I said last time that I was going to talk about radiology billing systems. We just went through the process of acquiring a new billing system.

Having spent 14 years of my career at IBM, I know a little bit about selecting software. The last time we made a software selection, we had a very short window in which to make a decision. This time around, we made sure we looked at it from every angle. The first thing we did was spend a lot of time at conferences and trade shows talking to rad groups about what they were using and what they liked/didn’t like. After about two dozen conversations like that, you begin to see that, in our opinion, there are three real players in the radiology billing software market; Imagine, Amicas and Zotec.

As you probably are aware, in April 2007, Amicas purchased a copy of the Imagine’s source code so the two systems look and feel the same. Since that time, the two companies have gone in two separate directions. There are many minor differences between the two systems, but the main differences we found were in how they packaged and priced the product.

Amicas has a one-stop shopping approach, while Imagine tends to partner with outside vendors. There are pros and cons to each approach. One could argue that if you focus on your basic apps and get best-of-breed vendors whose job is to be the best at their niche that is the right approach. However, it is always nice to have one phone number to call for any and every problem. In the end, this difference was not a major factor in our decision

We did not look at Zotec. During that period we were asking everyone we could find to tell us about their billing software experiences, we kept hearing how good Zotec’s software was, but we also kept hearing other stories that scared us away from even considering them. I wish I felt comfortable elaborating, but I don’t for a lot of reasons.

Our key decision criteria were as follows:

• Functionality of Base Billing System
• Price
• Annual Support Fees
• Statement options
• Electronic filing options
• Financing options
• Cost and Effort of Bringing on New Clients
• Conversion
• Partnership options
• Intangibles

As you can see, as a billing company, we will have a slightly different focus than a rad group. For example, unless a rad group is also going to bill for other groups, the cost and effort of bringing on new groups is a non-issue while integration with existing RIS/PACS may be a huge issue. These differences need to be factored in.

In my opinion, the Achilles Heel for both systems is their conversion options – or lack thereof. Conversion of existing data is expensive and cumbersome. One of these days I hope to make conversions to Amicas or Imagine a core competency of my company. There is a need, for sure.

If there was a key to my decision, it was mapping it to my business plan. I took my eight year business plan and mapped it to the proposals I received. In the end, it looked like a spreadsheet trying to land a man on the moon, but the results were the deciding factor. I factored in all the costs for new hospital interfaces, new licenses, planned price increases, etc. It really brought to light all of the nuances of how the two companies price and package their software, services and maintenance. Again, this will look entirely different for each company, but I highly recommend the exercise.

In the end, we settled on Imagine as our vendor of choice based on our business plan and selection criteria. It only became apparent after we did all of our homework.

To close, let me say that one option not discussed here is to engage a consultant in the software selection. We felt competent to do it ourselves, so there was no need for outside help. However, there are plenty of radiology specific consultants out there who can give you another pair of expert eyes on your software selection. Although I am not interested in acting as a consultant, feel free to call me if you want a few names or to chat about how I went about it.