How "paperless" are you?

[asanders]

Sorry in advance, but I need some advice. Been using OD for 2 1/2 years and love it.

We're using paper health histories, paper consent forms, etc.

From reading, I see 3 ways to really go "paperless".
1) Scan all pieces of paper into the computer.
2) Using a 3rd party program to have patients enter the data.
3) Have a staff member interview the patient and input data.

In my little rural community, probably 40% of my patients don't have access to the internet. At least that many would have difficulty if I handed them a tablet PC, laptop, etc. and asked them to fill out their forms. So, having patients input and update their data probably isn't an option.

Scanning paper seems intriguing, but a lot of work. Plus, updating would require the patient to fill out a new piece of paper.

I've noticed that when I visit my physician, they input all the data as it pertains to health histories and medications.

Here's what I'm thinking.

-Demographic and Insurance information would be easy enough to change in Open Dental directly. We do this already.
-Consent forms would be easy enough to input and use one of the electronic signature tablets for signatures. Same thing for treatment plans.
-EOB's could be scanned in without much trouble.

Health histories, dental histories, and drug information are what have me perplexed. Is there a health history form that is easily updatable? I'm thinking maybe have a paper copy of the health history that is identical to the electronic copy. Maybe have the patient fill out the initial form at the first visit and have a staff member transcribe all data into the computer copy. When it comes time to update, they can verbally inquire and check/uncheck boxes that apply to medical conditions and change medications as needed.

Ideas?

[Rickliftig]

Our office is proceeding gradually also. We went live with OD in January.

I agree with you 100% that not all patients will be comfortable with the tablet, e-forms and the internet. In central Connecticut, the dividing line seems to be about age 45-50 - over the age of 65 - ferget it (except for a few savvy souls).

Over the past ten years we have been using the Wisconsin Dental Association Forms (Thedentalrecord.com) and I have used these as models for autonote templates. A new patient is still asked to fill out medical hx, dental hx, reg info, sign sig on file/consent and HIPPA release. This year, I'm going to hopefully get the release/consent/Hippa onto signature pad/tablet. The dental/medical hx are very extensive and a fair number of patients can't even deal with the paper versions.

When a new patient comes in, the dental/medical hx is summarized in OD and of course all of the new info and charting is entered directly into OD.

Recall patients have medical hx and meds entered into OD, but I am waiting on getting signature pads before all of the clinical notes are entered. I have used the WDA forms to create autonote templates for recall and initial exams. It's now just a matter of training. When we take an fmx, it's an opportune time to convert the existing charting to digital. Or, if there is a break during the day, we will convert several charts (just the medical hx and charting/probing - no records). I'm trying not to get too compulsive about this. I have absolutely NO plans to scan in old clinical notes! They will stay in the paper chart.

I have been very successful at getting my staff to send electronic notes using the Task Lists... they have taken to it well. But I still have a problem with getting the front desk to enter things into the comm log. Both of my front desk employees are still very paper oriented - they talk on the phone and write at the same time, then they transcribe. I keep pushing (nagging) them every chance I get.

Letters from other docs and lab forms are scanned in to each chart - IO photos are imported. We do not have digital x-ray at this time, so the film is in the charts. I am trying to get in the habit of scanning lab forms - hope to generate them with the next version of OD. Rx is all from OD using tamper-proof paper. Referral letters/forms are either e-mailed or printed from within OD.

I anticipate that at the end of the year, all clinical notes will be in OD, most practice management stuff in OD. History and Registration will still be on paper. Films will still be films.

SO - not paperless, but a lot less paper.

[Rickliftig]

Also, forgot to mention EOBs... since the front desk is entering in the data to OD, we find it easier just to file the eob rather than scan it.In the course of a week, we may have to refer to only 2 or 3 of them, if that many. And of course, they are not needed past a certain time (one year for us). Several of teh companies place multiple patients on one eob and scanning this into one patients chart can be a PITA.

So eobs are staying on paper and in the file.

[wjstarck]

We are virtually 100% paperless. Patients think it's really cool, and comment on it all the time.The only paper we handle are things that are not of our making, such as letters from physicians and insurance company paperwork (such as EOBs). The staff took quickly to scanning this stuff, and now it is second nature. We have no file cabinets in our office anymore.

Someone on this forum came up with the neat little trick of laminating all of our forms, and having the patients sign them with erasable marker. Sharpie has nice ones with fine tips which work great. We'd have all of our consents converted to digital documents, which is easy to do with Adobe Acrobat Pro (not the free Acrobat reader), but the driver for our signature pads doesn't quite work with it yet. That may have changed in the last 6 months or so.

And remember, BACKUP BACKUP BACKUP BACKUP BACKUP BACKUP BACKUP. You have to be hardcore about this!!!

PS: If anyone wants to buy a couple of Hon 4 drawer lateral file cabinets, I have 2 nice ones for sale

[asanders]

Thanks for the replies.

We're going to start keeping track of how many patients have internet access. We already request e-mail addresses for new patients so I figure that should be a decent way of evaluating internet access.

In thinking further, forms requiring patients to input data are the biggest hurdle. Again, some patients could do it without help either over the internet or in the office on a computer/tablet/laptop. Those patients that aren't computer literate/knowledgeable are the ones that are my biggest concern. In those instances, I think the best solution is either have a staff member interview the patient and input the data or have the patient fill out paper forms and let the staff input the data.

Basically, I would like to skip the whole scanning process except for EOB's, letters, etc.

Is there any movement on OD's part to integrate forms such as Health Histories/Medications, Dental Histories, consent forms in a digital format or is it best to use a 3rd party software such as MedicTalk?

Thanks everyone.

[jordansparks]

Consent forms have been integrated for a while. Medical histories are far more complex and will take time.

[asanders]

So, to show my ignorance, how do I use the consent forms in OD? Are there some available already or do I import/create my own?

Additionally, I'm gathering that if I want to avoid scanning, I need to use MedicTalk or some other software? Correct?

-EOB's, letters, etc. can be scanned.
-Consents are already in Open Dental and we can use a signature pad.
-Demographic/Insurance information can be initially obtained via MedicTalk. Changes can be made directly within Open Dental?
-Health Histories/Medications will utilize MedicTalk initially and for all changes in the future?

Sorry to appear so thick-headed, but I'm trying to wrap my brain around this and my brain doesn't stretch far.

-sanders

[jordansparks]

http://www.open-dent.com/manual/consentforms.html

That shows the included consent form. You can create additional ones for yourself that are either typed out or scanned in. They can use the signature pad or a laptop that has a touch screen. Demographic info is going to be tough. If you really don't want to scan the registration forms, then you will have to use something like MedicTalk. But the receptionist will probably still have to key in the info. Paperless Technologies claims they can automate the process somewhat by using simulated keyboard and mouse tools. And MedicTalk is probably on the verge of being able to do something similar.

[Yorek]

Does anyone know if these pen tablet like Wacom's Bamboo or any other pen devices
can be used for a signiture pad or to enter drawings or handwritten notes?

[Jorgebon]

Yes, they work fine. I use an older model Wacom tablet with pen and mouse with the computer on my desk. I sign progress notes and draw on the tooth chart with it.
Jorge Bonilla, DMD