Softwords Blog

The Efficient Handling of Patient Records

Thu, 31 Mar 2005 15:32:35 EST

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.)

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How to become Web Wise

Mon, 04 Apr 2005 15:28:12 EDT

The Internet has rapidly become a part of our daily lives. It has erased borders between communities and has changed the whole globe by becoming a single entity. It is a significant tool offering an unconstrained quantity of information and services from around the globe. By using your PC, you can read a newspapers, order books, input and process data, view pictures or listen to radio stations from around the planet, with countless Web sites and services added daily. It can be overpowering; and at times, it's difficult to find the precise information you want. Knowledge is what keeps you surfing safely, and protecting your information, and so ignorance of the hazards is no excuse. Some of these threats can take the form of Viruses, Hackers, Spyware, Malware, Worms, Trojans and new to the scene, of internet threats, Phishing. If you are not sure what they mean then you must take the time to educate yourselves and how they can affect you.

Computer Viruses

A program or piece of code that is loaded onto your computer without your knowledge and runs against your wishes. Even a simple virus is dangerous because it will quickly use all available memory and bring the system to a halt. An even more dangerous type of virus is one capable of transmitting itself across networks and bypassing security systems.

Hacker / Hacking

Hackers have an ability to bypass or override password protection and other security strategies. Hackers often work at a distance from their target computers by abusing the facilities of the internet for the purpose of gaining unauthorized access to steal and/or corrupt data.

Spyware

Spyware is software that covertly gathers information through the user's Internet connection without his or her knowledge, usually for advertising. Once installed, the spyware monitors user activity on the Internet and transmits information in the background to someone else.

Malware

Short for malicious software, software designed specifically to damage or disrupt a system, such as a virus or a Trojan horse.

Worms

A worm is a program or algorithm that replicates itself over a computer network and performs malicious actions, such as using up the computer's resources and possibly shutting the system down.

Trojans

A Trojan is a benign destructive program that hides as an application. One of the most dangerous types of Trojan horse is a program that claims to rid your computer of viruses but instead introduces viruses onto your PC.

Phishing

The act of sending an e-mail to a user falsely claiming to be an established legitimate enterprise in an attempt to defraud the user into surrendering private information that is used for identity theft. The e-mail directs the user to visit an illegitimate Web site where they are asked to update personal information that the legitimate organization already has. The bogus Web site, however, is set up solely to steal the user’s information.

An unwanted computer virus, and/or PC problem can harm hardware, software and productivity. Learning how to browse the web safely, keeping informed and protected is always the best policy.

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Records Management and Document Imaging

Wed, 06 Apr 2005 13:40:57 EDT

Imaging is the process of converting original (source) paper documents into electronic images. This process is accomplished by passing each document through a scanner (much like a copier), which transfers the image onto a computer. The image is then compressed and indexed. The next step is to transfer the images onto another medium, such as a Compact Disk, DVD-RW, Optical Disk, Hard Drive etc. for storage. Document Management can also include the storage and organization of various types of data.

Recording the image is a relatively easy step. The key however is retrieval. Once the data is stored, how do we get them back? From a software standpoint, however, you need a system that accurately indexes each piece of paper or data stored.

Some points to remember on good features for a Document Management application.

1. Robust database on which to conduct retrieval / searches
2. An alternate storage method that replaces paper and microfilm
3. Ease of use
4. Built in security levels to limit access within your organization
5. Ability to have software data encrypted so that no one from outside the system can access
6. Can integrate into existing system/network
7. Notes can be attached to any of the imaged documents to better know what they are for
8. The data is portable to any storage medium

General cost justification for a business

CD/DVD can hold up to 1 full filing cabinet:

- Save on cost of file cabinets
- Save on floor space

Labor saving:

- Speed of retrieval greatly enhanced
- Negates moving overly heavy boxes
- No refilling of documents
- No searching for lost documents
- Reduces number of people needed to “file paper”

Security:

- No lost documents
- Duplicate CD/DVD or other media can act as a backup and be stored off site

