The three core components when transitioning to electronic health records . . .

March 19, 2013
EHR's will save the dental office staff time in the long run

Today’s dental practices are feeling the push to go paperless from the media, salespeople, advertisers, peers, and our government. There are seminars, webinars, and publications telling us what products to buy and why their product is better … but is it better for you? There is no set standard on how to go paperless. Yes, we have a couple compliance issues with HIPAA and PCI, but other than that we are pretty much making decisions on our own. Pretty scary, huh? There are, however, three core components that need to be included in your decision-making process, whether you are purchasing new software or buying a printer . . . Efficiency, Consistency, and Security. When I am hired to help an office transition from paper charts to a paperless environment, these are the staples that hold everything together. We cannot keep our sanity or rest easily at night if these three things are not met.

It has been interesting over the years working with hundreds of offices to find that the dynamics and personalities are basically the same from one office to another. One of the biggest complaints I hear from clinicians is, “I don’t have time to enter all that stuff in the computer and I am not going to stay late.” My response is, “I don’t want you to stay late. You have a family to get home to and that is why we are going to create systems that are as efficient as possible so you can get out on time.” Efficiency saves time, money, and your sanity. No matter what practice management software or imaging software is installed, you can create efficient solutions to help the front office team and the clinical team.

Ø Make sure all your printers are networked to all workstations . . . even that cute little Dymo label writer. This will save time having to move to another computer to print out a patient mailing label or appointment card.

Ø Setup your backup to run automatically at night when no one is in the office. Not only will you get a better backup because all the computers are shut down, but you won’t have to wait around for your entire team to exit the software to get a good backup. Now you can go home at a reasonable time.

Ø Use third-party software that seamlessly integrates with your practice management software. For example, if you are going to start using electronic patient forms so patients could fill out their new patient paperwork from home, it makes sense that the information could be downloaded directly into your PM software, right? It would be inefficient if your front desk had to then take that new patient data and manually enter it into the computer. Another example is third-party communication systems. If your patient confirms from an e-mail reminder, I would expect the confirmation status to be delivered all the way to your appointment book where it would save your front desk from having to check another “portal” or “dashboard” to see if the patient has confirmed and then manually enter the status into the appointment book. Manual entry and duplicate data entry creates inefficiencies.

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Ø Create templates and mouse-driven entries to help keep the clinician’s hands off the keyboard. What slows down your clinical team more than anything is typing. If you are entering chart notes into the computer, create templates with checkboxes and default answers. This helps the bulk of the note to be written with only a few personal notes that might need to be added.

Ø For the most part, anything you do manually can be managed in your practice management software, such as tracking lab cases, report monitoring, and printing postcards.

Consistency and efficiency pretty much go hand-in-hand. When things are consistent, it takes you less time to do them. You get into a routine and routines are efficient (if they are built correctly).

Ø Earlier, I talked about creating a template system so that writing out your chart note would be faster and more efficient, but a template also creates a more consistent clinical note as well. I know (for me when I worked in the front desk) it made it a lot easier to find information if the note was written the same way every time. I could scan the note very quickly and find the necessary information.

Ø Make notes in the same places every time and make sure your team knows where to find those notes. Where do you document collection calls and/or treatment follow-up calls? Where do you keep letters from referring doctors? Where do you document personal things about the patient? These are all extremely important. When you no longer have a paper chart, you must all come together as a team and decide where you are going to document this information … and then you must be consistent with that documentation decision.

Now let’s discuss the big one . . . security. You need to be able to sleep at night and not worry about your computers, so make sure you have systems in place to give you peace of mind.

Ø Earlier, I mentioned taking the human element out of your backup system, but you also must have a warning system in place. If a human is not actually running the backup, you need to have a monitoring tool in place to guarantee that your backup is successful and the data is good. This could come in the form of an e-mail notification or a pop-up window on the computer with a dialog box with the status of the backup.

Ø In addition to your backup notification, it is also imperative that your backup be tested. My recommendation is to do a test restore every quarter. This can be done on a laptop or workstation that is not connected to your network.

Ø Internet security is not what it used to be, especially when you must protect your patient data and credit card data. Make sure you hire an IT person who understands the guidelines that have been put in place by HIPAA and PCI. For more information on PCI, go to

Here’s the bottom line … when you have efficient systems, it will give your team more time to spend with patients and improve patient care. Don’t rush things. There is no reason to be pushed into going to a paperless practice. Make sure you take the time to put Efficient, Consistent, and Secure systems in place from the beginning and ensure you have a happy, productive team walking the “path to paperless” with you.