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Chapter1
ExecutiveSummary
ExecutiveSummary1-1
Chapter2
TotalU.S.PhysiciansPracticeManagementSystemsMarket
PhysiciansPracticeManagementSystemsMarketProfile2-1
Overview2-1
MarketSegmentation2-3
Stand-aloneandIntegratedSystems2-4
AdvantagesofIntegratedPPMSSystemsOvertheStand-aloneSystems2-5
RevenueForecastsandAnalysis2-5
ResearchMethodology2-5
TotalU.S.PPMSMarketRevenueForecastsandAnalysis2-6
RevenueForecastsbySizeofPractice2-8
PPMSMarketPenetrationAmongPhysicians2-10
ExistingPhysiciansUsingStand-alonePracticeManagementSystems2-11
ExistingPhysiciansUsinganIntegratedPracticeManagementSystem2-11
MarketEngineeringMeasurements2-11
MarketandTechnologyTrends2-13
PPMSIntegratedwithEMRSystems2-13
ApplicationServiceProviders(ASP)2-14
AdoptionRateofTechnologyAmongPhysicians2-14
GraphicalUserInterface(GUI)2-15
WirelessDevices2-15
IndustryChallengesandStrategicRecommendations2-16
IndustryChallenges2-16
BroaderPerspective2-16
SpecificIndustryChallenges2-17
TheNumberofClaims,F(xiàn)romthePhysicians,BeingDeniedandCancelledbythePayerCompaniesHasBeen
ConstantlyIncreasinginRecentTimes2-18
TheAdoptionRateoftheTechnologicalInnovationsinHealthcareInformationTechnology
isLowerThanExpectedAmongthePhysicians2-18
MoreNumberofPhysiciansHesitatetoUseInternetandWeb-basedSystemsasaPartofPPMS
DuetotheLackofConfidence,Safety,andPrivacy2-18
PhysiciansarenotveryComfortableEithertoUseTechnologicalSolutionsorChangeOverto
aNewerSystemfromTheirOlderPPMS2-19
TheU.S.PPMSVendorsArchitectureisHighlyCompetitive2-19
StrategicRecommendations2-20
PhysiciansShouldbeTrainedinEffectiveClaimsSubmissionsandClaimsDenialManagementSystems2-20
IncreaseAdoptionbyReducingClaimsDenials2-20
BuildConfidenceAmongPhysiciansbyIncludingaSecureandReliablee-MailasPartofthePPMSOffering2-21
ProvideWell-planned,IntensiveTrainingtoHelpPhysiciansAdapttoNewerSystems2-22
GainCompetitiveAdvantagebyDevelopingTotalCostofOwnershipandHighlightingOther
FavorableBenefitsandFeatures2-23
Chapter3
U.S.PhysiciansPracticeManagementSystemsMarketAnalysis
Overview3-1
NeedforaPracticeManagementSystemataPhysiciansOffice3-4
ClassificationofPhysicianPracticesintheUnitedStates3-5
ImplementationofNewPracticeManagementSystems3-6
TurnkeyModel3-6
OutsourcedModel3-6
MarketDrivers3-7
Reducingclaimsreimbursements,byinsurancepayers,forpapersubmissionsduetohighprobabilityoferrors3-7
Lowprobabilityoferrorsandquicksubmissionofclaimsthroughelectronicsystems3-8
RapidlyChangingGovernmentMandatesandRegulationsonthePhysiciansPracticeManagementSolution3-9
IncreasingInterestAmongPhysiciansforWirelessandWeb-basedPracticeManagementSystems3-9
IncreasingCompetitionintheHealthcareFieldAmongthePhysicians,F(xiàn)orcingThemtoStayAhead
inTreatingPatients3-9
MarketRestraints3-10
Replacingapaper-basedpracticemanagementbyelectronicsystemorreplacingastand-alonesystem
byanintegratedsystemhastheriskoflossofsensitivehealthrecorddataofthepatients3-11
CostConstraintsHinderAdoptionAmongSmall-sizedPhysicianPractices3-11
UpdatesandAnnualMaintenanceFeesConstrainAdoptionAmongMedium-sizedPhysicianPractices3-12
ComplexityofSystemCycles,HugeInvestment,andSecurityIssuesoftheDataDelayAdoption
AmongLarge-sizedPhysicianPractices3-12
DifficultiesinDevelopingConsolidatedPracticeManagementSystemSolutionsNegativelyAffectRevenues3-12
ConfusionAmongPhysiciansinChoosingaPracticeManagementSolutionDelayAdoption3-13
RevenueForecastsandAnalysis3-13
RevenueForecastsfortheStandalonesolutionsPPMSMarket3-13
RevenueForecastsfortheIntegratedPPMSSolutionsMarket3-15
PhysicianPracticeDemographics3-16
ForecastsforNumberofPhysiciansinVariousSizesofPractices3-16
NumberofFull-timePhysiciansWorkinginPhysician-basedPractices3-16
Small-sizedPhysicianPractices3-18
Medium-sizedPhysicianPractices3-18
Large-sizedPhysicianPractices3-18
MarketPenetrationofPPMSAmongPhysicians3-18
ForecastbySizeofPractice3-20
PricingForecastandAnalysis3-22
AveragePriceperPhysician3-22
AveragePriceperPractice3-23
Small-sizedPhysicianPractices3-24
Medium-sizedPhysicianPractices3-24
Large-sizedPhysicianPractices3-24
CompetitiveAnalysis3-25
CompetitiveStructure3-25
AcquisitionsofPhysician’sPracticeOffices3-26
HighlyCompetitiveMarketScenario3-26
Consolidation3-26
Namerecognition3-27
VendorDemographics3-27
MarketShareAnalysis3-28
ProductOverview3-29
AppointmentScheduling3-31
Patientperspective3-31
AppointmentCancellations3-32
ClaimsandBilling3-32
ANewBillingSystem3-32
TrainingonNewBillingSystems3-33
Chapter4
Appendix
DecisionSupportDatabase4-1
NumberofPracticingPhysicians4-1
NumberofSpecialtyCenters4-4
PerCapitaHealthcareExpenditure4-4
TotalHealthcareExpenditure4-7
The physicians practice management systems (PPMS) were introduced in the market in the late 1980s, when insurance claims of the patients in the Unites States were computerized. Though practice management systems were initially meant to be used as a computerized solution for billing and claims submission, later they started gaining importance in every function of a physician’s office to increase productivity and accuracy and also to save time.
Physicians started using practice management systems in both the front-office and backoffice operations of their practicing offices. Front-office operations included registration of new patients, scheduling appointments for registered patients, managing appointments, and for basic queries. Back-office operations included billing patients for their consultation with the physician, submitting the claims to the insurance provider, and following up the claims, and also claims management.