March 2005

The Efficient Handling of Patient Records

The efficient handling of patient records within a medical office can have far-reaching effects on many areas of the practice, including telephone management and physician and staff management. Few medical offices in Canada are entirely paperless, although numbers are growing annually, so it is still the majority of offices that need to tighten up their record management systems. Many years ago, I was called into an office to help improve staff telephone management. The office received numerous complaints from callers who constantly reached busy signals, or were put on hold for anywhere up to 10 or 12 minutes. Several patients transferred to other doctors because they found it impossible to get through to the office to make appointments. Other patients became no-shows when they couldn’t get through to cancel an appointment.

On interviewing the staff and observing what was happening at the front desk, I realized that the main culprit here was a badly managed record system rather than poor telephone management. Charts were often not where they should be – in the filing system. Completed chats sat in piles in the reception area waiting to be filed. Doctors took charts home with them to write progress notes, or left them in any one of a dozen different places within the office. Thus, when a phone call generated the need to find information from a chart, the phone lines were tied up as the staff put the caller on hold to search for the chart. Staff spent an unacceptable portion of each day hunting for charts when they should have been completing other work, and doctors’ time was wasted as they often had to delay returning telephone calls – or even seeing patients – until a chart had been found. General inefficiency pervaded every area of office productivity, and in nearly every instance this could be traced back at some level to poor chart management. I always recommend that no chart should be out of the system for more than twenty-four hours whether they have been completed or not. Physicians should get into the habit of writing or dictating their progress notes at the end of each patient visit. Not only does this help get the chart back into the system, but it takes a lot less time to write notes when the information is still fresh than it does to write notes after seeing dozens of patients. Doctors should never remove a chart from the office to complete at home without a proper tracking system in place to ensure that the whereabouts of the chart are known to staff.

Staff, too, must take their share of responsibility for ensuring charts are where they should be – in the filing system – and abide by the ‘twenty-four hour rule’ to return them. If the chart isn’t completed at the end of the day (e.g. an insurance for or medical/legal letter is needed) the chart should still be returned to its proper place on the shelf or in the cabinet, with a log kept up to date of work that has yet to be done. I have visited hundred of offices over the past 25 years as a Practice Management Consultant and unfortunately have found that there are still far too many physicians and staff who don’t afford the proper degree of importance to their charts and filing systems. Patient charts should be considered the heart of a practice, and without a high level of efficiency in this area overall office productivity suffers, and doctors are unable to provide consistently excellent patient care.

(This article first appeared in The Practice Manager, a newsletter published by Don Price & Associates.)

Click here to view other Softwords publications

Click here if you are looking for an Electronic Document Management Software solution

Note: All issues from the year 2000 are provided in Adobe Portable Document Format (PDF). To view these files, you need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe Web site.

Why Update? Why Not!

Technological changes in the medical industry are simply a part of life. Sometimes it’s due to security concerns and other times it’s to upgrade on the current situation. But security consists of many things. When an employee leaves the company, are locks and security codes changed? User names and passwords? These issues must be acted on and dealt with immediately and has nothing to do with the existing hardware or software. The hardware and software would work just fine if no changes had occurred with the employment status. If a disgruntled employee leaves, are they taking personal or valuable information with them that should be left in the office? With the advent of PIPEDA, otherwise known as the Privacy Act, greater care must be taken to secure information from leaking into the public domain.

With the computer, the public domain can be a two way street which can also be accessed through your computer if you have access to the Internet. As most of you know, “www”, stands for “World Wide Web”. You can surf the web and look for just about any information you wish. However, an astute computer “intruder” can send out signals, similar to sonar, and if they get signals back, that’s a hint that somebody out there may not be properly protected. This “intruder” may then try a number of ways to force their way into your computer and see what’s available. That’s why there are a number of companies that produce security software and peripheral hardware to prevent it. Anti-virus “Suite” programs may now include firewalls and other protectants like spam filters, incoming/outgoing e-mail scans, and script blocking. As technology forges ahead, everyone will get caught up in it’s crest and be forced to move along especially if one of the leaders like Microsoft moves forward. Working in conjunction with other leaders in the software and hardware industries, companies are constantly looking to improve their products. Security with Microsoft is no different.

Click here to read the full article in publication

Click here to view other Softwords publications

Note: All issues from the year 2000 are provided in Adobe Portable Document Format (PDF). To view these files, you need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe Web site.