Eliminates Paper:

- Printing multiple copies unnecessary - Access can be shared
- Copies can be faxed or emailed directly from the computer
- You can cross search in seconds

Storage Space:

- Use space for productive money making area
- All data in one location

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

What is the Microsoft Windows XP Tablet PC

Fri, 01 Jul 2005 15:52:38 EDT

Microsoft Windows XP Tablet PC Edition has all the capabilities of Windows XP Professional, extending the core operating system with pen, ink, and speech functions. The Tablet PC offers a more natural and intuitive mobile computing experience by integrating pen capabilities more deeply into the operating system and the programs.

Windows XP Tablet PC Edition enhances productivity by delivering deep pen-and-ink integration. You can share your ink documents with others—even if they are not using a Tablet PC.

Significant improvements to word and case recognition in Tablet PC Input Panel include a dynamic ink-to-text conversion process and the option to make corrections before you insert text. Using an ‘electronic’ pen to annotate over a document or template and save the file with your own handwriting, truly enhancing your paperless office solution. Let us show you how A&L Document Console, in conjunction with XP Tablet Edition, can improve your office or business workflow.

A&L Document Console

Break Glass and Pull Lever in the event of an emergency

Tue, 30 Aug 2005 15:51:59 EDT

We’ve all seen fire alarms that ask you to break the glass and pull the lever. But what do you do in a computer emergency? That would depend on what went wrong and what things you need to get back on track as soon as possible. In this scenario one would set into motion a contingency plan, if you have one. The contingency plan is dependent on whether you took time during good times to have something to fall back on. In this article we will discuss the plans you need to have in place for emergency situations.

Let us take a step back. The only way you can have a contingency plan is if you have the proper equipment and take the time to use. What is the proper equipment? Did you know, MOHLTC technical staff suggests that you have a 3.5” floppy drives in your new computer even if you submit claims via EDT? Nowadays, computer manufacturers are removing certain devices like 3.5” floppy drives and conventional modems, replacing them with different types of drives and connection devices. This will continue to happen as the industry researches and develops new components and peripherals that are more efficient. Nevertheless, whether you use the technology or not it’s strongly recommended you have them. Since MOHLTC stipulates the medium and path for you to submit your claims, it’s always good to start with them to determine your minimum requirements. You can then speak with a computer professional to see what else is recommended. The backup process is a great example. Some people have chosen to use an automated tape backup and depending on the level of technology in your office, this may be best suited to you. However, if you computer is a few years old and the backup device is designed to work on older operating systems, you may not be able to use or take the technology forward if you have a crash or have to replace your hardware. What do you do if the manufacturer doesn’t produce that product anymore or if the manufacturer is no longer in business? What do you do if the device doesn’t work with your new operating system? Of course, if everything works, then you are in luck. If not, you will have nothing to show from you contingency plan. As technology rolls on, and our dependency on the equipment grows, we tend to take things for granted. We rely on modems and phone lines, believing that it will always work, that upgrading hardware or software will not affect anything in our existing set up, our computer will work trouble free for many years (not withstanding user error), and our staff will always be there to do the little things that need to be done. But that one instance when things don’t go our way, it can certainly be a huge inconvenience.

To help yourself you must provide your own safety net. Software and hardware companies can only help you if you have taken the proper precautions, so please be sure you have the following:

1. 3.5” floppy drives and disks.

2. Daily backups to work with.

3. Ensure that your existing office technology can be used with today’s current technology market.

By taking care of these issues, you will be in a better position to overcome emergencies.

Electronic Document Imaging Case Study

Thu, 01 Sep 2005 15:58:43 EDT

Dr. Rose Kung - Case Study

"For more than three years we have enjoyed the luxury of having an office with no filing cabinets bulging with patient charts, files and documents. Yet we still have all patient information at our fingertips – or more accurately, at just a few clicks of our computer mouse.” – Dr. Rose Kung

The Headache

I operate a busy ob/gyn practice at Women’s College Hospital in Toronto. As my practice grew, the storage and retrieval of patient charts along with all the associated examination documents became a burdensome task, not to mention the cost of filing cabinets, file folders and my assistant’s time taken to access and file the relevant material for each patient’s visit.

