A&L Softwords Newsletter

February 1996: A Strange Attitude

There are salesmen in all walks of life who sell every scheme imaginable to make money. They call it investment... if it works, happily, we call it investment too. If it doesn't work we have many other names for it. In the last ten years, there have been all kinds of sales people selling investments of every sort under the sun. It is difficult to find an investment that does better than a good RRSP, but isn't it surprising how many of us keep hoping to find an investment that will hit pay dirt.

It is a bit of a strange attitude. Surely, no business investment is better than the business you are in and understand best; the medical profession. Yet, most of us try to put aside savings to invest in other fields that will win us the jackpot. Now, obviously nothing is wrong with diversifying investments, but surely investing in your own office is an investment you are knowledgeable about and in a unique position to gage.
The jackpot investment that most of us seek is right before our eyes. It's as if we need a paradigm shift in order to see it. The normal paradigm is such that we see our office as the place where we work and make money so that we can invest it somewhere else. What???? What would a small monthly investment in your practice yield if put toward technology? Do you know? Or, a new system or way of filing or billing? Do you see? We just don't think of our own business this way. We don't recognize that the best potential investment could be in our own practice. If you were to approach others with a proposal for investment in your practice, many would jump at the opportunity.

The future life-line of the medical community is in changing these limiting paradigms. It's not just Ontario, it's not just Canada. It is the same story everywhere; in America, France, Europe and across Asia. There is not a country, state or province that is exempt. Some places are at different stages, that is true, but the story everywhere is the same; Medical resources are scarce in relation to an increased demand. Those paying are trying to cut costs and reduce expenditures. Specialized technology is expensive and modern medicine relies on modern technology. Costs continue to soar. Funds available are decreasing when demand and costs are increasing.

Changes will have to be made. And maybe those changes include how we see what is before us. Is there anything we can do? We think so. Technology can help make your office more efficient. But a change of attitude is just as important. Offering more services, keeping patients, helping your practice grow... even in times of fiscal restraint, these are things in our control. People still require medical attention.

Part of the shift will be changing how we view patients. Are we able to build a practice, keep our patients and run an office efficiently? (Technology can help, but not without a change of attitude as well.) Could hiring a medical assistant to work in your practice help? Clearly if your assistant were in a position to do all the preliminaries, this would result in more focussed time with each patient. Many offices are starting to see the value of a medically trained and qualified assistant. Assistants could do everything from weigh-ins and taking blood-pressure to preliminary examinations. All of this would allow the doctor to provide patients with the best possible care.

Maybe it's time to change how we approach our most precious investment... our medical practice.

The Internet and you...Always Being Informed

The Internet doesn't exit at a particular place. It is not one computer. There is no person, group or government in charge or taking care of every single aspect of it.

As we have mentioned before, the Internet is a collection of computers all around the world. They are linked via telephone-type lines that are looked after by keepers who make sure the computers and connections are working. They help people hook up to the Internet by giving them an account that provides access to that particular computer.

The Internet is just beyond your walls, pulsing around the world throughout the telephone-type lines of the world. Plugging in to it is as easy as connecting your computer. If your computer has a modem or fax modem, you're in business. Modems are little machines usually inside your computer and come equipped with software that enables it to communicate with other modems and computers via the telephone line.

Many hospitals, clinics and research foundations are already plugged in. Ask the system administrator about an account or dial-in via modem to a Internet Service provider. The service provider computers will be connected to the Internet. Of course you must buy a subscription to the Internet through a service provider.

Not unlike long distance phone companies, the rates and plans vary depending on the provider. Usually for a fixed monthly fee, $10 to $30, a service provider will set you up with e-mail and access to the Internet for a set number of hours.

Once you have an account with a computer connected to the Internet you are free to roam around the entire planet (Internet), using a browser or a collection of browser type programs. (Browsers are the easiest to use.) It doesn't matter if the computer you are accessing through the Internet is next door or halfway around the world, the telephone connection doesn't rack up long-distance bills the way regular lines do. Once you are connected to the Internet, you can go to any other Internet computer and it may as well be on the desk beside you for all that matters. Join in the pulse of the world that is just beyond your walls.

Interested in a topic or subject? Get a browser's search engine working for you. With all these people e-talking and putting stuff into electronic form, you will pretty much find anything you put your mind to. People are typing in messages to each other that are delivered instantly, across thousands of miles, from one screen to another. They answer back and forth, and soon they're having a chat through their keyboards.

Someone else is looking for a file that he will down load into his computer, moving it from the Internet's computer hard drive to his... he wants a video presentation including the music playing with it... Thousands of people are reading on-line news... Scientist are transmitting research, people are playing games, looking for pin-ups, sharing recipes, commenting on dissertations, taking credited courses, writing papers, joining chats, complaining about how the Internet is changing, and a million other on-line things... just beyond your wall...

Join in and come visit us, we are a part of it. A&L at anl.com or leave us an e-mail at dstamant@anl.com

File Health and Utilities: Diagnosis/Service Code...

