4.26.13 Issue #581 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Nancy Caudill
Senior Consultant
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Going Chartless - Not As Scary As You May Think!
By Nancy Caudill

All those paper records that are sitting on your shelves…what to do about them? It’s a daunting task just thinking about where to start. Since I don’t sell software or hardware, I am writing this article from a practice management standpoint to hopefully eliminate some of the fears that this project brings to dentists.

Reason to Go Chartless #1 - Better Use of Employee Time
Let’s do some simple math: 15 doctor patients + 18 hygiene patients (1 doctor and 2 hygienists) = 33 charts per day that must be located and placed in a pile somewhere, waiting for the day to arrive that these patients will be seen. Let’s say that, at best, it takes 2 minutes to locate and 2 minutes to file back on the shelves = 132 minutes /60 minutes = 2.2 hours/day for someone to do this task. Multiply that by 200 days/year = 440 hours or 55 days. Let’s say that you are paying someone $15/hr x 440 hours = $6,600 in manpower alone. If your practice is larger, the cost increases. A better use of 440 hours would be calling past due recall patients, unscheduled treatment, outstanding insurance claims or unpaid account balances. Would you agree?

Reason to Go Chartless #2 - Instant Access to Information
Instant access to the patient’s clinical information without having to locate a paper record. Can you imagine how great that would be? No need to ask Susie at the front desk to pull a chart for you. Susie needs to call the patient to schedule an appointment and she has information at her fingertips with a few key-strokes, as opposed to locating a chart and having the chart sitting on the desk.

Reason to Go Chartless #3 - Reduction of Clutter
Reduction of clutter - no matter how “pretty” your paper charts look, if you were to walk around your office, they are like rabbits. They are everywhere! And let’s not even think about all the employees that have touched these paper records with less than sanitary hands. Walk up to your front desk and see how many charts are sitting around taking up valuable counter space. Many offices choose to pull their patients’ charts a week in advance - although I am not sure why since the schedule changes so much. These charts are sitting around somewhere taking up space.

Reason to Go Chartless #4 - Storage Space
How many old patient records do you have in your garage, attic or a rented storage building somewhere? Hopefully, your practice continues to grow so you have more active patients, requiring more inactive charts to be removed from the shelves to make room. This makes it more difficult to retrieve an inactive chart that is not on the premises.

Reason to Go Chartless #5 - Supply Cost Savings Over Time
The investment that you make annually for all the paper that makes up a paper chart, not including the expensive alphabetic and numeric tabs, is eliminated. No need to inventory these supplies, as well.

These are a few of the primary reasons. Let’s review what it takes to make the move, keeping it simple. I am not going to discuss the investment that is needed, since this involves hardware and software.

Steps to Go Chartless - Software Training
After the hardware and software is installed, training must take place before you make the change. Training for the business team is minimal. Clinical training in order to use the clinical aspect of the software is essential. The clinical team, including you, would continue to use the paper charts and start entering the clinical notes into the computer and in the chart for a week or two until everyone is comfortable. 

Steps to Go Chartless - Digital X-ray Training
If you are not already digital, evolving from film to digital carries a learning curve for the clinical team. If you have already made the change, then the rest of the conversion is rather easy.

Steps to Go Chartless - Set a Date to Stop Pulling Charts
Do not “throw away the charts.” Your patient charts will remain on the shelves and are readily available if you need one. What will happen, however, is that on the date that you set, no more charts will be pulled. Everyone will implement all that they have learned and will rely on the computer for their information. All new patients will have their information scanned (if applicable) and saved in the patient’s digital record.

This step does require some preliminary work. Fast and small scanners are needed to make the scanning of existing information quick and easy. It is not necessary to scan everything that is in the patient’s record. Sit down with your team and determine what historical information you need access to in the patient’s digital record - these are the papers that are scanned. Some offices scan the last page of their clinical notes that are in the chart for reference. Scanning the medical history may be necessary unless you update all the patients’ medical history in the computer when they check in (depending on the software).

If you have not already implemented the use of routing forms, now is the time. Your routing form is like a small temporary chart and contains valuable information that is readily accessible so you don’t have to retrieve if from the digital record.

In conclusion, please don’t be scared that all your charts are going to suddenly disappear. You should keep them on the shelves for a period of time until you feel comfortable removing them from the office. I find this is a piece that is always missing from the doctor thinking of going chartless - letting go of that piece of paper!

If you would like more information on how McKenzie's Consulting Coaching Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com

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