The Paperless Dental Office

This is the first in a series of posts where I will present my thoughts on how any dental office can best move from the traditional paper-based charting and billing system to a full-functioning “paperless” practice.

There have been many “webinars” and industry magazine articles written on this subject, but most have been thinly veiled advertisements for some particular office management software product. Most of those dental software products are not really capable of creating accurate, legally sufficient and HIPAA compliant patient records in my opinion. I’ll get into the “why” of that opinion in a minute.

A lot of becoming “paperless” depends on exactly how you define paperless. You can consider yourself paperless by some definitions if you simply record all your patient transactions, appointment scheduling, and other administrative tasks in electronic form. I knew a dentist years ago who was about as paperless as you could get back in those days ten years ago. He did not use any special software that was designed specifically for a dental practice, despite the availability of several popular packages available back in those days ten or fifteen years ago. Instead of buying a dental specific software package, he used Quicken or QuickBooks to keep track of all the procedures he performed on his patients and the charges for those procedures so he could keep track of all his patient billings and account balances. He even created an invoice form in his QuickBooks that looked like an insurance claim form in order to file claims with the various insurance company payors he worked with. I have to admire his dedication and computer skills in setting that system up! For his appointment book, he used the standard Microsoft Outlook calendar and he used Microsoft Office to keep a series of documents for his patients that contained his clinical notes, referral letters, case presentations, and other such items for his records.

Remarkably, this New England dentist even made up a full screen sized drawing of a basic tooth chart similar to what was normally purchased in paper form for charting back in those days. He could then open up that basic, blank chart drawing with Microsoft Paint and then, using his mouse, he could draw on the chart with a blue or red “brush” just as if he were drawing on a paper chart with colored pencils. He would then save the chart drawing to that specific patient’s folder where he could look at it any time he wanted to. At the next patient visit, he would re-open the previous chart drawing and make any changes to it as necessary and then save the modified chart drawing as a new file in the patient’s folder. Over time, this would result in a series of chart drawings for any given patient, each dated for when it was created or last edited. This allowed the dentist to “go back” and look at a patient’s chart at any point in time in his history with the dentist, a capability that some current dental programs that do any kind of charting still can’t do today!

Dental office management programs were all designed to bring all the functions just described above into one overall program that should make those tasks easier and more efficient for the dentist. Most of those programs were either DOS based programs or Unix programs designed in the early days of the 80’s and 90’s to take care of the administrative tasks (billing and account tracking, insurance filing and appointment book maintenance), and they had no way to manage the clinical records.

Today, many programs are designed to keep at least a generic version of clinical records, and a few have even developed a graphical tooth chart of sorts.
With the advent of better programs, the question now becomes “How can I utilize some of the technologies available today to eliminate unnecessary paper from my office”. Before answering that question, you may ask “Why would I want to convert my office to Electronic Records,” or to put it differently, “Why would I want to go paperless?”

The answers to the “Why” questions are fairly straightforward. Becoming paperless saves administrative expense in several ways. You save money by not having to buy all those paper products, which can be significantly expensive. You also save by not having to store all that paper that can easily be lost or mis-filed making it difficult to find when you need it next.

To me, the biggest advantage of using Electronic Dental Records is their availability at any time anywhere in the office, and even in two or more places at the very same time. The elimination of the time required to file and retrieve paper files when needed is way more significant than most offices realize, especially when a patient file is not filed correctly whenever a user is finished with it.

Then to, there are the government mandates that all healthcare providers, including dentists, must implement electronic records within the next few years, so why not start now?

Given that long introduction to EMR (Electronic Medical Records) in the dental office, and assuming that you want to convert your practice over to all electronic records, how can you efficiently and effectively accomplish that transition?

That will be the subject of my next post following in a couple of days. Check back later if you are interested in my thoughts on how best to transition to an all-electronic patient records or paperless practice. I will also post a link to where you can download an ebook of the whole process at once.