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Web based practice managment systems

Discussion in 'Practice Management' started by AUStudent, Apr 24, 2012.

  1. AUStudent

    AUStudent Member

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    Hi All,
    Just wanting to know if any Aussie pods out there use a web based booking system?. I know that some of the better ones do not have support within Australia such as PPS and Practice Pal. Is there any good web based programs for pods with support in Australia?
  2. Steve5572

    Steve5572 Active Member

    i use OPMS, they have very good support.

    In general i am happy with the product and service they provide. My only complaint is the letter writting function, it is a but clumsy so i still do my letters manually with Word.

    Take a look at their website www.intracore.com.au , i believe they offer a free trial so you can play around with it before committing financially.
  3. AUStudent

    AUStudent Member

    Hi Steve,
    Thanks for your reply I have just signed up with Nookal and they are fantastic! Letter templates are great with them also.
  4. Buffalo Bill

    Buffalo Bill Member

    How is Nookal and did you look at other programs like Cliniko?
  5. Nat Smith

    Nat Smith Active Member

    I've been using Cliniko at one of my clinics for a few months now. My other clinic is still using FrontDesk...I must say, I wish Cliniko had of been around yrs ago before I wasted all the money on buying Front Desk.
    As far as web based systems go, it is the only way to go forward as far as I'm concerned.

    With my clinic on Front Desk, I found it very inconvenient and expensive last yr when I had to upgrade my computers. When you initially sign up, you get the CD/DVD to upload your software & after that all your upgrades are downloaded from the net. If you let your subscription lapse, you then can't use your initial software to upload onto a new computer...they then charge you an extortionate rate to access & re-download your software, (that you already bought). I just found it a bit unethical that you are essentially forced to keep upgrading, even if you're quite happy working with your current version.

    Cliniko has thus far been brilliant IMO. They do constant upgrades and improvements; there's no huge upfront cost (unlike FD $4000); a reasonable monthly access fee (that is less than FD's annual subscription); you don't have to worry about backing up; and I can use it on any computer accessing it anywhere, anytime (I'm a Mac girl), even iPhone & iPad apps...

    Get on it...

  6. Buffalo Bill

    Buffalo Bill Member

    Thanks Nat, very helpful. I've started a trial and have enjoyed it thus far- is that sad?
  7. joelfriedlaender

    joelfriedlaender Active Member

    Thanks for the kind words Nat! We have had a great response from Podiatrists so far and are always looking to improve Cliniko to make it better.

    If anyone has any questions about our system, you can see all the details on our website http://www.cliniko.com or I can answer any question.

  8. Zac

    Zac Active Member

    Hi Joel. Do you have any plans to allow us (Allied Health) to monitor Team Care Arrangement (Medicare) refferals & the monitoring of how many visits the patient has had & maybe reminders of the need to write the initial & final letters? That would be really neat & would sway me to go to an online practice management system.
  9. joelfriedlaender

    joelfriedlaender Active Member

    Hi Zac,

    I would probably need a little more detail to answer accurately, but these are some related things we have planned:
    • Direct integration with Medicare online claiming (we have already started working on this)
    • Track treatment plans (ie. a certain number of planned sessions and how many are completed)
    • Customisable notifications based on rules (ie. send a certain email out at the end of a treatment plan, or if a patient has not been in for over 6 months).
    The latter two points I don't have any estimated timeframe for yet but the Medicare integration is underway now.

    We are really active on development though (on average, we release 2 - 3 updates per week based on customer feedback). We have maintained this speed since launch day just over 1 year ago now.

  10. Spiro01

    Spiro01 Member

    Hi Nat

    I felt compelled to post here, as my experience is quite different.

    I have been using Front Desk for more than 10 years to run multiple podiatry practices. I have tried other products and they don’t compare. The Software works all the time, is flexible and keeps meeting my changing needs. They take support seriously with a real helpdesk and technical people you can talk to on the phone. I pay their (reasonable) annual support fees and have never been asked to pay to upgrade my software. I have been using their Medicare/DVA online claiming for years.

    I had a look at Cliniko with another practitioner and IT person, and can’t see how this can run a busy practice, It looks too rudimentary and looks like a work in progress. The other thing that worried me is that the data is hosted overseas so Australian consumer and privacy laws don’t apply. You might want to google “data sovereignty” issues.

