Practice Management System (PMS) vs Electronic Medical Records (EMR) - Do you need one or both?

A practice management system is a software technology solution which helps a practice manager with the practice's administrative and financial functions. A PMS works to streamline and automate office procedures while improving communication between the healthcare professional and the patient. The administrative tasks of a practice include scheduling appointments, processing insurance claims to the medical scheme, maintaining the patient records, inventory management and providing the practice manager, healthcare professional with dashboards, reports and analytics of the patient and practice. The financial functions of a PMS would include administering the billing of the patient which involves the creation of and management of patient invoices, automatically generate invoices while keeping track of previous payments done by the patient. It would provide the existing payment details of the patient based on the services provided or the appointment booked. When processing the payment, the PMS can access if the patient has enough funds from their medical insurance to process the outstanding invoice. This would mean that the PMS is integrated with the insurance/medical scheme so it can have visibility of the patient's financial records. Essentially, a PM system can help the practice manager oversee the patient’s payments, submit their claims to their insurance scheme and assess if the patient has enough funds to undergo the procedure. Thereafter, provide the payment details to the patient as an invoice.  

Since we have provided an overview of the administrative and financial information of a PM system, we can see what the functions of an electronic medical record are. Basically, an EMR is to organize the storage and accessibility of patient health information while improving the safety and quality of the patient's medical documents. It would provide all these functions by keeping a digitized version of the patient’s medical history including any allergies the patient has, their symptoms for that visit, the diagnosis and treatment plan. Should the patient have lab results, these would also be stored in their EMR along with the doctor’s notes. Some of the vital information recorded in an EMR which is important to the health professional is the immunization dates and the vaccine batch used to immunize. This information is important due to the safety and quality control of vaccines administered to the patient. By having this information, the doctor can access if there is any adverse reaction the patient has to the vaccine. The batch details would help with the efficacy tracking and effectiveness monitoring to ensure that there are no vaccine-related issues experienced by the patient. Normally any side effects, whether mild, moderate or severe, are picked up during the human trial phase. It is important to note that vaccines undergo rigorous testing and clinical trials before they are approved for use. However, each person reacts differently to a vaccine, and some may experience what is regarded as a serious adverse event. If that is the case, a serious adverse report would need to be filled and advise if the patient experienced death, life-threatening illness, hospitalization, permanent disability, congenital anomaly, or birth defect. 

If there are any flaws detected in a certain batch of a vaccine, the Centre of Disease Control and Prevention would recall the entire batch to have them tested and sometimes destroyed. All the information pertained in an EMR is essential for the ongoing treatment and medical history of the patient.  

With all systems we always need to ascertain which functions are most critical to having it run efficiently. With the PMS the administrative and billing functions would include: 

•  The all-round benefits of using a PMS.  

By having access to all these tools and functionality within a PMS would assist towards patient management by storing all data pertaining to the patient such as their contact details, appointment schedule, treatment plan and billing data under a single umbrella and this would in turn help doctors not have to navigate through paper documents and folders. By having the patient’s information in one place this will also mitigate unauthorized access to the patient’s information and use it for illegal purposes. Upholding patient confidentiality builds trust between healthcare providers and patients. What is fundamental to adhere to is that the patient also has access to their own information. This will assist them if they need to inform a referral doctor of the treatment regimen they were administered by the initial doctor.  

We all have our preferred physician which we always go to when we are not feeling well. However, if they are our favorite physician, it is highly possible that they have a roster full of patients that they need to see. Some GPs have waiting lists up to 2 weeks long for patients who strictly want to be treated by them only. I also am victim to this trend so it is easy and faster if you can schedule a telephonic consultation for patients that do not have serious ailments. This trend was exceedingly popular when we were on a global lockdown not so long ago. Unfortunately, not all PMS offer this solution, however, CheckApp provides this service by facilitating integration with Zoom, Teams, and Skype. So, you can see your doctor via video conferencing from the comfort of your home without having to spend unknown amounts of time waiting for your turn at their waiting rooms.  

Simply put, the function of an EMR is to assist physicians track patients' data while streamlining clinical workflows to best suit the patient and the professional alike. This involves identifying patients due for their treatments, their diagnoses, treatment details, updated prescribed medications, family medical history, medical screening and monitoring their vaccinations. It could be recognized as the patient’s Bible – their medical history, current treatment, and conditions to look out for. An EMR needs to be accurate as the information it holds is important for the patient. By having accurate information, it will allow clear and concise communication between the different members within the healthcare fraternity. For instance, a GP can make detailed notes for a psychiatrist to assist a patient if they find that their issues are not medically triggered but psychological. Even important medical lab results like blood tests, X-rays, and MRI feedback, to ensure that the patient has a digitized and comprehensive medical chart that is centralized and in a secure format.  

By using a centralized and comprehensive database for the patient, a pharmacist and laboratory assistant can also access vital patient information. This makes it easy to access and retrieve information that would otherwise take days to obtain if it was done physically.  

