Interview: Best Practice
Pulse+IT: What products does Best Practice have available to GPs and Specialists?
We currently have 2 products, Best Practice and Top Pocket. Best Practice is a Windows desktop application. It has two components, Clinical and Management. The basic application is Clinical and includes script writing, progress notes, pathology and radiology, correspondence etc. The Management module is an optional component that includes an appointment book, waiting room, billing and reporting features. Together, they form a fully integrated practice management and clinical package.
Top Pocket is an application that runs on the Pocket PC type of PDA (Personal Digital Assistant). Patient data, including demographics, current medications, allergies and past history, can be transferred from Best Practice to Top Pocket for home or nursing home visits. This can then be re-synchronized back into the Best Practice database.
Pulse+IT: What Best Practice features are new users attracted to?
With Best Practice, I have tried to get back to the concept of a program that is focussed on the needs of practicing GPs. I still practice 12 hours per week myself and I think that this keeps me in touch with the issues facing GPs in daily practice.
Some of the features of BP that are particularly worthy of mention include:
- No advertising.
- No intrusive prompts.
- Comprehensive family and social history.
- Live drug database updates are performed on the server only. No need to log users out of the system during the update.
- Flexible, intuitive prescription module.
- Full occupational history.
- Progress notes that include images. The images then stay in place within the notes when they are inserted into letters etc.
- Multiple reasons for visit can be recorded.
- Flexible Past History entry.
- The Autotext feature includes character formatting and bulleted/numbered lists.
- Percentile charts using Australian data.
- EPC module including 45-49yo Health Check.
- There is a single Inbox for incoming reports for each doctor with flexible notation of results and the ability to allocate incoming reports to either the Investigations section or the Correspondence In section.
- Reminder system including comprehensive management of previously sent reminders.
- Doctors To-Do list.
- Internal messaging system.
- Highly customisable user permissions.
- Patient records can be made confidential within the practice.
- A very flexible Search utility allows SQL queries to be run against the database. This enables very complex searches and searches on criteria other than the supplied preset ones to be performed.
Pulse+IT: Which competing programs can you import data from?
Pulse+IT: How is the data conversion performed?
We install the conversion program into the Best Practice section of the Windows start menu. When it is run, it prompts for the location of the MD2 data to convert and then starts converting it. The MD2 data can be either in its normal DBF file format or in a zipped backup. No changes are made to the data during the conversion, but we do have to modify some of the indexes, so we do not recommend that the conversion is run on the practices live data. The size of the converted data is roughly the same as the size of the uncompressed MD2 data, so you need to ensure that you have enough free disk space before starting. The conversion takes approximately 40 minutes per 5000 active patients on a reasonably powerful computer. The largest sites we have converted have had over 130,000 patients.
Pulse+IT: In addition to your own practice management solution, do you allow other solutions to interface with your clinical product?
Yes. We recognise that many practices are happy with their existing PM system. Ours is very new and may not yet have all the features that their current system has, so we are able to link BP Clinical with any other PM system that can share data via the patients.in file format. This includes most of the systems currently in the Australian market.
Pulse+IT: Which secure messaging products does Best Practice integrate with?
BP creates HL7 REF messages that can be interpreted by programs like Argus, HealthLink and Medical Objects. These programs can determine the addressee from the HL7 data and then encrypt it appropriately for transmission to the correct person.
Pulse+IT: How is training and support provided?
All support is via telephone or e-mail. We have an after hours roster of the support staff to ensure that someone is always available, particularly on weekends when most conversions are performed. Because our philosophy is to keep program and drug database updates separate, we do not have to rush out program updates to coincide with the date that the drug database changes take effect. This means that we can test program updates and release them when they have been thoroughly debugged. Consequently, we give the user a stable program and at the same time minimise our support load.
For training, we have a series of training DVDs that we provide free to our customers. BP includes a comprehensive help file and the CD contains an extensive series of FAQ documents explaining how to perform common tasks in BP.
Pulse+IT: How many people make up the Best Practice team?
We are a small team, currently 9, but we have a lot of experience in developing and supporting medical software, with 7 of us having previously worked within the industry. There is no strict division of the staff into development/support/documentation roles. We all contribute where necessary and I am on the after hours support roster myself. We do not have an automated telephone system, so support calls are answered by real people who can generally help immediately. Our ratio of staff to users is higher than that of our major competitors and that enables us to provide a better quality service.
Pulse+IT: Overview your pricing structure.
$1100 per practice to purchase the application plus an ongoing annual fee that starts at $550/full time doctor/year. The management module is an optional extra costing $275 per full time doctor/year. We use a sliding scale and the annual fee reduces slightly as the number of users increases.
Part time users are generally charged half of the full time user fee (depending on the average hours worked per week).
Anyone interested should contact our sales desk by phone or email for an individual quote.
Pulse+IT: In addition to the Best Practice licenses, what other costs may practices have to meet?
The vast majority of BP sites are using either MSDE or the newer SQL Express. These range from small sites to very large practices (with 30+ doctors). Practices with very large databases may need to move to the full version of MS SQL Server, although at present, we have very few sites that have needed to do this. Most of the sites that are using full SQL Server had already purchased it as part of the MS Small Business Server package. There are no special OS or hardware requirements. Obviously the hardware required will vary depending on the size of the practice. Since the server processes all of the data in an SQL based system, it needs to have plenty of RAM and fast hard disk access. The workstations dont need to be as powerful, and as a rule of thumb, a workstation that runs MD2 adequately will run BP as well, so practices changing from MD2 do not need to replace their workstations. There are more detailed hardware specifications on our website.
Pulse+IT: How frequently does Best Practice release drug updates?
We release drug updates to coincide with the PBS changes and these are currently being produced monthly. They are available on our website for download. For practices with poor internet connections, we can supply the updates on CD. Our updates only need to be applied on the server and can be done live without needing to log anyone out of the program during the update. Generally, the whole process can be performed in under 10 minutes and can easily be done by IT competent practice staff.
Pulse+IT: How frequently does Best Practice release program updates?
There is no set interval for our program updates. We supply them independently of our drug database updates. This means that we can test them extensively before releasing them.
We aim to provide at least 2 program updates per year, but sometimes we may have to release a minor upgrade to incorporate a change required by Medicare e.g. the Streamlined Authority System, or a change to the immunisation schedules.
The program updates are available both on the web and as a CD.
Pulse+IT: Is professional IT assistance required to perform these updates?
Not if the practice staff are reasonably computer literate. Program updates need to be done on each computer. The installation program auto-loads from the CD and it is then a matter of following the prompts. Of course a backup should always be performed beforehand.
Pulse+IT: How many practices are currently running Best Practice?
Approximately 2000 users at 300 sites.
Pulse+IT: What new features are you working on that Best Practice users should look forward to?
Our current focus is on finishing the Online Claiming module. After that we intend to do some work on the clinical module, particularly the skin and Musculo-Skeletal sections. We also intend to enhance the management module further as we get feedback from the initial users.
We will also be incorporating the Streamlined Authority prescribing initiative that Medicare Australia are introducing from 1st July. This allows us to automatically populate the Authority approval number on the prescription, saving the doctor from having to ring for approval. This will apply to around 200 of the more commonly prescribed drugs that require authority prescriptions and I think it will be a major time saver for GPs.
Posted in Australian eHealth