    The key with any product that is continually evolving is to stay in touch. We’ve always paid our support fees and have been delighted with the product (and service). Have you stayed up to date with your support?

    Sorry Nat, but I wouldn’t risk my practice (or my data for that matter) to anyone else.

    Podiatry Care
  11. joelfriedlaender

    joelfriedlaender Active Member

    Hi Spiro,

    Cliniko certainly isn't for everyone, each practice has their own needs and you obviously need to find what works for you best. I wouldn't say it isn't for busy practices though or is rudimentary and a work in progress. We have all size businesses using Cliniko all around the world (I think our largest business has over 20 practitioners).

    As for work in progress, well, I think software is always a work in progress. We release updates to Cliniko every week (we have now released over 150 updates in the last 12 months). I don't think we will ever be able to say it is finished as needs change, technology changes and also we are really striving for perfection. It is definitely ready to be used right now though, and has been used by many for over a year now.

    We also take patient information and data security very seriously. We do store information overseas, but we made that choice due to the security and availability we could get from vendors in the US compared to what is available here. We meet and exceed all legal requirements in Australia and most other countries (we are based in Melbourne ourselves). You can see further details on our security here http://www.cliniko.com/security.

    I think FrontDesk is a decent choice for practices, in my mind it is a over-priced and not so easy to use, but if they aren't your deciding factors then it has a lot of functionality available.

    Thousands of people are using Cliniko already (and we have only been around just over 1 year), I believe it to be the fastest growing practice management system available. We don't have everything you might need yet, but we are improving it everyday.


  12. Spiro01

    Spiro01 Member

    Certainly appreciate that Joel. I wanted to convey that my experience with Front Desk has been positive. I have had awesome service from the guys at FD ... this has been because i have kept up my end and supported them also (paid support). Just annoyed me that judgment was passed without the full story being told.
  13. joelfriedlaender

    joelfriedlaender Active Member

    Absolutely. I wish there was a better place for people to review software systems. People's experiences are way more indicative than the sales pitch on the software companies websites (including ours of course). At least a forum like this is a good place for people to share.
  14. björn

    björn Active Member

    I like what I see with Cliniko - I have had a good look at it, and will yet use it one day, but its a little bit annoying to me when I see a few people on here sharing pros and cons on different options, and then a thread gets taken along a slightly different path by at least one person with a declared self interest, and someone anonymous with such a staunch defence, that I'd worry about a vested interest.

    Joel, fair enough you got asked a question and you answered in a balanced fashion and you are upfront as to your role, but nearly every article I read on similar topics has you suggesting your software - which like I said looks great. I think it would be fairer if you perhaps had your own thread, sponsored or whatever, and then perhaps only monitored our other posts, so people don't "stop" talking on the topic. People are maybe less likely to keep discussing their experiences, when it turns into a 'mine's better than yours" scenario like we have here at the moment?

    The thing that annoys me with either web based or computer based options is: Why can't I just buy the software, get x months amount support included and then if I stop paying the fee, I get no support - but not roped into an ongoing contract? Make the software, take your money, support it briefly and then say your on your own to the customer?


  15. TonyT

    TonyT Welcome New Poster

    Hi Björn

    Most Australian vendors of Allied Health PMS have optional support and upgrades agreements.

    In our case almost all our clients choose to take up a support and upgrades agreement as their software is critical to the running of their practice, requiring professional support should it be required, and that at some point they will need a software update due to changes in IT environments (Windows 8 ?), 3rd party interfaces (printers, scanners, HICAPS, Medicare Online…) and practice management requirements (EHealth..).

    Being on a support/upgrades agreement is definitely the easiest and most cost effective way to use critical software over time, which is confirmed by many of our business savvy clients who would not purchase software unless future support and upgrades agreements are available, however it is optional.

    I wish I could get the same deal on my car. (smile)

  16. joelfriedlaender

    joelfriedlaender Active Member

    Hi Björn,

    It's definitely not my intention to stifle good conversation here. I wish more podiatrists would get in here and discuss pros/cons of systems, I think it's good for the industry. I will be more cognisant of my level of activity.

