1,035
X
X
X
X
X
Small Therapists Practice Application
SOS Software (Synergistic Office Solutions) sosoft.com
$2,963 to $32,105
X
X
X
X
X
X
X
Medical Practice Management Application
SSIMED
ssimed.com
$7,000 for single provider
X
X
X
X
X
X
X
X
Practice Management App.: $3,000 per Service Provider FTE
The CIMS Group, Inc. (ChartEvolve)
thecimsgroup.com
$499 to $1,200 per user per yearX
X
X
X
X
X
X
X
X
Comprehesive Behavioral Health Solution
Teresa Pickering (IL)
$12,000 to $21,000
X
X
X
X
Illinois Application
7/5/2006
Page 8 of 8
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