With the right tools and proper training, going chartless can be timesaving, rewarding, and fun.
The dental office is rapidly evolving technologically. Practice-management software, digital radiography, hands-free charting, and multimedia patient education tools are seemingly everywhere. While all of these tools and options flood the marketplace, it is important to remember that today’s technology not only simplifies daily tasks, but also makes the initial transition to technology simple. With the right tools and proper training, establishing, developing, and eventually working in a chartless/paperless practice is timesaving, rewarding, and fun.
This article is the first in a three-part series about the hygienist’s role as a technology user. It will detail the importance of using computerized records, both in and out of the operatory, to treat patients more efficiently and perform daily responsibilities. To launch the series, it is essential to address the basics - how computers drastically improve the hygienist’s work quality and efficiency, why digital charting will soon make paper charting obsolete, and how even small tasks like notation and scheduling can be streamlined with technology.
In my experience, making use of computers throughout a practice assists both staff and patients. While computers provide ease and accessibility for hygienists, they also help to assure patients that they are receiving consistent, quality care.
One of the primary benefits of a paperless practice is digitally storing patient files. Digital files allow patient records to be stored in one central location, saving the time required to pull, refile, and search for misplaced files. The flexibility of digital files creates a historic overlap in documenting a patient’s medical history and other vital information. A patient’s entire history - past procedures, proposed procedures, future appointment dates, medical alerts and tooth-specific notes, and historic radiographs - can be easily viewed on one screen. Patient information can be sorted and filtered to easily find the information needed, without having to flip through pages of notes to see what was last done on a specific tooth. Storing this type of information in a computer, instead of locked in a file cabinet, keeps necessary information at the hygienist’s fingertips for more efficient workflow.
Features that accompany computers in the operatory may include other time-savers such as a digital signature pad. Similar to those seen at shopping malls and grocery stores, digital signature pads help eliminate the need for added paperwork. When stored in conjunction with patient files, hygienists are able to easily review what a patient has consented to, what forms have been signed, and what signatures are needed. The signature becomes a legally binding document, just as a signature on paper, but eradicates the need for bulky paper storage.
A hygienist’s role goes well beyond treatment planning, recording, and documentation. Often, hygienists also are responsible for educating their patients about a variety of procedures such as perio charting and tooth charting. Both of these are drastically simplified by the use of computers in the operatory. Computers make charting faster, easier, and a learning experience for your patients too.
Many dental software programs - my experience is with Patterson EagleSoft Practice Management and Clinical Software - have the ability to start a new perio chart already populated with the patient’s previous perio charting numbers. This allows for faster data collection, and by letting patients view their numbers on-screen, it is a wonderful way for a patient to see if readings are improving or worsening from one appointment to the next. To further clarify for patients or provide them with an up-to-date progress report, digital charting provides high-quality graphs that a patient can use to compare visits.
While perio charting may still be somewhat of a mystery to your patients, a graph outlining problem areas can help them more fully understand the process. In this case, a picture truly is worth a thousand words. If you as the clinician want a perio reading history or a note history on just one tooth, this can be done with just one click. Imagine how long that would take with a stack of paper perio charts and chart notes. All of these features offer a great opportunity for hygienists to educate patients about their progress and offer strategies for improvement.
The same graphs that assist patients also can assist a practice when handling insurance claims for acceptance of periodontics procedures. No longer drawn by hand, digital graphs can be printed for insurance providers and often allow for better insurance acceptance.
Additional features such as a voice-activated headset will undoubtedly save you more time, a benefit worth the initial cost. With a minimal amount of training, voice-activated headsets will recognize your voice and allow you to chart hands-free. This process also allows your patient to hear the recording of perio readings. For some patients, the combination of hearing the numbers and seeing the perio charting process helps them to recognize, remember, and get motivated to do something about problem areas.
As with digital perio charting, digital tooth charting is a more efficient method for recording information about your patient’s dental health. Computerized charting not only draws the needed crown on the chart quickly, but at the same time records the specific type of crown a patient needs and the date it was proposed. This eliminates having to learn the ADA codes and is done by merely clicking on a button with a verbal description of the type of crown needed. This information is then made available as the patient appointment continues. These services can be used when planning treatments, scheduling appointments, creating informed consent documents, launching appropriate patient education videos, and printing documentation for a patient. It also eliminates the need for chart audits, because the computer searches for all proposed services that would otherwise be hiding in traditional paper charts. It is also important to note that with filtering and sorting capabilities, all of the patient’s information is readily available without spending time sorting through the paper chart.
With an automated charting system, hygienists have more time for in-depth discussions with patients about treatment options, costs, and the most appropriate next steps. Simply filter out unnecessary information when presenting an on-screen chart to highlight pertinent facts about a patient’s teeth while eliminating confusion. By presenting clear and concise information, hygienists can ensure that patients have a better understanding of their oral health.
Computers not only simplify the patient assessment and treatment processes, but also the daily administrative duties hygienists must perform. Activities such as note-taking and scheduling can be extremely time-consuming if they are not managed with proper technology. Once again, practice-management software can help alleviate these issues by streamlining note-taking and scheduling.
Making use of notation short-cuts within a software program saves time in a variety of capacities. Hygienists can store frequently used notes for easy recall. They can be color-coded, sorted by provider, and filtered by category. Better yet, most programs also include spell-check.
As with note-taking, scheduling can be drastically simplified with the use of computer technology. Patient cancellations become easy to fill, because although you may forget to make a notation regarding rescheduling a patient on all schedules, the computer will not.
With computerized scheduling, hygienists can have all appointments made at the front desk or schedule appointments themselves. Imagine having control over your own schedule! Who knows better than you which patients require more time and which ones require shorter appointments? Integrating computers and technology into a practice is intended to accommodate staff and patients, not constrain them. If you are having difficulty adjusting to new technology within your practice, take advantage of online resources or suggest a staff training session. Proper training will help alleviate those difficulties while increasing productivity and efficiency.