6-Apr-09 1:00 PM EST

Stuck in the Stone Age of Paper Charts?

by Belle DuCharme CDPMA

Still struggling up the paper chart mountain? You might as well write it on stone because that is as “with the times” as you are. Recently, I read an article in a local newspaper that “fluffy” toilet paper is not made from recycled product but from living trees because living trees produce a softer touch. To save trees, I will live with regular tissue. What is going to make you quit the paper and go chartless in your practice? As senior trainer for McKenzie Management’s Advanced Training Courses, it is apparent to me from the feedback of business teams that they are being held back on this technological advance by their employers. Hungry to use more than the typical 20–30% of their software program, they ask me, “How can I get my employer to go chartless and start using the clinical chart, treatment phasing and the periodontal module in the computer?” If saving a tree is not sufficient motivation, how about saving money?

Doing double entry becomes troublesome when time management is a barrier to better productivity. In many practices, doctors don’t seem to mind that the business team has to keep records on paper and digitally for accuracy. These same practices often employ extra staff to pull charts and then file them back at the end of the day, along with letters, radiographs, etc. Paper is becoming more and more expensive—as is the square footage to store all those charts. There is a lot of waste in this system. What are people waiting for? The doctor is afraid of losing all of the information should the computer go down. Or, When the computers are down we cannot get into the files, but if we have the paper charts, we‘re saved, say the trainees.

How many offices have emergency generators for electrical blackouts? If the fear is a computer crash on a daily or weekly basis, you need to get a computer support person in there who can troubleshoot your network or wiring issues. It is always wise to have someone with these talents as a member of your team or at least have a relationship with a company that has agreed to respond to your call promptly. But most offices say that they rarely have such problems (or they are short-lived at most) and that this is a small annoyance when you consider the efficiency of managing data electronically. Replacing paper with digital is not a trend that is going to end. Eliminating the need for a paper chart is something that is achievable now. We will still have to deal with paper but it will be a molehill and not a mountain.

What is the best plan to achieve this change without upsetting the flow of the office? Look at every piece of paper and form used to create the paper chart and then match it to its digital counterpart in the software program. Most offices have the appointment scheduler and the ledger posting under control and thus have eliminated the large paper appointment book and the pegboard system of tracking charges and payments. This is the first step. Keep up with software updates to keep your system support ongoing. If you have an old computer system, you will most likely need to upgrade to a system with full operating modules that handle insurance estimating, e-claims, tracking, and treatment planning and maintain a recall system and patient retention information. Your system must be compatible with the digital program that you intend to install. You must have security for the transfer of patient data and a fail-proof back-up system that is off site for best protection.

In the clinical operatories, computers and monitors are necessary for the clinical team to enter treatment plans and to record clinical notes. Hygienists must have a computer and monitor in order to record periodontal charting and recommended treatment notes. Having a system that allows for full integration of digital x-rays and intraoral photos is necessary to make accurate diagnosis and impressive treatment presentations.

Changing old habits is the biggest challenge, but realize that there is a learning curve to anything new. Keep focused on the benefits that going chartless will bring. Some of these benefits are

reducing payroll and paper supplies overhead
never losing or misfiling a chart again, and accessing it at anytime, anywhere in the office or via remote access
better communication, and no more worries about misspelled words, poor grammar and illegible handwriting
a more sterile environment—paper charts collect bacteria and cross-contaminate staff and patients
space savings—you no longer have to pay to store charts or to shred them many years later
better retention of records with scanners to keep everything organized in one central location
faster filing of claims without the hassle of copying, stapling, envelopes and postage
better treatment presentations for patients and education for staff with digital x-rays and photos that can be enhanced for increased visibility and understanding

So get out of the Stone Age of paper charts and get into the cleaner, more efficient digital solution. For help implementing new systems, contact McKenzie Management today.

Reprinted from www.mckenziemgmt.com