1. Document management – the EMR also assists to make sure that paper-based record keeping for the patient is eliminated. An EMR can use voice technology and template forms to rule out the need for manual record keeping. This would in turn reduce the risk of errors by providing document accuracy. It allows for the patients' details to be organized in a concise and structured manner. This compact repository can include any type of imaging documentation, whether it be from your dentist, GP, or hospital. Location and healthcare setting no longer need to be a factor due to the exclusive use of an EMR solution.  
2. Decision support – this is the ability to provide alerts and reminders to the health professional. This function also aids in providing clinical guidelines about patient care. A good example of how this function can be used is if two health professionals prescribe conflicting medication for a patient, an EMR would alert the second professional of the initial prescription and flag the potential drug interactions, suggest appropriate alternative treatments based on a patient's condition or remind healthcare professionals about preventive screenings. This function fosters collaboration and communication amongst health professionals. Multiple professionals involved in a patient's care can access and update the EMR in real-time, leading to better care coordination and continuity. 
3. Patient Management – patients do have a right to their own patient records. These are not purely for health professionals, therefore some EMR’s have the capability to have patient portals where they can request prescriptions refill, book appointments, and view the results of the lab tests. Some even have the functionality to communicate directly with their health team.  
4. Data reporting and dashboard analytics – Consolidated and de-identified patient information can be analyzed to identify patterns, aid in medical research studies and track disease prevalence. For an EMR to be able to achieve this data organization and integration is vital and essential. Information from multiple sources would help provide an eclectic outlook on the patient’s health.  

If you had to run a world-class practice, it would be optimal to include both systems and have them integrated with each other. Fortunately, with the functionality of the EMR, it can be integrated within a PMS. Integrating the systems promotes the exchange and use of information between them and would promote a seamless and unified environment where clinical and administrative information can be accessed and managed cohesively. The integration would aid in avoiding duplication of records and work with the patient. Patient information, including diagnosis, treatment plan and lab results, appointment scheduling, billing details, can be provided in a synchronized dashboard along with patient demographic information. With integration, it would serve to better security and access control as staff credentials and authorized permissions can be centrally managed from one point. It would also foster a robust security measure and ensure that the patients' data is always protected.  

To successfully accomplish this would require intensive integration which might not always be achieved if compatibility and varying data standards are not similar. This would mean that continuous customization and data migration would be required. Obstacles such as inexperienced vendors and IT specialists can make this an even bigger challenge. The health professionals would also need specialized training to avoid duplication and optimally work the two systems harmoniously while providing the patient with the best care possible.  

It would be wise to consider how having both systems might affect your practice's budget, especially if you have a individually run practice. The initial investment to implement both PMS and EMR would include the licensing fees, hardware and software purchases, installation and training required for staff. The maintenance of both systems is crucial as most PMS and EMR run on a subscription package basis. The cost would vary depending on the vendor, system complexity and number of users. The good thing is that most vendors take this into account and therefore offer the option of having a monthly or annual subscription. The subscription fees usually include software updates, technical support, and sometimes cloud storage. The cost of hardware and IT infrastructure would depend on the size of the practice and the support systems needed. With customization you would need to identify overlapping features and workflows and thus streamline them. Integration between PMS and EMR would mean aligning your practices specific requirements which could result in needing a third party and thus add to the overall costs.  

To maximize the benefits of both systems, staff training is required to eliminate any difficulty for them to utilize the systems. Adequate training would facilitate the easy transition between the two systems. These systems can help streamline administrative tasks, improve billing accuracy, enhance patient care, reduce errors, and increase overall efficiency. It is essential to analyze the long-term financial benefits to determine the actual cost-effectiveness of investing in both systems. Essentially, while the initial implementation may involve costs, it would be beneficial to consider the potential ROI. To get the best for your budget, it is advisable to evaluate different suppliers, pricing models, and implementation strategies before deciding. Conducting a cost-benefit analysis and consulting with industry experts can assist in determining the most suitable and financially viable solution for your practice.  

Comparing the two systems serves to better understand what each system is used for and if there is a need to accommodate both systems within a health practice. Can a practice work with both systems simultaneously? It can, as both systems provide divergent functions, although some slightly overlap. We have evaluated how an EMR focuses on patient information while the PMS looks at the billing and administrative side of how a medical center is run. Not having either system in place would be impractical and tedious and therefore infringe on how successfully a practice is organized with the patient's satisfaction in mind as it would obstruct the productivity of how the functions are carried out. Innovation and paperless capability would benefit the patient and the health professional. It’s imperative to look at each system holistically and see how it can provide the best outcome for the patient and health professional alike. 

We have gone through countless benefits and challenges of both systems. In conclusion, even though both PMS and EMR system are required within a healthcare organization, and they play crucial roles in modern healthcare, they serve different purposes. Ultimately the choice of whether to get a PMS or EMR system or have them integrated, would depend on the specific needs of that healthcare practice or organization. As technology continues to advance, we can expect to see even more innovative solutions that integrate an EMR with a PMS which brings numerous advantages to healthcare practices and the experience of the patient. When used together these systems can improve patient outcomes and enhance the quality of care provided, streamline workflows, improve data accuracy, enhance security, and ultimately contribute to better patient care and operational efficiency of the practice. With careful planning, and the right expertise, the integration process can be successfully achieved, benefiting both healthcare providers and patients alike.