    In response to your direct point about buying the software outright. I don't think that's in anyones best interests. I really think paying up front for licenses and then optional customer support/maintenance is a broken pricing model. I won't divert the conversation again, but if you want to discuss more, send me an email to [email protected] and I will be more than happy to discuss.

  17. TonyT

    TonyT Welcome New Poster


    If you read Björn's post he is also questioning paying ongoing fees for web based solutions. Can he keep using your system if he stops paying his reoccurring fees?

    I disagree with your comment below as this is how almost all vertical market software is sold and supported.

    <<I really think paying up front for licenses and then optional customer support/maintenance is a broken pricing model>>

    At least your simplistic views on practice management and how others should run their businesses is consistent. You really should stop touting for business and knocking established vendors on this forum.

  18. Stuart Blyth

    Stuart Blyth Active Member

    Hi Joel
    As a practice manager that has used many different PMS packages over a number different health industries I understand the importance of data security and disaster recovery. The importance of our patient and financial data cannot be understated and indeed if my PMS data disappeared overnight my practice would probably not survive.

    The first question I ask when looking at a PMS, especially in a hosted environment such as yours, is “Where is my data? Can I get my data out in a easily readable format (I.e. SQL, Excel , Access etc.) in the event that the provider of the software disappears overnight?”

    I am not casting dispersions on anyone’s company here, but software providers do come and go and penalty have gone broke over the years, trust in a PMS provider is one thing but it doesn’t compare to a copy of my patient files and financial data in my hot little hand that I can restore without the help of said PMS provider.
  19. Two Shoes

    Two Shoes Member

    I am a sole practitioner about to open my own practice so I am doing a lot of research and looking at PMS at the moment. Threads like these are a useful guide.

    My experiences so far:
    I have used Frontdesk at another practice for the past 3 years and found it good, but confusing.

    I also recently contacted Frontdesk and was told it would cost $4550 up-front and $695 per annum for upgrades. For a sole practitioner, this is very high and too much for me.

    I am looking towards trying Cliniko and plan to take their one-month trial offer soon, just to get a feel for it.

    The points raised about ongoing payments to Cliniko and data retrieval are also valid and I wonder what happens to all my data if I decide to leave Cliniko at a point in the future.

    To TonyT: Smartsoft has a good product, but way too expensive.

    And I don't believe Joel has been flogging his product any worse than some other members here. I am not stupid so I can see through the guff and I believe it is a good thing that people can take part on forums to answer criticisms/praise or queries from posters.

  20. Spiro01

    Spiro01 Member

    Its interesting to hear peoples perceptions on what's expensive.

    Ive been in private practice for 20 years and paid $5500 in the early 90's for a D base system called FootWare ... promised the earth but was gone in 18 months. The point here is what value do you put on a vital tool that is literally the nerve centre of your practice? A great PMS system directs your marketing dollars, determines associate productivity, controls direct mail and referrer communication, handles sales processes, creates powerful databases, helps design and safely store clinical notes etc etc.
    All software is confusing if not trained to use it.
    As a practice owner who has also consulted for the medical industry as medical marketer, spending $4500 for a powerful, proven, supported, evolving tool is NOT expensive ... I would go as far as to say that I would NEVER consider operating a practice without FD.
    Dear colleagues, being myopic on an up front fee and cutting this corner/expense will cost you plenty in the long run ... Id be happy to share my experiences with you personally.
    Spiro V
    Podiatry Care and author of the Practice Builder Program
  21. Two Shoes

    Two Shoes Member

    Hi Spiro

    You make valid points, but my start-up budget will only stretch so far.

    I won't direct $4550 to FD because that money will be directed towards other priorities during my initial set-up.

    I am going to go the old hard copy method until I get some money coming into the business then re-assess.

    Now, who to see about this myopia???

  22. joelfriedlaender

    joelfriedlaender Active Member

    Hi Stuart,

    Control of your data is really important. In Cliniko you can export everything at any time into CSV files (we think this is the best format for you to be able to take your data elsewhere). The export looks like this http://cl.ly/image/3O221c163w0P.

    You can do that export at any time (for regular backups), we even still make the export available to you after your subscription has ended with Cliniko (you can log in for 90 days after a subscription has ended and export everything out).

    A web-based solution doesn't exclude having control of your data as long as they have the features built in to let you get it out easily.

