Overcoming Computer Phobia
by Barry Freydberg, D.D.S., F.A.G.D., F.I.C.D.
In the roaring heydays of dental computer development, any hacker with a computer and a little business savvy could set up shop as a dental systems vendor (even with no knowledge of dentistry) and expect to be successful. However, as the computer field became more competitive, many of the original fly-by-night operations matured into solid, reputable companies. Today, most of their systems have been tested in the marketplace by generations of users, who identified the special quirks of each package and encouraged the development of new features.
In some ways, competition has simplified the computer selection process. Many of the surviving vendors have made a commitment to system development and customer support. Despite this, computers are an unknown and forbidden territory for many dentists. And choosing the wrong software system can be costly, in both time and money, as well as causing considerable patient and staff frustration.
The best decisions are guided by an understanding of how each system can meet the practice's unique concerns and enhance its personality. Computer systems can be divided into three fundamental categories: basic, intermediate, and advanced. Table 1 lists the features of each system type. To fit into a specific category, a system should have at least 80 percent of the features listed for its type.
Basic Systems
Basic systems contain the essential features necessary for the smooth operation of an automated practice. In fact, if a system doesn't possess these crucial features, using it can be crippling. With the choices now available in the dental marketplace, no practice should consider buying a system with less than basic features. For starters, the system should include a patient information screen that displays the patient's name, address, phone number, recall date, date of first visit and referral source. In addition, the system must be able to track and remind the practice of medical alerts, as well as generating treatment plans, statements, insurance benefit estimates, and insurance claims and predeterminations. It should be possible to send recall notices on the system. Word processing is a basic feature, but be prepared for limitations.
Even a basic system should be able to produce well-designed reports and generate important management information. The 11 reports that no system should be without are:
- Gross practice production
- Revenue and collection
- Overdue patient and insurance accounts
- Overdue insurance claims
- Overdue recalls
- Overdue predeterminations
- Unbilled insurance procedures this report identifies any treatment that has been completed, but not billed to the insurance company.
- Incomplete dentistry a list of treatment that has been presented but not completed within a certain time span.
- Lost patients patients that have not been into the practice within a specified time period (i.e. a year)
- New patients
- Elementary tracking of referral sources
Even a system with only one terminal needs to be multi-tasked. It should also possess multi-user capabilities and allow for future software and hardware expansion. Audit trails add accountability by identifying when specific tasks were completed and which team member carried them out. Software security features should restrict access to specific features of the system. For example, you may prefer to limit the number of staff members who can make adjustments to patient accounts or view payroll information.
All systems should possess both a modem and the ability to submit claims electronically. Using a modem, a practice can take advantage of on-line software support directly from the computer vendor and have access to any present or future off-site databases. Electronic claims processing has taken a large step forward with development of EDI and the CDAnet program. Practices that are unable to submit claims electronically risk losing patients to practices that offer a faster return on insurance benefits.
Intermediate Systems
Practices that are upgrading from a basic system or need more sophisticated features may wish to purchase an intermediate system. The difference between intermediate and basic systems lies in the diversity and sophistication of the built-in features. Intermediate systems have fewer limitations and greater capability for customization.
Interoffice communications are also much more advanced with intermediate systems. For example, the receptionist can send a message from her terminal to the operatory terminal stating that the next patient has arrived. Similarly, the assistant can key in a response on her terminal, informing the receptionist that the doctor is running behind schedule and that she should prepare the patient for a short wait.
Another advantage of intermediate systems is that treatment plans can be presented in laymen's terms. The system can divide treatment plans into phases, indicate insurance coverage, and provide several options for patient statements. In addition, insurance estimates should be more accurate, as the system can learn about each insurance company's fee schedule. It should be capable of sending and receiving instant or batched letters, while keeping track of the letters that have already been sent.
Intermediate systems provide the same reports as basic systems, but freeform text can be easily added. Practices can create their own customized reports, and capital reports should be available. Overdue treatments can be easily tracked and automatically entered into reports and letters. This type of system can also code patients and track them. For example, patients with young children could be coded by the child's age. When the child becomes old enough for dentistry, the practice could send a birthday card encouraging a first dental visit. Automatic reminders should be built into the system to notify the practice of necessary tasks, and some tasks should be completed automatically. For example, after a new patient's first visit, a letter to the patient's physician could be automatically generated, asking if there are any specific medical concerns.
The specific features of intermediate systems make them the minimum type of system that group practice should consider. Ideally, the selected system will offer automatic revenue distribution and powerful electronic scheduler. The vendor should also be developing or planning to add clinical applications to the program.
Advanced Systems
The introduction of computers to dentistry was accomplished by sweeping predictions of a paperless office, but this was precluded by hardware and software limitations. While a paperless office is still futurist concept, recent advances in dental software and hardware have made reduced-paper offices a reality.
In addition to having all of the features of intermediate systems, advanced systems have excellent telemarketing capabilities ( also called telemangement). The computer automatically lists who should be called that day and for what reason. This reduces the number of human errors and oversights that frequently occur when staff search through reports manually. It also eliminates the need to print each and every report.
In this way, advanced systems can complete many tasks without staff intervention, and help the practice run more efficiently. Chairside terminals allow automatic scheduling from anywhere in the practice, and even electronic progress notes are possible. Clinical applications, including patient charting and charting and radiovisiography should be available, with further features under development. These systems should also be capable of storing data indefinitely, without affecting their speed.
Whether basic, intermediate or advanced, your future system should be easy to learn and enjoyable to use. By selecting a user friendly system with the right features, you, your patients and your staff will enjoy all the benefits an automated practice can offer.