How to Assess Ophthalmic Software Systems & Avoid Buyers' Remorse

Every ophthalmic practice has purchased a software product or system that doesn’t meet their expectations (if you haven’t, you belong in the software hall of fame!). Having spent most of my career building software and providing software to others, much of which has been with medical practices, I offer you these suggestions for the next time you need to make a buying decision. 

4 Immutable Rules

When assessing software, keep these four immutable rules in mind: 

• No software solution or company is perfect. Each will have strengths, weaknesses, solve certain problems better than others, and so on. Bring this understanding and knowledge to every sales call and/or buying process you undertake.
• ‍No software buyer will be able to understand everything or know all the right questions to ask to determine the pitfalls and avoid making purchasing mistakes. Write a list of mistakes you want to avoid and dig into those areas deeply during the buying process. 
• Most software will have more—features, bells, whistles, tools—than you will ever need or use. What are the core features and how do they actually meet your needs? 
  
• You might not know what you need. What most software buyers think they need might be a mismatch between what is needed and what’s being offered. Know how to anticipate a potential mismatch—and how to correct for it. 

What Can Go Wrong During A Purchase

Companies generally tend to make three mistakes when purchasing software: not negotiating flexible contracts, holding erroneous performance expectations, and not clarifying the exact need, nature, or uniqueness of the problem they want software to solve. Here, a list of the specifics, with remedies to right the wrongs. 

Long-term contracts without a way out. Ask for a trial period, negotiate a shorter term, and make sure you have a way out of the contract if the agreed-upon services or the reasons you are purchasing the software are not being fulfilled. Maybe there is a specific way to set up templates for your provider, interface to a different system or piece of equipment that must work so that this succeeds, or access a level of support or responsiveness critical to your business. It’s a red flag if your vendor won’t make certain commitments in writing or at minimum get you comfortable with important issues prior to closing. 

Expecting certain features to solve a problem perfectly. Speak with others who are solving this exact problem with the software you are considering buying. Speak to the actual users if possible, not the managers or executives. Look at the reports and understand precisely how you handle and work the exceptions and tasks that require human intervention. Walk through the process with someone currently using the solution and think about how it relates to what you do today.

Expecting a software solution to have everything you need and work perfectly. Ask yourself (and a sales rep or even other customers) this: Where are potential friction points in my list of needs or problems? If you have not identified these, that’s a red flag.

Expecting interfaces to perform perfectly with disparate systems, or even within a common family of systems. Speak to customers who have the interfaces already and understand the limitations, or work with an expert system integrator who gives you straight talk on what can and can’t be done. Be super-specific on data points that need to flow over and why. For example, maybe you need an identifier to match up patients, or a document to be available in both systems. 

Everyone has purchased a software product or system that doesn’t meet their expectations. Here are suggestions that might be helpful the next time you need to make a buying decision.

‍Not recognizing the amount of human work involved in implementing a specific feature, tool, or system. Successful implementation (the key to getting the most from your purchase) takes effort, planning, dedication, and an implementation leader on your team. Understand the complexity required, including set-up time, resources, and ongoing system management. The more flexible and complex the system, the more set-up time involved and the fewer process changes required; the less flexible the system, the less set-up time involved—but more internal process changes will be required. Having the right key person on your team might be the important decision you make for successful implementation. 

Not being clear on what is most important for your organization regarding this software purchase. Are you most focused on increasing charting speed, getting paid faster, or reducing paperwork at the front desk? Each of these is a different problem and most likely you will not get all of them solved perfectly in a single solution or product suite. Get clear on this with your team before making a big change or purchase. 

Expecting a software system to solve a problem unique to your situation. Short of custom coding, most software doesn’t address unique problems. For example, maybe you love a specific community insurance provider in your area or have an old piece of equipment that won’t talk to newer systems, or a vendor you love who doesn’t work with a lot of medical groups. Be clear on how important nuanced or unique problems are to your business and understand what sacrifices (financial, people, time, etc.) you can devote to solving them. 

Ensuring Success, Pre- and Post-Sale

Taking these six steps will ensure a successful software purchase:‍

‍Be clear on what’s most important—and why. ‍

• Limit your core needs to three (or fewer) primary things. 
• Tie these core important needs directly to economics and ROI.
• Don’t focus on checking all boxes; if possible, focus on solving what matters most with one or two solutions. ‍

‍Be skeptical. 

• If you are not clear about the product’s weaknesses, you have not done enough work. Hold off buying. 
• If you think a product does everything well, there is something wrong. Do more homework to identify potential problems, shortcomings, and friction points.‍

Speak to others, get referrals, and look at reviews. ‍

• Ask to speak to customers who have been unhappy and find out how their problems were resolved, and/or find people you know and trust who use the product. 
• If customers or referrals don’t detail the product’s or company team’s weakness(es), be skeptical. Ask follow-up questions.
• If no one has told you any type of weakness during the evaluation process, be skeptical. ‍

Don’t underestimate the implementation process. ‍

• Understand the intricacies of the implementation process from start to finish and make sure you have quality resources, time, and dedication available. I can’t tell you how many times I have seen misconfigured systems or tools not set up correctly to help a practice accomplish what it actually needs. 
• If someone tells you implementation is not a fair amount of work and vitally important—be very skeptical. ‍

Negotiate contracts well. ‍

• Identify key features, integrations, or other important aspects being added. If possible, insist on these elements being spelled out in the contract. 
• Have some expectations and an exit clause if the implementation is a disaster or the provisions or services don’t meet your needs or expectations. ‍

Expect some mistakes. ‍

• Know you will make them. Be aware of your own shortcomings and how they might contribute to mistakes. 
• The smaller the cost, the less important it is to worry about making a mistake. The bigger the economic and ROI impact, the more important it is to have a way to get out or hold the other party materially accountable for delivery.

This article first appeared in Administrative Eyecare Vol. 32 No. 6, November-December 2023, and is reprinted here with permission from the American Society of Ophthalmic Administrators (ASOA).‍

Please contact Megan Odell, ASOA Executive Director, ASOA (megan@asoa.org) for any further permissions regarding reprint or distribution. 

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