  23. joelfriedlaender

    joelfriedlaender Active Member

    Hi Tony,

    They cannot continue to use Cliniko if they don't continue the subscription, that is how our system works, it is a service, not a licensing purchase. This is also why they can get started with no upfront fees, and paying as little as $45 p/month.

    They aren't just paying for use of the software though, we also provide backups, unlimited support, hosting, monitoring, upgrades, etc.

    As for the licensing model not being broken because that's how almost all vertical market software is sold... well frankly I think we can do better than was done in the past. I think the software industry is evolving, we are finding better ways to build software and also better business models that work well for customers and vendors.

    I think the SaaS model is win/win, customers get access to software with no big upfront cost (which helps small businesses a lot), their expenses are very predictable, and they can end at any time and change vendors with no invested money lost. For the vendor we get a reliable income stream so that we can plan and manage our business more effectively rather than relying on the inconsistency of sales. Of course there is more to it than that, but hard to sum up SaaS vs. Upfront licensing in a paragraph.

    Also, please don't get me wrong, I think you have built a great product and it is helping many businesses. I just personally think there are better business models now for selling software.

  24. Spiro01

    Spiro01 Member

    Hi Darren,
    Point taken about start up capital.
    More than happy to help direct you during this phase of your business. It can be a scary time but also an exciting one.
    Call the clinic on 0883570747 for a chat if you like.
    PS OPSM?
  25. TonyT

    TonyT Welcome New Poster

    Hi Joel

    I have no problem with the “software as a service” model per se. However let’s be clear that this is not the significant difference in our offerings. I wouldn’t normally comment on these matters as there is room for all types of products but it is important to balance your frequent self-serving views posted here.

    Looking at your product, it has a small subset of the features ( < 10%) of that provided by traditional vendors in this space and would only be suitable for the simplest of practice management requirements. Your product certainly is simple and doesn’t require any training, not because you have come up with a new advanced interface/software model but only because it doesn’t do very much. Further, your attempt to keep your costs down by hosting overseas, as mentioned by yourself and others, outside of your company’s and clients’ ultimate control is of concern when dealing with this type of sensitive data.

    The salutation option of “Zombie Lord” when adding a new patient in your system in the list of possible titles ie Mr, Mrs… shows the level of professionalism we are dealing with here. Perhaps this is funny to you.

    25 years’ experience in practice management, the first 7 as a practitioner, and 20 years as a commercial software developer tells me your clients are just getting what they are paying for and perhaps less @ $25 per month.

    Zombie Lord Tony
  26. Zac

    Zac Active Member

    Wow this turned personal quickly. I dont use either system & I have no doubt there are pros & cons for each system.
  27. Heather J Bassett

    Heather J Bassett Well-Known Member

    Hi Zac, Aus you really started something here. Hi Nat missed you at Private practice special interest groups. Hope you are fit and well. Spiro Podiatry Care and author of the Practice Builder Program, are you promoting a program?


  28. Zac

    Zac Active Member

    I did notice Spiro01 initially signed off with Spiro & then he signed off with Spiro Podiatry Care & Parctice Builder Program later on.
  29. joelfriedlaender

    joelfriedlaender Active Member

    We are going to be in real trouble at Cliniko if it turns out that professionalism and fun are mutually exclusive. Both are core to our company.

    As for "< 10% of features that other vendors have", if we can provide our customers with a system that meets their needs and still have less than 10% of features our competitors have... well that's a stat I will be most proud of.

    Cliniko - www.cliniko.com
    Last edited: Aug 21, 2012
  30. Heather J Bassett

    Heather J Bassett Well-Known Member

    Hi Joel, I have tried to send you a private message but am unable to do so! I think it may be due to my change in security product!! Painful experience I am finding out. I also am struggling to access my private messages here!! arrrgh. I am good at Podiatry NOOOOT so good at IT stuff. Trying to catch up with you... :)


  31. joelfriedlaender

    joelfriedlaender Active Member

    You can reach me at [email protected] if that helps.
  32. Very interesting points of view from other software companies on selling practice management systems with on-going support costs compared to the newer Software as a Service model that ultimately ends in larger costs over longer periods of time for the user due to many factors.