Also, it was not uncommon for an occasional document to be misplaced or misfiled, resulting in additional time being needed to locate the missing material.

Since we were already using computers in the office to handle such administrative tasks as our billing procedures I began to consider whether a computer could also be used to speed up the process of storing, accessing and archiving all data in our patient files. ... Thus, we were introduced to A&L’s Document Console.

The A&L Solution

It has since proven to be a good decision. Our office efficiency has improved and there have been no adverse effects on patient care. In addition, I am happy to say that a further important benefit has been an improvement financially. For the number of patients I service, I would need two large filing cabinets to store their charts and documents in the traditional manner. With the document imaging system I have no need for filing cabinets. I also save costly floor space. Likewise, there are no hanging files or file folders to purchase. The cost saving thus realized paid for the A&L Document Console software.

I can understand a physician’s reluctance to destroy hard copy patient documents. I also experienced this trepidation. But over a period of time, the reliability of the system convinced me that it was no longer necessary to save them. After all, this would defeat the purpose of having the system in the first place. Of course, our database is backed up every day by the hospital’s Information Technology department; so if something does happen to our computer system we always have a copy of our files from which the database can be easily recreated. Now our hard copy documents are regularly sent for shredding every two weeks or so...

Security of patient information is not an issue since password protection is provided by the system. Also, different types of access capabilities can be assigned to staff at the time their passwords are established.

Another advantage the system provides is the ability to send copies of patient documents to another physician anywhere in the world, directly from my computer, as long as that physician has the capability to receive information electronically. This can be done by fax or by an e-mail attachment and avoids the necessity of having to make a hard copy of a document as well as the expense incurred in mailing it. In the same manner, electronic documents can be received from other sources and easily attached to a patient’s file in my database...

The Conclusion

All in all we find the convenience and time saved by using this system to be a great advantage to our office operations. It also presents an efficient way to archive inactive patient files, and in my type of practice they are in the majority. After having used this system for over three years now, I would not want to return to the manual method for storing patient charts and files.

To find out more about the Document Console click here

Advantages Of Using Adobe Acrobat PDF Files

Thu, 01 Sep 2005 16:01:25 EDT

Adobe PDF documents can be shared, viewed, and printed by anyone, on any system, using free Adobe Reader® software — regardless of the operating system, original application, or fonts. Adobe Reader® software can be installed on every network computer or system for free and people and you can download it for free from the Internet. PDF files are an advantage to your A&L Document Console system because it allows you to share documents easily with anyone with no added expenses.

Benefits listed are as follows:

• Documents always look exactly the same

• Documents can be distributed worldwide for almost zero cost and then be digitally printed.

• Documents can be magnified by up to 1600%, without diminishing the quality.

• The documents can be navigated by keyword search, table of contents or hyperlinks.

• The format is ideal for presentations, since PDF documents always look exactly the same on all platforms.

• The file format is very compact, so files can be sent quickly to recipients.

• Ideal for archiving, since the look and feel of documents is retained and the document size is compact

• The file format is essential for business documents like agreements and forms that must retain their exact appearance for legal reasons.

Sharing across Platforms

A PDF File is a document format that represents a document in a manner independent of the hardware, operating system and application software used to create the document. It was designed to enable documents to be transferred and shared across computer platforms. A PDF document created in one platform such as Windows can be read in another platform such as Macintosh or Unix. All these advantages translate into faster, cheaper and less complex documents, improving workflow throughout the your office or business.

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Disposing of Old Equipment

Thu, 10 Aug 2006 16:02:30 EDT

Keeping up with the Joneses, when it comes to computers, can be a complicated thing especially when your kids are asking to upgrade their computers because their friends have it. On the other hand, maybe you’re always looking for the newest, latest, and greatest when it comes to hardware.

