If you view practice management software as a cash register, it is time to get with the program. Practice management software has the potential to improve efficiency in the veterinary hospital, improve patient care, and even improve your bottom line. To achieve that goal, however, practice management vendors and other equipment providers are going to have to work together to provide you with the functionality you need.

Recently, AAHA convened a group of veterinary practice management software providers, imaging equipment providers, and veterinarians to encourage and increase information flow and interoperability in the veterinary hospital.

To understand the direction practice management software is headed, veterinarians and practice administrators need to understand that there is great potential for an expanded computing environment and we have only just begun to realize what is possible.

The need for information flow and communication

To understand why information flow and communication are as essential to your veterinary practice management software as they are to your day to day life, consider the ATM (automatic teller machine). Years ago, you could only get cash from the ATM at your local bank. You couldn't' just use any old ATM, you could only use the ATM at your bank. This was a hassle, and you certainly couldn't expect to get money out of your ATM while on vacation in Yugoslavia.

Then something happened. Banks realized that you wanted to use any ATM anywhere in the world. So, at some point they got together and decided to agree to use an agreed upon method of information flow and allow their users to access their money regardless of which bank they used. Now you can access your money on an ATM in Chicago, the Czech Republic, or China.

Currently, most software runs like a bank that won't allow you to use another bank's ATM machines. My bet is that you would switch banks if you could only get money from your bank's ATM. Currently, the different practice management software products speak their OWN language and really don't do a good job of talking to one another. It is obvious why you would want to have your bank's ATM talk to another bank's ATM, but right now, it may not be apparent to you why your hospital management system has to be able to communicate with the outside world. Keep reading…it will!

• What if your practice management software could talk to the outside world???

• If your practice management software could speak with other practice management software and other software entities, such as your digital radiography system or your outside laboratory service, annoying everyday hassles would be minimized, and you and your hospital team would be more productive.

• What if you could use any outside lab service and have patient lab reports automatically sync with the patient record and automatically bill the client?

• What if you could use any digital radiography system with any practice management software vendor and automatically bill the client when radiographs are obtained?

• What if you could automatically request a teleradiology study from any teleradiology service provider and have the report automatically reconcile with the EHR/PMS and invoice the client?

• What if you could automatically send the patient record to the local referral hospital and automatically have communications from the referral hospital sync with the patient record in your hospital?

• What if you could buy additional "modules" to add functionality to your practice management software without switching practice management software vendors?

All of these scenarios are theoretically possible but it is going to take a great commitment and effort by the practice management vendors. In April Dr. Charles Cohen attended the AAHA Electronic Health Records Task Force Summit. Dr. Cohen states this meeting has been 15 years in the making. For so many years vendors of any sort of information tools more or less tried to pretend that the others weren't even in the same exhibit hall. Now, because of the costs and problems associated with accessing and managing data, information and knowledge appropriately there is great willingness among the vendors in knowing each other, understanding each other's problems (which are essentially the professions problems) and working towards solving these problems efficiently. This means that by working on problems together, especially the standardization of so many aspects of the health record and communications protocols, they can develop solutions less costly and more timely.

As Dr. Cohen points asks, "What are examples of standardization? Pick the simplest thing one can do - enter the breed of the animal into the client information screen. As of last counting there were 27 ways of spelling Dachshund. Forget all the other breeds! Things like that confound vendors and make life miserable for relating various software modules, laboratories, etc. Speaking of which: how many DVMs have sat and looked at the laboratory results printed out by their in-house analyzers and then tried to match them up to a report from a referral laboratory two days earlier? All while a client is thumping their fingers on a table or your assistant is telling you about three other things that need doing. It's impossible. Believe it or not the solution is not easy. Idexx for years now has been working toward being able to generate reports from their regional labs that line by line are the same as the reports generated by their in-office VetTest and various other analyzers. It is not that Idexx hasn't done it well; it is just that the problems are significant; and they are compounded by the fact that standardization has not occurred. It is not just something that AAHA and various societies, etc. across the profession must come to grips with, but also in which vendors agree too. I.e., some issues, such as the line by line presentation of lab reports are not major enough for AAHA to deal with; but, they are nevertheless very important and require vendors to be able to understand, discuss and resolve."

What needs to be done to move forward?

The next step in the process of achieving the goal of open communication in and out of practice management is to develop a standard of communication that all practice vendors can use. In human medicine, there are a number of standards that are used. Currently, there is discussion about how best to develop a standard and which of the available standards would best suit the needs of the veterinary profession.

It is likely that the veterinary community will follow the lead of the efforts made on the human side. In human medicine, the IHE is devoted to this type of efficiency and integration in the human space. The IHE depends on standards such as HL7. For more information on the human IHE please visit http://www.ihe.net.

On the human side, connect-a-thons have been organized to demonstrate the ability of different pieces of equipment to communicate with one another. There is a large veterinary organization that has even shown interest in creating a veterinary informatics connect-a-thon to help guide veterinarians in choosing equipment that can improve the workflow in the veterinary hospital.

These are exciting times in veterinary informatics. It is not an overstatement to say that the way we practice veterinary medicine is about to change as a result of the efforts of AAHA and several dedicated veterinary equipment and practice management vendors.

If you would like to help, simply tell your practice management software vendor that this type of functionality is important to you.