Trendsighting: How Computers Are Decentralizing Dental Practices
ExperDent
"The greatest thing in this world is not so much where we stand, but in which direction we are moving." - Goethe
Though German writer J.W. von Goethe likely imagined that the above musing would have a profound philosophical impact on the thinking people of his time—and infinitely beyond—he probably never suspected that it would be summoned up as the consummate reference in an article about high tech dentistry in 1994. But Goethe's statement is perfect in that it encapsulates not only where we're at (experiencing a galloping pace of dental computerization) but where we're headed (towards the furlong of decentralization).
If you haven't already heard the word decentralization tossed about in discussions of the use of computers in dental practices, it won't be long; decentralization is fast becoming the standard by which to measure the level of computerization. In other words, the former black-and-white discussion—a practice is computerized or it isn't—has now taken on a shade of gray; today, the acid test is to what extent a practice is computerized and whether or not this incorporates decentralization.
As many practitioners were reluctant to computerize initially, that same reluctance rears its head when it comes to decentralizing computer use. However, an important point to keep in mind is this: a practice that automates and is unhappy with its system, for whatever reason, doesn't retreat into the cave of a manual system. Invariarbly, it looks for another computer system, one that better meets its needs. This trend occurs with practices that make the mental and logistical leap to decentralization; once they've experienced its profound benefits, these offices never return to front desk-based systems.
Decentralization Offers Myriad Benefits
What exactly do we mean by decentralization? De-centralization is any action taken which eliminates the need for the front desk to be at the hub and center of all activity in the practice, be it electronic scheduling (no manual appointment book), in-operatory terminals, or the ability to answer telephones in non-traffic areas of the office.
Improving management capabilities in the dental office takes a lot of planning, education, and study. However, when you place a computer terminal in the operatory and decentralize part of the practice, you automatically reach a higher level of management efficiency. In tangible terms, the workload becomes redistributed throughout the practice; the staff members handling the greeting/dismissing area experience a visible decrease in stress levels; and, though the staff costs remain constant, office productivity and efficiency increase.
With the appointment scheduler accessible from any terminal in the office, staff aren't scrambling for that one coveted book but can accomplish scheduling (even concurrently) from various locations in the practice. (And because off-site terminals can be used to accomplish the same, this feature opens a whole new world to retaining competent staff members whose presence in the practice is altered, be it because of maternity leave or a reduction in hours from full- to part-time.)
In-operatory terminals eliminate the dual entry of data, a common time-waster plaguing dental practices. Traditionally, a front desk person had to enter into the computer what the clinical people had just documented manually. The result: a backlog of patients in the greeting and dismissing areas of the front desk. In-operatory terminals provide the single entry of data from any terminal. Fees, recalls, medical alerts, histories' updates, changes to insurance coverage, new addresses, etc. are done on-the-spot in the operatory. And since the practice information can be found anywhere, various team members can access information for marketing purposes.
With computers in the operatories, the world of technology unfolds well beyond management. For example, electronic progress notes can now be a part of the patient record; increased legibility in these notes make them more useful; and the information is backed-up, thus making it more secure. In addition, enhancements to dental software allow for more thorough note-taking with less effort. Diagnostically, the advantages are staggering when one considers the potential blend of all management aspects with areas involving computer imaging, intra-oral photography, digital radiography, and modalities such as the T-Scan. Imagine answering a patient phone call and, without searching for the record, seeing the patient's face on a screen (hooked up to the phone), and being able to access all their information at the stroke of a key or the click of a mouse.
Decentralization, with in-operatory terminals, also stands to make strides in operatory infection control as electronic documentation ultimately eliminates the need to pass paper records between people. (And because we are seeing so many advances in voice activated programs, we should eventually be able to accomplish all of the above mentioned functions hands-free.)
Downside to Decentralization? Are there any negatives to using technology this way? Well, the basic tenet is this: you must have an organized practice before you commit to a program of this nature. If the organization is not there first, you'll simply be automating errors. Assuming that you're not trying to automate your way out of fundamental practice dsyfunction, there is no downside to decentralization.
The evidence is in: North American practices that automate never go back to manual records. And likewise, those offices that decentralize never return to traditional automation. Steps forward are rarely followed by steps backward.
"Thoughts and ideas on the future," by Dr. Barry Freydberg of Chicago and Dr. Ken Neuman of Vancouver, members of the ExperDent team.