You are not alone. Many people purchase and upgrade their computers only to have old computer equipment languishing in their offices and basements. Landfill sites are the premature destination for the computer wasteland when many of the parts can be recycled and certain metals extracted from the equipment. With spring in the air, maybe it’s time to do some spring-cleaning. One of the best ways to recycle your old computer is to donate it to your local education system. With under funded schools looking to make ends meet, what better way to help the future of tomorrow by giving them your used equipment. Many Windows software products run in a legacy type manner where current software programs are very similar to their previous versions. From a hardware perspective, the components of the architecture are similar. All have motherboards, expansion slots, processors, memory, hard drives, and fans. High schools and colleges might be able to use your hardware to teach technical aspects of the Information Technology sector. If you decide to go this route, be sure to remove all business and personal related matter. Remember, your office is working under the rules of the Privacy Act so please remove or delete everything first. In addition, if you are giving away your home computer, make sure it doesn’t contain personal and financial information on you or your loved ones. You don’t want that falling into the wrong hands especially to young, inquisitive, mischievous minds. For those of you who are more advanced, formatting the hard drive and then reloading accompanying software might be a better idea. Be sure to give them all operating, program disks and documentation in case they have to uninstall and re-install operating systems, drivers, or software.

If your equipment is of a vintage state, (where it can only be used as a doorstop), some municipalities have a recycling depot program where they have a depot for old electronic equipment. Even if you are dumping your equipment, be sure to format or uninstall all personal information. Please check with your local municipality for available recycling programs. Many monitors and television sets contain lead, which are harmful to the environment, so it’s best to dispose of it this way. Some of the larger business retailers also have programs to recycle old telephones and ink cartridges. If you really want to recycle, in the past Hewlett Packard has occasional programs where they will recycle old printers, whether manufactured by them or not, at a cost, if you ship it to them.

Recycling your old equipment is good for young minds and the environment. It will also help you clean up your office or basement.

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Understanding Spyware, Malware and Adware

Tue, 05 Sep 2006 16:04:36 EDT

Spyware, malware and adware are programs designed to infect a computer and often hamper the owner’s activity. Spyware is often thought to solely describe a program that examines a computer user; however the implications are much greater. These stealth applications often gather information through the user's Internet connection without his or her knowledge, transmitting information in the background to someone else. As for the avoidance and elimination of spyware, there are numerous programs designed to thwart these applications.

Malware, short for malicious software, is designed specifically to damage or disrupt a system, such as a virus or a Trojan horse. Malware includes things like spyware or adware programs, such as tracking cookies, which are used to monitor your surfing habits. It also includes more sinister items, such as keyloggers, Trojan horses, worms, and viruses. A good anti-virus application can be configured to scan for any type of malicious code, and alert you to its existence, even if it is not currently known malware. However, remember that your anti-virus software, security application or even computer operating system is only as good as its last update. To get full protection, on a regular basis you MUST update with the latest virus definition files, scanning engines, patches and fixes. They can often overlook certain types of malware. It is a good idea to run at least one anti-adware application in combination with your anti-virus software. In addition, utilizing a firewall can be helpful. While it won't keep malware out, it can help to stop such programs from accessing the Internet and sending your personal information to the intended target.

Adware, while not necessarily malware, is considered to go beyond the reasonable advertising that one might expect from freeware or shareware. Typically they're designed for commercial gain and are appropriately titled as a program that routinely shows advertisements to a PC. Adware will regularly continue to produce ads even when the user is not running the originally application installed. Usually bundled into another program, adware is considered a way for many developers to recover programming costs since a program since shareware or freeware is offered at little or no costs to the user. Adware and spyware are sometimes grouped together because the computer user’s Internet activity is frequently tracked, recorded and may even be sold to a third party. Software is available to help block advertisements and/or remove adware programs altogether.

Remember to always take time to be web wise and keep informed. If spyware, malware and adware destroy nothing else, they destroy your confidence in your PC or network, which is something that is quite valuable.

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