by Risa Pollack-Simon, CMC
It's time to take the NO out of technology. After all, veteran "techies" have provided us with a "boiler plate" of what's working and a tremendous opportunity to learn and excel from their experiences. Likewise, software and hardware companies have enhanced the functionality of their programs and are now thinking in terms of "plug and play" flexibility and "future-proofing" their designs for optimal long-term performance.
So what's holding us back? Do we really want to continue working below optimum levels of efficiency with outdated equipment and software? Perhaps if we all better understood the dynamics involved in cultivating a fully networked facility — and the associated benefits — the process would be more inviting.
With that in mind, let's discuss the basics that have a huge impact on the success of your networked environment. The most important consideration is seamless integration. Do not even begin to consider integrating technology into your treatment environment if it is not capable of being seamlessly networked into your main operating system. An environment void of this type of synchronicity will play havoc with the efficiency and productivity of your practice, making all your efforts "all for not."
The ultimate goal of total integration is to save time and motion by minimizing the need to enter information more than once. After information is initially entered, it becomes the nucleus for all subsequent procedures, such as scheduling, treatment documentation, posting, billing, and reporting. The information should be accessible from any workstation — i.e., no more searching for charts or past entries that, for the most part, are illegible. Likewise, letters, reports, and insurance submissions can be "ordered up" immediately.
A networked system also allows satellite offices to remotely access electronic patient records. The records also can be outsourced for outcome analysis, as well as emailed to specialists for diagnosis, interdisciplinary treatment-planning, and educational purposes.
Business owners must realize that this new mode of operation requires staff input. We suggest you engage team members in the evaluation and selection process to ensure functional needs are met.
Of equal importance, each piece of technology must support operating team ergonomics, practice-management efficiency, and the delivery of consistent, high-quality patient care.
The hidden gem behind a fully networked office is that the office becomes fluent in cross-training, which ultimately supports an atmosphere of real teamwork. When each staff member can handle the majority of all patient-processing procedures, it allows the office to be less vulnerable to being short-handed during employee vacations or sick leave.
The primary objective is to shift your organizational structure from a multistation, micro-managed operation to a "one-stop" comprehensive-care environment. Decentralizing allows one person to become accountable for handling the patient full cycle. This provides the patient with a feeling of continuity, which builds trust and creates long-term loyalty. Likewise the staff can save a significant amount of time when using "single-entry" charting.
Single-entry charting also has the added benefit of seamlessly connecting treatment that has been diagnosed with a master treatment plan. The treatment plan is linked to a schedule, which is linked to the posting of charges, as well as insurance claims. Single-entry automation has been proven to minimize posting errors and streamlines dismissal procedures dramatically.
The master plan
To digitally network patient profiles and practice-management information throughout the entire office, a network connection (such as an RJ-45 connector) must be available at each computer workstation. A layout of the office, detailing these locations — as well as location of the hub and the main server — must be identified during the planning stage to ensure that nothing is left out of the network. To ensure bandwidth and speed of transmission to and from the server, networking cable (known as Cat 5 enhanced) is used.
The installation and design should be managed by a certified network installer who understands the intricacies of networking.
To fully integrate the patient record and optimize patient education and communication, an array of digital devices must be integrated. Each treatment room's central processing unit (CPU) should offer speed in performance with plenty of expansion slots for sound and video cards.
It is equally important to have accessible ports to ease access connection of external devices to appropriate ports. Laptops are not a good choice for this function because they do not provide this flexibility without great expense and inconvenience.
Offices must have a standardized scheme for positioning treatment room technologies. We have identified four zones for this purpose.
- Zone 1 manages the private, clinical computer workstation for professional staff access and is positioned behind the patient. This workstation must be adjustable for viewing. The monitor and keyboard for this unit should be mounted on an extension arm that telescopes, pivots, and tilts to either side of the chair for dual operation.
- Zone 2 manages the "open" monitor for patient viewing. It should be positioned on the wall or ceiling so that patients can view it whether the dental chair is in a reclining or upright position.
- Zone 3 manages all remaining support technology for cameras, X-ray sensors, electronic probes, and blood-pressure equipment. The equipment should be positioned for ease of access on the utility wall or side cabinetry.
- Zone 4 houses procedure-related items that are not currently networked. Handpieces, instruments, air abrasion, laser, and curing-light units are ideally part of the dental unit.
In dentistry, unbalanced seated postures and the use of intensive upper-extremity movements contribute to a great number of inefficiencies and musculoskeletal health risks. As clinical environments are modified to accept new treatment modalities, human performance factors must be employed for maximum benefit.
Optimizing networked environments demands an upfront investment of both time and money. The time and money spent in research and planning can, without a doubt, be one of the best investments you'll ever make. With greater accuracy in posting, billing, and tracking — and a huge reduction in the "information transfer error factor" — the practice experiences a revolving door of benefits. The staff benefits from a model of partnering for greater accountability through enhanced teamwork, and patients come away with a feeling of genuine continuity of care.
