Web Version...Unconventionable application

[savvy]

Greetings Jordan et al,

As you may recall, I am one of the dentists on the sports medicine team of an NCAA Div I school that has roughly 900 athletes.
There are two other dentists (GP and Endo).
Each practice out of separate offices.

Each of us treat athletes at our respective offices and, therefore, the patient info/treatment is unable to be easily shared should an athlete visit more than one of us.

When the web version of OD materializes, would it be possible to set up a "practice".....
Practice Name, address, being the university entity.
Multiple providers (different addresses)
Such that patient info and dental histry could be available to view by everyone in the sports medicine dept.

It appears that the sticking point might be the multiple address capability.
(Hypothetically speaking, what kind of $$ contribution would it take to create such a feature?)

[savvy]

Similarly....

What kind of $$ contribution would it take to get an OD to NextGen EHR bridge?
http://www.nextgen.com/

[jordansparks]

Those are tough questions.
1. Technically, you can already do this. You certainly don't need a web browser. Set up a Citrix server. Set up Open Dental with three clinics, each having a different address. Anyone can access it from anywhere. With the small number of patients, the load will not be heavy, so the hardware and Citrix environment won't be too expensive.
2. Medical software companies tend to not want to waste time on integration unless they have a customer who is very serious about needing the integration. There would be some work on their end as well as on our end. It's nothing we haven't both done before, but it is effort. They will likely charge for it. We try hard not to charge for bridges, but bridges to EMRs can get very complicated. If you are very serious about making it happen, we might be able to start looking into it.

[savvy]

Thanks for the reply.

I'll place the EMR bridge on the back burner for now.

Regarding the multi-clinic Citrix thought....
Could you explain to a 3rd grader, me, what is involved or direct me to a Citrix for real dummies site.
Thanks!

[jordansparks]

I mentioned Citrix, but it's also built into Windows Server.
http://www.microsoft.com/windowsserver2 ... -home.aspx
Install the OD client program on the server. Set up user accounts. Run from any computer in the world by connecting to the server. So you really have multiple versions of OD all running on the server. Each user is connected to their very own running copy.

Also, of course, from within OD, you would set up three Clinics just to keep track of what was being done where, but that has nothing to do with the technology for allowing users to access it from multiple locations.

[savvy]

OK...
From a third grader perspective....

I'm reasonably confident that the university sports medicine department in question has computers with some sort, probably Windows, server setup.
I'm also reasonably confident that the EMR program is on one of these servers and, therefore, accessible to their multiple healthcare providers and staff.
So what I am reading from you is this....
OD can be installed on one of these machines.
In this OD program, there is a clinic set up for each dental provider location.
Question....
Does each clinic access a master database, or are there now three different databases?
Is there one patient chart?
Is there one accounting chart, or does each clinic have a separate accounting chart?
Is there one fee schedule, or can each clinic have its own fee schedule?
Are insurance claims clinic specific?

The goal, in my mind, is that freshman soccer player A gets a traumatic injury and the initial accident report is written up by Athletic Trainer A at Clinic D who then refers Soccer Player A to Dentist A at Clinic A for management of acute trauma. Soccer player A then sees Dentist B at Clinic B for endo the next day, Soccer Player A sees Dentist C at Clinic C for final restoration, Soccer Player A sees Dentist D for year post-op endo eval at Clinic B. Athletic Trainer A at Clinic D(university training facility) can view Soccer Player A's dental history after now Senior Soccer Player A gets injured again 4 years later.
Along with dental history, would med Hx updates and other info that has been entered for the patient follow the patient at each clinic?

Thank you for taking the time to answer this unique issue.

Oh yes....
What could one expect to pay to OD monthly for such a setup?
Or might there be some bargaining if OD could market as the "Official Dental Program of the C.........a G....n ...rs"

[jordansparks]

Does each clinic access a master database, or are there now three different databases?
Is there one patient chart?
Is there one accounting chart, or does each clinic have a separate accounting chart?
Is there one fee schedule, or can each clinic have its own fee schedule?
Are insurance claims clinic specific?

There is one database, one patient chart, and one account per patient. Billing is done for all clinics at the same time. Claims are clinic specific. Patient payments and insurance payments that come in can be assigned to the correct clinic. A little more effort needs to go into assigning the correct clinic and provider to various appointments. This is best handled by dropping appointments into columns that are assigned to clinics. I believe fee schedules follow from the patient primary provider and not necessarily from the clinic where the work was performed.

The fee that we charge would normally be based on the number of physical locations. For example, if there were 4 clinics, it would be equivalent to 4 support contracts. However, since we understand that it's essentially a small single practice, we would probably negotiate and lower the price to that of a single practice. But for licensing purposes, we have to track it as 4 separate licenses for separate locations.

[savvy]

So far, this sounds great.

Need for clarification:
If Doctor B at Clinic B does a procedure and bills to the insurance co, does the insurance payment go to the clinic address or the practice address?

Can each clinic scan/import images that all clinics can see? Does this include digital x-ray sensors as well (I'm not sure how the xray image part works as I am a Cliniview user)?

Simply put, I understand you to say that this setup functions similar to a regular office OD setup with multiple providers, just that multiple licenses are required and the operatories might be 2 miles apart.
Is this a fair understanding?

Again, thanks very much for this input!!!

[jordansparks]

If you set the claim to have the billing prov and the treating prov be the correct providers, then it will go to the practice address.

Yes, each clinic sees all images that are in OD. However, you will have a separate Cliniview database at each location. Cliniview will be used outside of the remote window. You could also install Cliniview on the main server to have a view-only images database for viewing everywhere. Also, Apteryx has a synch tool that can be used to keep all the images synched at all locations.

Right, this setup functions sort of like an ordinary single installation where the operatories just happen to be a few miles apart.

[savvy]

Thank you for being so patient with me.

I like all your answers.

Cheers!!