3 Obstacles to going Chartless in Dentistry; and how to get around them!

Well, it's no secret. Chartless dentistry is coming, fast and furious! It's not a requirement in dentistry yet (unless 30% of your practice is treating Medicaid or Medicare patients), but at some time in the future, it's going to be. Let's look at your practice. Have you started the process of eliminating paper from your chart yet?  If not, it is highly recommended to begin.  For eliminating a chart in an existing practice with hundreds and even thousands of charts, the process is best done over a longer period of time. Most of the chartless practices today are new ones; that have been built from the ground-up to practice electronically. As for the 25-year old practice that has been pulling, stuffing, and filing charts since its inception, it's going to take some time; and certainly lots of planning.

This is not going to be a "how-to" article on how to go chartless. There are just too many variables that are different for everyone. A strategy should be developed with someone that has the proper expertise, like a Dental Technology Integrator, software trainer, or a practice management consultant. As for any financial investment that would need to be made, there are only three “Main ingredients”; an adequate Practice Management system, a Digital X-ray system, and a computer in the operatories. Most practices today have all three of these already, making the transition fairly painless from any large monetary investment.

This article, however, is about the obstacles that the typical doctor has created for themselves, in order to move forward (Or to at least begin the process). But here is a secret.....most dentists don't even realize that they have already started the process.  There are quite a few technologies that have already been adopted into the practice that have already set the ball rolling, eliminating pieces of the paper chart and turning them into bits & bytes and one's & zero's. Take for instance, electronic claims. There was a time when we used to manually fill out a dental claim form, and then make a copy for the chart. Then there is the innovation of digital x-ray technology. Almost 75% of all practices have already eliminated x-ray film mounts from their charts. So let's keep it going.

As a dental IT consultant, my daily conversations with clients and prospects will always lead to a discussion about going chartless.  At this point in the evolution of dental technology it certainly should be a goal of your practice.  If it’s not, you will do one of two things after reading this article. For one, you will call your IT support professional and start the wheels turning (even at a slow pace), moving your practice more and more towards “chartlessness”.  Or, you will create one of the three most popular obstacles for yourself in order to not move forward; or to even stop the movement towards eliminating a chart in your practice.

Obstacle 1: Nervous about losing data or patient records to a crash!

Obstacle 2: Doctor or staff’s computer skills are not adequate.

Obstacle 3: The computers or computer network are not stable, slow, or unreliable.

These three obstacles are real, and I hear at least one of them in any given day. Chances are that you are using one, two, or all three of these reasons to keep your practice from moving forward. These are obstacles that you probably have not received good answers to, or you never asked yourself the question. So, let’s address them now; very simply and adequately.

Obstacle 1: Nervous about losing data or patient records to a crash!

This is a very real concern. Losing patient records is a real issue these days, and every healthcare provider with a computer should take this one very seriously. In the industry, we call this a data breach. And data breaches in the healthcare community are now subject to huge fines and serious consequences for losing someone’s patient record; but that’s a different article, for a later date. Getting past this obstacle though, is very easy. BACK IT UP!

Please take the time out of your busy practice to meet with a skilled computer professional to design an adequate, full-proof backup strategy. Your strategy should include at least two (2) backup systems, with at least one (1) of them having an offsite option. Also, as a chartless office, it is not only recommended to have a regular backup system, but you should really make the investment in a Backup/Disaster Recovery (BDR) system. A BDR will not only backup your data, but it will also include technology that allows you to deploy a backup server if ever needed.   As long as you take this strategy very seriously, and do the research to learn what your technology support company actually recommends and supports, you might never have to worry about this obstacle again.

Here are two very important hints for success to make note of:

First, test your backup system, including manually restoring data on a monthly basis.  Second, have the backup system monitored. Most IT firms offer backup and server monitoring these days

 Obstacle 2: Doctor or staff’s computer skills are not adequate.

This is tough one; even tougher than data security. There is a real human element to this obstacle, which may lead to some tough decisions about the practice’s personnel.  Computer skills are skills that are pretty much a standard necessity these days, not only in dentistry and healthcare, but in any profession. Computers are here and are not going away. If anything, they are becoming more involved in our lives. I hear this obstacle pretty often, and it’s not just from the older generation of doctors. We have seen some pretty young doctors, both male and female, who admit that they have very weak computer skills.

 Make no mistake about it; if you’re going to have a chartless office, you are going to either need very good computer skills yourself, or have staff with very strong computer skills.  I have seen many offices get by with a doctor that did not have the skills to work the computer in the operatory himself, but the routine with his assistant had to be redefined and adjusted to compensate for the doctor’s lacking skills.

 Here are two very important hints for success to make note of:

First, is to get training…and the second, is to get MORE training. Training has been such an important factor in the success of the transition to Chartless Dentistry. If you think you know everything that your Charting program can do, wait until you realize what it can do that you are not even aware of. Furthermore, there are many customizable features in your software that HAVE to be setup and personalized for you before you even begin.

 Obstacle 3: The computers or computer network are not stable, slow, or unreliable.

OK doctors; brace yourself. It’s time to hire a legitimate IT firm, and one that has adequate experience with dental technology. Once you have decided to move in to the chartless age of dentistry, it’s time to get rid of the part time friend or patient who takes care of your computer network for you.  Or, it’s time to give up that that “Do It Yourself” responsibility of being your own computer technician.

 My company has recently gone through a major philosophy change, which included investing in new software and tools to become more proactive for our customers, as opposed to reactive. Our old ways of doing business are gone. Hiring people to answer your calls about a computer not working, or a network down, is a thing of the past. We changed this reactive way of doing IT support because by the time we receive your call, it’s too late!  At this stage of the game with dental technology, down systems mean no productivity, no patient treatment, and lost revenue.

 The answer is simple. Catch the issues before they bring down a computer.

 The way to do this is to work with a company that actively monitors your server and monitors your network; watching for issues and failures that can potentially bring down a computer. For instance, most people do not realize that hard drives give off a distress signal, sometimes up to 6 months prior to it ever going down. So, if it’s possible to avoid going down, why not be proactive and avoid the catastrophe?

 The obstacle you create about your unreliable computer network can be eliminated by doing two related things. First, work with a reputable computer consultant, preferably in the dental community, that offers remote monitoring and support. It will be very critical in keeping your chartless practice running smoothly and efficiently. Secondly, you should put together an IT hardware plan that promotes obsolescence and reliability, consistently refreshing slow and old computers in your practice. There are very easy ways of doing this so it’s not too hard on the wallet, or purse, if planned correctly.  Don’t be scared about taking out a lease on your equipment. Why own computers these days? I don’t!

 So, that’s the 3 Most Common Obstacles that dentists create in keeping their practices from moving forward with “chartless dentistry”. I’m sure there are others, however, this would be a good time to schedule a consultation with your IT Support firm or Software vendor to see where your practice is at with your charts. And take that knowledge one step further by putting a plan in place to slowly start eliminating the paper inside of it. So when being chartless is required, you will be there already.

Jeffrey Weiss is President and partner of High Tech Innovations, LLC, the largest dental integrator in the NY tri-state area; currently supporting 600+ dental practices. High Tech Innovations prides itself on not only knowing IT and technology, but also understanding the field of dentistry. They are certified as installers by most of the largest dental technology companies in the profession. Weiss can be contacted at (973)889-0030 or at jeffw@hticonsultants.com.