Thursday, December 19, 2013
One of the fastest growing trends in dental tech is “going paperless.” Creating paperless electronic patient records is not only possible with current technology it is highly desirable. How? Take a look at these previous Emmott on Technology articles.
The Advantages of Digital Treatment Notes
Managing a Paper-Based Dental Practice is a True Juggling Act
If you want to join the trend and start using electronic records what do you need to get started?
Integrated Practice Management Software: The first essential element is software. Look at a paper chart. What all do you have in there? Forms, medical histories, tooth charts, radiographs, treatment notes, prescriptions, perio charts, financial information, treatment plans, specialist reports, lab slips, insurance information, consent forms and more. Your management software must allow you to re-create all that in a digital format as part of an electronic record.
The leading dental management systems such as Dentrix and Eaglesoft have been designed for paperless records and will work well. If you have a different management system you like and want to keep, you should seek out an office using it to make paperless records and arrange to visit and see how they do it.
Computers in the Treatment Rooms: It should go without saying but some dentists still resist putting computers in the clinical area. You need a computer linked to a server to access the electronic clinical record in any place you might have needed a paper chart. This usually means the front desk, the treatment rooms and the doctor’s office. Not only do you need computers but you need up-to-date computers.
Computers age like dogs, only worse. Dog years are supposed to about seven human years. A computer year is triple that and equal to twenty-one human years. Do the math, a three year old computer is a 63-year-old person, still working but ready for retirement. A four year old computer is an 84-year-old human, still around but well beyond normal life expectancy.
Note: New ways of computerizing a dental office are on the way. The standard server client network is being replaced by cloud based servers with local thin client computers or mobile hand held devices in place of desktop clients. These new systems promise to reduce the initial cost of hardware and the need for constant upgrades. The potential is fantastic, but for now these new systems are still developing and for most dentists seeking a trouble-free, proven system, the client server model is still the best.
Digital Radiography: There are several digital diagnostics that are nice to have, but only one that is essential to a paperless record. Radiographs are not an option. We need them on every patient. If you have film radiographs, you still need a paper folder to store them in, and you need to file the folder and then retrieve it every time you want to view the image.
The best starting point is a corded, solid state sensor and that is all you absolutely need to go paperless. At the next level you may consider a digital panoramic machine and eventually a cone beam CT. Another diagnostic that adds great value but is not essential are digital photos both intraoral and extraoral.
Scanner: How can you go paperless when the world still sends paper? Scan the incoming. You can use a desktop scanner to digitize correspondence, specialists’ reports, selected pages from the old paper chart, and even film radiographs and photos. A good HP or Epson photo scanner with a transparency adaptor will work well and cost less than $300.
Do not try and scan all the old charts. That is a huge expensive task with virtually no value. Just keep the old paper records as an archive and refer to them as needed. You will discover you do not need them nearly as much as you think you do.
Training: Even if you have all the stuff listed above if you do not know how to use it well you are not ready to go paperless. Start with basic software training. That is what you learned at the two day session you had when you first bought the system. Most of the time, we forget much of what we learned in those two days, we have not kept up with the upgrades and never bothered to train new people at all. If the dentist and the team are not competent with the basic functions of the system, trying to go paperless will end in frustration and failure.
The second level is specific training for going paperless. This involves things such as creating treatment notes, using digital forms and scanning paper to the chart. This is training with a purpose. All training starts with showing people which icon to click, but training with purpose tells them why they need to push that icon. The final result of training should not be a staff person who simply knows how to use the software, but a staff person who knows how using this software will help reach a goal and further the mission of the practice.
The final step is to just stop making paper. Many dentists have everything in place to go paperless but allow the inertia of routine keep them stuck in place. The future is coming and it will be amazing!