4 minute read

Selecting a Practice Management (PM) or an Electronic Health Records (EHR) solution can be a scary decision for an ASC administrator and management team. Due to nightmare installs and subsequent uninstalls due to epic fails, the adage of healthcare administrators is, “there are two ways to make career-ending moves; change a physician’s compensation plan or implement a new practice management/EHR system.”

As a former ASC administrator, I have been through the process four times over my career, so I greatly appreciate the challenges of going through the selection process. In 2020, I set out to select a PM and an EHR for the last ASC I helped develop. I knew how important technology was in creating a thriving center, so I spent more than a year looking for the right PM and EHR to deploy in our new ASC.

I had five criteria when I started my search:

  1. Customer Support
  2. Company Stability & Trustworthiness
  3. Software Performance
  4. Number of ASCs Using the Software Successfully
  5. Price

We narrowed our choices to EPIC, Cerner, SIS, and HST Pathways. Based on my criteria and ample research, my board and I chose HST Pathways. EPIC and Cerner were not created for an Ambulatory Surgery Center environment, so those were easy to check off our list. However, I must tell you I was impressed when I saw the SIS PowerPoint presentation, but unfortunately, the presentation and their pricing were the only things that were better at first glance.


Here’s a little more detail for each criterion you should be looking for. I hope you find it helpful, and if you have any questions, I’m here as a resource for you.

Customer Support

Hands down, HST had better reviews, which is no surprise, as they rank consistently 1st in KLAS ratings (a third-party software rating company). HST provided references for me to call, and every reference I spoke with told me they were assigned a customer support rep that calls them periodically just to check-in. They also shared that if they were having any issue, they would email or call their representative, and the problem was addressed. This is the reason that HST has a 98% retention rate. In the past four years, HST has converted over 400 SIS systems.


Company Stability & Trustworthiness

I found the team members of HST that I met had all been with the company for many years, and I recently found out that there is a very low turnover with HST employees. The representative that sold me HST was more like an advisor than a sales rep; he later became a friend. He was sincere and helped me with things other than the software, and he is the main reason I am now employed by HST. Not only that, once we had purchased the system, he continued to call me and check-in to make sure our implementation was going well, which is very rare. Financially, due to their recent infusion of capital from Bain Capital, HST is as strong as they ever have been. They are adding more staff and enhancing their existing products for a true one system solution.


Software Performance

HST’s PM has been around for 16 years, and most of the enhancements have come from client recommendations. Clients can submit suggestions to improve the software, and the changes that get the most backing typically become part of the upgraded version. HST also performs quarterly software enhancements, so new and improved features and improvements are constantly added. The ASCs using HST were very happy with their revenue cycle management and accounts receivable balances. The system is built to ensure that surgery to revenue happens as quickly as possible. The HST end users all had one consistent statement, “the software is intuitive, easy to learn, and easy to use.” I went on two ASC reference site visits, one for SIS Complete and one for HST, which cinched my decision as to what software to choose. As part of an administrator’s search, a site visit is a critical aspect of the search and decision-making.


Number of ASCs Using the Software Successfully

When I was selecting a system for our ASC, I wanted to find out what my peers were using. I am a member of ASCA, the national ASC Association, and when we were searching for our new system, I attended their national meeting to ask my peers what systems they were using. Many of them used HST, and they all seemed to genuinely like it (which is rare for EHR companies). It’s also very telling that the top 5 ASC management companies reviewed and selected HST. Lastly, HST has 1,400 ASCs using their system, and that statistic stuck with me when I was conducting my research. Always ask your vendor how many successful installs they have of the version of the product you are considering purchasing.



HST was about 5% higher than SIS. Price was last on my list because some things are more important than price. There is something called the “total cost of ownership,” which includes downtime, issue resolution, surgical procedure documentation time, and most importantly, the percent of accepted claims the first time through. HST has a 99.1% clean claim rate the first time, with claims submitted via their Waystar integration. I also realized there was a reason so many people were paying a little more for HST and were not complaining about the price. When deciding on something as critical as this, price should be at the bottom of anyone’s list.


I will leave you with one final thought on the selection process. When I called references that the vendor did not provide, I discovered that it was always a better and more informative call. Seek out other peers that are already using the vendor’s system. At the time, I reached out to my peers in my state ASC association and did not find one using SIS Complete. More than half the ASCs in my state were using HST, and all of those had primarily positive feedback.

Whether you are a new center just starting, an existing center that is thinking about switching from paper charts to digital charts, or a center looking to move from a legacy-based PM system to a new cloud-based system, this is a critical decision for you. Take your time, be methodical about your process, and make sure you get buy-in from your team and physicians!


Connect with HST to learn more