"An integrated best-of-breed product helps patient care and clinical error reduction, financial performance, and regulatory compliance," says Boris Petrikovsky, MD, PhD, Chairman of Obstetrics/Gynecology Department at Nassau University Medical Center and Professor of Obstetrics, Gynecology, and Reproductive Sciences at Stony Brook University School of Medicine.

Comprehensive integrated best-of-breed solutions combining modern EMR software and billing service can be utilized under the "pay-as-you-go" business model. Software-as-a-Service (SaaS) model allows physicians to confirm the benefits of technology solutions first and pay later. While such solutions deliver multiple risk management and operations control benefits, they also pose significant transition challenges.

Integrated SaaS and Outsourced Service

Improved operations control, risk avoidance, and added revenue are the most significant benefits of integrated outsourced and SaaS solutions during both implementation and exploitation phases:

1. SaaS requires no large upfront investment in hardware, software licenses, or systems integration on the part of the user.
2. SaaS shifts the onus of systems management from the user to the SaaS vendor

In business accounting terms, SaaS turns capital expense into operating expense, which translates into

1. Better balance sheet
2. Lower risk, especially during the period of rapid technology innovation on one hand and practice-building stages on the other hand

Transition Challenges - People and Processes

Once you selected your outsourced solution vendor(s) for EMR and billing, you face a transition challenge. It involves people, processes, and technology. Since SaaS model eliminates traditional systems management headaches, you can focus only on people and processes:

1. Communicate, communicate, and communicate. The likelihood for implementation success is directly proportional to staff involvement. Review current workflow, understand expected changes, and make sure everybody in the practice agrees with them, including practice manager, doctors, and office personnel.
2. Manage expectations. Document specific changes in the new workflow. Identify specific steps in the new workflow that require fewer or less qualified resources. Quantify expected benefits in terms of saved resources, added revenue, and personnel savings.
3. Control the Fear of Change. Do not force the new system on the old workflow. Had the old processes met practice business requirements, you would not be looking for better solutions. Carefully design the new workflow leveraging the new solutions together with workflow participants, including the practice manager and every doctor.
4. Prioritize. Do not try to implement an entirely new process including all new features at once. Soften the transition shock by using a gradual approach, minimizing the amount of changes but maintaining a steady and sufficiently frequent pace of such small changes to complete the transition on time.
5. Lead. Without a manager for entire transition process, members of the transition team will find other priorities and will not take responsibility for delivery.
6. Track. Schedule regular (weekly) implementation review meetings with practice manager.
7. Schedule. Without specific action items including specific owners and delivery dates, implementation will drag on and exceed allocated costs. Consider using a process tracking system, e.g., TrackLogix.
8. Train Gradually. Allocate enough time to train everybody on both the new processes and technology. Do not try to jam everything your system can do in a single training session. Expect multiple training sessions, adjusting to participants' learning pace.