A multispecialty clinic does not become complicated because it has several note templates. It becomes complicated when one patient moves from front desk to one doctor, another department, a test, billing, and follow-up without anyone losing the thread.
Buy software around those handoffs. A long module list can still leave staff retyping names, doctors hunting for prior notes, and billing guessing which department owns a charge.
Draw five patient journeys before the demo
Use journeys that actually cross specialties. Keep them synthetic during procurement.
- A new patient sees general medicine and receives an internal referral to cardiology.
- A returning patient books dermatology with changed contact details already known to another department.
- A child sees paediatrics while a guardian handles registration and payment.
- Two consultants contribute to one episode but need separate authorship and sign-off.
- A patient moves between branches and later requests a correction or copy.
For each journey, mark the owner at registration, scheduling, consultation, orders, results, billing, follow-up, and correction. Then make the vendor run the entire path. Slides do not count.
Keep one identity and governed specialty views
Duplicate patient identities create bad handoffs. The ASTP/ONC patient-identification SAFER Guide is written for US health IT, but its operational questions travel well: search before creation, handle similar names, review duplicates, and make identity errors visible.
Test Indian naming and contact realities. Include initials, transliteration differences, shared family phones, changed surnames, incomplete addresses, and a guardian. Ask what the system does when it is unsure. The correct answer is often a staff review queue, not an automatic merge.
One identity does not mean every user sees every detail. Ask for a role and access matrix by specialty, job, location, and task. Verify a permitted view and a denied view. Confirm that emergency or break-glass access, if offered, creates a reason and audit event.
Let specialties differ without fragmenting the chart
Cardiology, dermatology, orthopaedics, gynaecology, psychiatry, and physiotherapy do not document the same encounter. The software should support specialty templates and forms without turning the patient’s history into disconnected islands.
During the demo, change a template. Check who approves it, which version applies to new visits, and what happens to old notes. Have two specialties document the same synthetic patient. Confirm that authorship, date, source, corrections, and visibility remain clear.
Avoid a template contest. More fields can mean more clicks and more copied text. Ask each specialty to identify the smallest record that supports its work, then test the difficult exceptions.
Test internal referral as a closed loop
An internal referral is not complete when one doctor types “cardiology opinion.” The receiving department needs an actionable request, relevant information, urgency, owner, status, and result back to the referrer.
Run four variations:
- The patient accepts and books before leaving.
- The patient wants to book later.
- The receiving specialty asks for more information.
- The patient never attends.
Ask who sees each state and what closes the loop. A shared calendar with no owner can lose work just as easily as a paper slip.
Separate orders, results, and interpretation
If the clinic offers diagnostics or connects to an outside provider, map the order and result path. Confirm patient matching, ordering clinician, destination, review queue, communication, amendment, and downtime.
Do not accept “lab integration available” as a complete answer. Name the laboratory, interface or transfer method, supported fields, error queue, implementation owner, and commercial dependency in writing. Patient Square itself does not claim named lab, imaging, EHR, HL7, or FHIR integrations.
The same boundary applies to AI. A draft note, ICD-10 suggestion, or prescription draft is not a final clinical decision. The treating clinician reviews and signs what belongs in the record.
Make billing follow the clinical journey
Define who owns registration fees, consultation charges, packages, procedures, discounts, refunds, and taxes. Test a patient who sees two specialties on one day, cancels the second visit, and returns for a procedure at another branch.
Watch for hidden duplicates. A system may create one bill per department even when the front desk expects one patient statement. Another may combine charges but obscure who approved a discount. Ask for a clear audit trail and a reconciliation report.
Pricing needs the same discipline. Compare subscription, setup, migration, template work, messaging, payment fees, training, custom reports, support, storage, integrations, and exit assistance. A low per-doctor rate can be expensive after every cross-department workflow becomes a custom project.
Treat privacy as a workflow decision
Map which personal data each role collects, why, where it goes, and how patients can use the practice’s approved request and correction process. Use the official DPDP framework page as the starting point with Indian counsel and the clinic’s privacy lead.
Ask the vendor to show role access, authentication, activity logs, support access, backups, incident handling, retention, export, deletion, and subcontractors. Review contract language against the demonstrated system. A privacy slide is not operating evidence.
If a vendor says ABDM ready, stop and ask for the exact milestone certificate, product name, environment, and production scope. Patient Square makes no ABDM milestone claim today. ABDM is on the roadmap.
Use NABH’s software programme as a question source
NABH now publishes a Digital Health Standards programme for Clinic Management Systems. Its official page describes assessment of safe, secure, interoperable clinic software and sets specific eligibility and certification conditions for vendors.
That does not make every clinic buyer an assessor. It does give procurement teams a useful warning: “NABH aligned” and “NABH certified” are not interchangeable. Verify certificates on the NABH site and read the scope. Patient Square does not claim this certification.
For a non-certified product, ask the same practical questions about identity, access, documentation, continuity, security, and evidence. Judge the answers you can observe.
Run downtime and exit before signing
Switch off a dependency in the test environment. Can staff see the interruption? Can doctors continue under the clinic’s approved fallback? What queues for later, who reconciles it, and how does replay avoid duplicates?
Then test exit. Export synthetic patients with notes, attachments, author, dates, corrections, appointments, bills, and audit information included in the agreed scope. Open the export without the vendor’s application. Record the format and gaps in the contract.
The final scorecard should keep hard failures separate from preferences. A missing identity review queue is not equivalent to an inconvenient colour scheme.
Patient Square is an AI clinical platform. Practice Copilot brings the whole practice under one AI copilot — an ambient AI Medical Scribe that hands back a structured SOAP note, ICD-10 suggestions, and a prescription draft minutes after the visit, plus a bundled AI EHR, scheduling, and messaging as you move up the plan. Hospitals get Hospital Copilot.
The scope and plan boundaries are shown on the India pricing page. Patient Square does not establish every multispecialty registration, billing, diagnostic, or accreditation workflow described here.