6 Factors to Consider When Selecting a Practice Management System

Dan Dube

Experienced CEO in the ABA/Healthcare and Cloud Software industries

May 18, 2023

I’m fortunate to have a rather unique background when it comes to evaluating practice management systems. I am a former co-founder and CEO of both a cloud software company and an ABA business. In the last 10 years, I have reviewed just about every practice management system out there, and have negotiated contracts with several of them.

Based on that experience, here are 6 factors that I think are crucial if you are considering investing in a practice management system for your company.

(Please note: I will not make any specific software recommendations here, because each solution has their own strengths and weaknesses, and every client’s set of requirements is unique.)

#1: The system must NEVER go down!

Practice management is a “mission-critical” application. In most cases, you will have BTs taking data on tablets, and both clinical and operational management will need constant access to the system in order to do their jobs. Make sure that your contract ensures that the system will have an “uptime” of at LEAST 99.5% (the bare minimum for any cloud software application).

Last year, a major practice management software company made headlines when their system crashed several times a day. My employer at the time was affected by these outages, and it caused severe issues internally at the company.

I have a strong preference for systems that are built on enterprise platforms with large user bases that have been proven to never go down. For example, there are a few practice management systems out there that are built on top of the Salesforce platform, which has proven performance at a large scale of users globally. (Systems that run on Salesforce include Artemis ABA, Lumary, and TotalTherapy.)

#2: “All in one” is not always better.

My doctor once told me that “multi-symptom” cold medications that contain ingredients to fight different symptoms do an “okay” job at managing the symptoms, but not as good a job as the individual medications for each symptom. This analogy can apply to practice management systems. In some cases, a large system that “does it all” really only does an adequate job at each task, whereas some focused systems (like data collection) do a really great job at that task. You will need to evaluate your priorities when looking at solutions. (There are some packages out there that “do it all” really well.)

#3: Pricing models

Most of the pricing models I’ve seen fall into one of 3 categories: 1) user-based licenses with unlimited clients (the number of your staff using the system), 2) client-based licenses with unlimited users (one license for each client you are supporting), or 3) a hybrid model, where you pay for each internal user, with a surcharge for each client. In my opinion, the most cost-effective of these options is the user-based pricing model, because hopefully your practice will have more clients than staff. In an ideal scenario, the software provider should provide a different price for “clinical users” than for “admin users” (which should be cheaper, since they won’t use all of the clinical features).

#4: Be cautious of features like “labels”, which are prone to human error.

This is a little “techie”, but it is very important. As I mentioned, a previous employer used a large practice management system, and heavily used a feature called “labels” to classify and make associations (for example, which region an employee worked at, which clients were served by a specific BCBA, etc.). On the surface, this is a very useful feature for querying the system and getting quick results. The problem is that you are dependent on your users to: 1) remember to apply a label every time, and 2) apply the CORRECT label every time. This is ripe for human error. I saw many reports with incorrect financial tracking information because labels were applied incorrectly, and there was no way to validate it. This defeats the entire purpose of a practice management system.

This is another reason that I like systems based on a Salesforce platform, which is a true database. You can make data entry fields be “required”, and then provide a drop-down list of values. This helps to ensure that users must enter the data and largely takes away the ability for a user to enter an incorrect data value. Your reporting is much more trustworthy in a system like this.

#5: Read the ENTIRE contract.

In one instance where I was negotiating a contract with a large practice management vendor, I noticed that when I printed their standard contract it was only a few pages long. However, there were lots of links in that document. I’m guessing that most ABA business owners only read the 2-3 pages and then sign.

I clicked on every hyperlink and printed out each linked document, and the total contract was approximately 100 pages long! It had lots of uncomfortable things hidden in the linked documents, such as automatic contract renewals with a baked-in price increase and an automatic increase in licenses each renewal period. Make sure you always know the fine print in any contract that you are signing!

#6: Contracts are ALWAYS negotiable.

I’m not a lawyer. (That would be my brother.) But, I do know enough about the law to be aware that a contract is a legally binding document between 2 parties. Both parties have the ability to negotiate the terms. If you don’t like the terms in a standard contract from a practice management software company, tell them what you want changed. You will almost always either get what you want or reach a fair compromise.