    Of course there are more benefits to SaaS which you pay for such as lower in-house IT costs for the practice, less hassle with data from a backup/disaster recovery point of view and more besides but it really is horses for courses as not everyone has failing or bad IT equipment in their practice. In fact I am happy to say that most of the people I speak to have a very good working IT system that wants for nothing and so the SaaS model isn’t for them.

    The point is that neither pricing model is “broken” as there can never be one that reigns supreme and suits everyone’s needs.

    However I have to agree with Björn’s comment on the 14th August as being from a software provider myself (obviously), I am not here to suggest anything such as which software other forum members should look into.

    Instead we should simply be here to offer as much general advice where possible as my own experience in advising, supporting and training practice owners and employees may come in useful to other forum members from time to time whilst I can keep myself up to date with what everyone is asking for from a practice management system by browsing the various threads.
  33. Zac

    Zac Active Member

    Im looking into new practice management software & am intrigued by Cloud based software (such as Cliniko) as I have multiple locations. Any comments particularly from those who maybe use Cliniko or an alternative Cloud based system? I have sent an email before to Cliniko as (maybe I'm the only one) I think it would be very useful to have PMS that could track Medicare patient visits & maybe give reminders on things like when letters are due, when referrals expire etc.
  34. Bob Bond

    Bob Bond Member

    Hey Zac,

    Cliniko looks like a great product. You might also want to take a look at writeupp.com

    In the interests of disclosure I'm the CEO of WriteUpp but this should give you another cloud-based option to keep Cliniko on their toes!

  35. Zac

    Zac Active Member

    Thanks Bob. I think Cloud based systems really appeal to me but I think at the moment (in Australia at least) they have some limitations as I believe they don't have access to Medicare & Hicaps. Using a PMS that has these connections, it will be very hard & time consuming (due to having to go back to manual inputting of information) for my staff & I to swap over. At the moment it would be a step backward. But I can see products like Cliniko have a real niche market that will grow.
  36. joelfriedlaender

    joelfriedlaender Active Member

    Hi Zac,

    We (Cliniko) have begun working on Medicare integration. It's quite difficult for cloud-based apps due to the "older" technology Medicare uses, but it's doable and we will get there. It's likely a few months away though.

    As for HICAPS, they don't offer integration with web-based apps (nor does it work on Mac), I am not sure yet if it's something we can work around, we haven't investigated it yet. Most of our Aussie customers use HICAPS with Cliniko though and it's not something that we hear is a problem.


  37. joelfriedlaender

    joelfriedlaender Active Member

    We (Cliniko) are always on our toes :)

    I checked out your website, nice stuff! Great to see other companies in this industry taking a simple and customer focused approach.

    Obviously I hope people choose Cliniko, but if not, looks like yours is a solid system.

  38. Zac

    Zac Active Member

    Joel regards Hicaps we do the processing through our PMS & everything is automatically done through the Hicaps terminal without us inputting any info other than swiping the card - it's all a matter of time/efficiency. Medicare is an even bigger issue because again with our PMS it is all automatic with Medicare. To manually input a patients info, Medicare number, GP details is quite time consuming. Seeing 20-30 patients a day means anything that saves time is extremely important.
  39. joelfriedlaender

    joelfriedlaender Active Member

    I can understand how Medicare is a showstopper, those that do a lot of transactions through it certainly need the integration.

    HICAPS however... I think still judge the system on a whole. Let's say you lose 5 seconds for doing the HICAPS manually, but because Cliniko is awesome, every patient processing is 30 seconds faster, well you are still in front. Now I obviously have no idea how we compare in speed, I just think that HICAPS may not be the most critical thing.

    I don't say this just for Cliniko of course, but for any system. They all have their pros/cons but a feature list doesn't really tell you how quick it will be. There is a lot of variation on that side.
  40. Zac

    Zac Active Member

    It's maybe not critical but it forms a package of functions that makes a busy practice function as smoothly as possible - & i think when PMS are standardly providing that function, staff (mine at least) would find it hard to go to a Cloud alternative. The less double entry, the less errors are made & the less time taken to process a patient. I am not denigrating Cloud systems (I really like the basic premise) I just think maybe at the moment the Medicare/Hicaps issues are something that I hope maybe somehow can be addressed in the future - I would then seriously look at them.

    What specifically makes Cliniko awesome?

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