Name of Person Completing
Survey:
Company Name:
Company Address:
Company Website:
E-mail:
COMPANY DETAILS:
Year Company Founded:
Total Employees:
Total Number of Users as of
10/04:
Total Number of Installations
as of 10/04:
Product Names (List All):
Practice Specialties Your
Products Focus on:
Is your company publicly traded?:
Is there a full working demo
available on your website?:
What database does your software
utilize?:
Do you use an open database?:
Do you encourage/allow 3rd party software
companies to interface with your system?:
What operating systems
will your software work with?:
Is there an ASP or Internet
version of your system?:
Is there an in-office or
stand-alone version of your system?:
Will your system work with a
Tablet PC?:
Will your system work with a
PDA?:
RESELLER PROGRAM:
Does your company have a
reseller program?:
(if No, skip to next section)
Name of Individual in Charge of
your Reseller Program:
Contact information of
Individual in Charge of your Reseller Program:
How many total resellers do you have?:
Average Margins on Products:
Basic requirements to become a
reseller:
PRODUCT FEATURES:
Please answer Yes, No, Limited, Planned, or
Requires 3rd Party Software
Does your software include
Practice Management Features?:
(if No, skip to next section)
** Accounts Receivable Tracking:
** Accounts Payable Tracking:
** Payroll/Timeclock Features:
** Quickbooks or Peachtree Interface:
** Credit Card Processing:
** Direct Electronic Filing of Insurance Claims:
** Payment Remittance (direct posting from
insurance carriers):
** On-Line Eligibility Verification :
** Electronic Statements:
** Customizable Statements and Insurance
Forms:
** Practice Management Reports:
** Integrated Report Designer:
** Patient Reminders:
** Export/Import Data:
** Waiting Room Kiosk (Patient Data Entry):
Additional Practice Management-Related
Features:
Does your software include
Appointment Scheduling Features?:
(if No, skip to next section)
** Interface with Microsoft Outlook:
** Allow Scheduling of Resources (i.e.
rooms, x-ray machines):
** Customizable Views/Displays:
Additional Appointment Scheduling-Related
Features:
Does your software include EMR
Features?
(if No, skip to next section)
** Customizable Exams/Pick Lists
** Patient Advice Forms:
** HL7 Lab Interface (Input):
** HL7 Lab Interface (Lab Orders):
** Prescription Writing:
** Formulary Guidelines:
** Adverse Drug Interaction Tables:
** E&M Code Assistance:
** Automated or Intelligent E&M
Coding:
** Stores Digital Images and X-Rays:
** Freeform Sketches/Annotation on Images:
** Dictation/Transcription Features:
** Voice Recognition:
Additional EMR-Related Features:
HIPAA-RELATED FEATURES:
Please answer Yes, No, Limited, Planned, or Requires 3rd Party
Software
** Auto-Logoff:
** Data File Encryption:
** Employee Audit Trail:
** Multi-Levels of Security:
** ANSI 4010 Claim File:
Additional HIPAA-Related Features:
PRICE:
Enter estimated prices, not including computer and
network hardware.
Estimated Total Cost for 1
Physician / 3 Office Staff:
Set-Up Fees:
Annual Maintenance Fees:
Additional or Optional Fees:
BONUS SECTION:
Optional
Please include any testimonials on your
products from users
here:
Additional Comments:
By pressing submit, you agree to allow us to include
your information in the InvestMed 2005 Software Comparison Matrix to be
shared with Physicians and Software Resellers across the country.
You also agree that, as far as you know, the information you are
providing is accurate .
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