Many physician group practices want the benefits of information technology, but often they don't know where to look for it or how to judge what they find.
Because an information system is costly and organization-changing, a purchase decision can make or break a practice or a practice manager.
While a medical group may realize it can't afford to continue its inefficient ways, it also realizes it can't afford to fix those ways with the wrong technology.
That's the situation as sized up by a subsidiary of the American Medical Association called AMA Solutions, a for-profit unit that uses the AMA's membership leverage to negotiate deals that support the business of physician practice.
In focus groups convened to determine practice-support needs, the cries for help were loud and clear when it came to information systems evaluation, selection and ongoing aid, says Fern Lentini, vice president of marketing and sales for AMA Solutions.
In response, the unit commissioned an investigation of information systems that automate scheduling, insurance eligibility and billing, and offer solutions for emerging management issues such as referral tracking and specialist reimbursement under managed-care contracts.
From an initial field of a dozen candidates, a Dayton, Ohio-based company--Reynolds and Reynolds Healthcare Systems--was selected to receive the first seal of approval.
AMA Solutions negotiated a set of exclusive product and service agreements with Reynolds and Reynolds to launch a new program called TechnologyLink.
Aimed at medical groups of more than 15 but fewer than 100 physicians, the program will provide information on recommended technology vendors and offer brokered deals on service and support.
The subsidiary aims to stand behind the selection and service of those with which it affiliates, Lentini says.
"We need to satisfy physicians," she says. "This is a membership organization. If we recommend something to them and it isn't what they want, we could lose a member."
"This is the riskiest decision a lot of (physician practices) will make," says Kelly Kavanaugh, vice president of marketing for Reynolds and Reynolds. "People do get fired over this decision."
In return for endorsing the Reynolds and Reynolds practice management information systems, AMA Solutions will get a percentage of resulting sales, Lentini says.
The evaluation and partnering process is similar to that of healthcare alliances VHA and Premier, which try to influence their members as they sort through the maze of multiple software products and purchase terms available to hospitals and large provider networks.
The TechnologyLink program also looks closely at software features, but the predicament of most mid-sized medical groups has prompted the program to look beyond just the product, Lentini says.
The average medical group doesn't have the legions of information systems professionals common to hospitals or large multispecialty physician practices. Turnover of office workers in that setting is also frequent.
That's why the selection process closely weighed "energy level" and commitment by the typical physician or office staffer to using the software. "It takes a high level of support and handling to keep that person happy," Lentini says.
The customer service and support offered by Reynolds and Reynolds was a prime factor in its selection as the first partner, she says. Plus, the AMA unit was able to negotiate even more training and support for its members than the company normally would offer clients.
For example, an off-hours hot line will expand the availability of telephone support to workers who need to be talked through a problem, Lentini says.
"(The physicians) want us to make a recommendation, but they want a choice," Lentini says. And they want a company with staying power and financial stability.
The physician software sector is home to thousands of small companies with practice management information systems, but the AMA unit is gravitating toward companies that can propose ways to add value to their products through attractions such as stepped-up service commitments and toward those with a larger revenue base.
The Reynolds and Reynolds healthcare division, for example, is part of a larger publicly traded company that also makes computer systems and business forms for the automotive industry and for general business operations. The company posted revenues of $1.1 billion in 1996.