File Health and Utilities in the A&L Medical System are designed to correct lost or non-recallable data. It also allows you to Merge Patient Profiles (move one patient's billing history to another's) Purge Patient Profiles and Transaction File Reports. It allows you to Cross Reference your files in cases where pointers for some reason have not been connected to the master files. For instance if a patient name is missing or a service code description or diagnostic code description cannot not be accessed, the Cross Reference Files feature of the File Health and Utilities allows you to run a program which rebuilds your cross reference listing.

The File Health & Utilities also has features which allow you to get a quick, view-able count of all files in the system, including an External Reference Count. As well, features that allows you to rebuild or repair any damaged data attached to the patient billing history. This is used when you cannot find a claim or if a claim's balance shows an incorrect amount from the patient billing history. It automatically rebuilds the patient history indexes.

The File Health and Utilities are also designed to make accessing data fast and easy. Say a new drug comes out for osteoporosis and you would like to contact all patients with a Diagnostic Code 733. This is one of the main purposes behind Search by Diagnosis\Service Code. Basically, this feature of the program will search a patient's visits based on selected Diagnosis and\or Service Code. Instead of using the Query Language to bring up a list or report of various patients with a specific diagnostic or service code, you can use the the Search by Diagnosis|Service Code feature. This will print out a report which includes the patient's name, number, gender, date of birth, phone number, last visit date and the referring physician name(s) if applicable. It will also add a comment to those patient's medical history notes should you so desire.

From the Main Menu, choose File Health and Utilities. Select Search by Diagnosis|Service Code and press ENTER. The screen will prompt you to enter a Diagnostic Code or Service Fee Code. Enter the Starting and Ending Dates (in DD MMM YY format) and a comment you may wish to append to their Medical History. This feature will find and list all those patients who have had the diagnosis code on their last visit within the date range set.

The system will ask if you want the report printed. Select Y for yes, and the report will start to print. When finished the system will return back to the File Health & Utilities menu.

You may wish to keep in mind that with other features of the File Health & Utilities, including Patient and Transaction File Purge, Cross Reference Files, External Reference Count, Indexing Directory Files and File Health Batch Run Selection it is recommended that you have a Verified Backup before proceeding.

Document Imaging...What is it about?

Document Imaging is the electronic process that treats documents as a collection of data, organized into some logical order, (usually on paper) and records this "human-readable" image-- including pictures, images, motion, text, etc.-- into "machine-readable" or "computer-readable" format.

In other words, Document Imaging is the name given to this process of storing documents electronically, in a database for easy retrieval. The advantages of course are numerous; physical storage space is reduced, access is easy, faster and it allows remote access, and doing anything with these electronic documents becomes simply a matter of manipulating a computer file. There is also the reduction of paper handling and consumption, which helps to significantly reduce operating costs. There is a good chance that someday in the future, you will eliminate half of everything that is on your desk right now. Including your in-trays, out-trays, the newspaper or magazine, the notes from others in your office... you will turn on your computer much like you have a morning coffee... without even a thought about it; everything you want and need will be available on your computer screen.

Click... and your morning paper will be in your computer, including sound and graphics. How about plugging into the stock market to see how your stock is doing? Click on a different article and while you are reading one article there is a reference to a particular subject that you are not familiar with. So, you click on the topic and call forward a whole new document on that subject which relates to the original topic you were reading, supplying you with a context and information base that you would not otherwise have.

Work will be changed much the same way. The computer will organize your files and paper will become less and less necessary. Documents will be much more versatile and extensive paper use will be seen as a waste of human and natural resources.

For quite sometime we have heard of the technological evolution toward the paperless office. Today and probably in the foreseeable future, few people truly expect to see a totally paperless workplace. But it's not the point. Telephones did not make letter writing obsolete. They serve different functions, although most of us still write the occasional letter. But at one time letters or cards were required for everything, including visiting friends or visiting a tailor. It's not an all or nothing- telephones helped in making certain things faster, more effortless and yes, more efficient. The same standard must be true of any technology. From a one-person office to hospitals and clinics. The benefits of advances in document management are available- making document management faster, easier, less effort and more efficient.

Maybe this will result in all of us handling fewer and fewer pieces of paper... leaving us with more and more time.

You've Got To Do It

Click on the search tool and enter Vampire. Movies, books, articles, myths... and the Vampire Bat are all listed. Double click on Vampire bat and several pictures appear on the screen (ugly) and one in particular looks as if it is perched upside-down and about to come out of your computer screen. He screeches a call and you watch his flight patterns as he flies toward you with an open mouth revealing his long and sharp teeth. You call up your sound wave program to study its harsh screech... you add it to a special tape you have been compiling to scare your friends with... Then you turn back to see what else there is about the Vampire bat.

You discover that it really does feed exclusively on the blood of other animals. Actually, it is barely the size of a mouse or barn swallow and by biting domestic animals on the neck, shoulder, rump or ankle with its incredibly long teeth, it feeds on blood. The only thing the vampire bat eats is blood, which it laps from the wound it has inflicted on its host or poor Betsy. The bat's tongue has two lateral grooves which open and close to create a sucking action while it feeds. Chemicals in the bat's saliva prevent the blood from clotting (for at least 2-3 minutes) and an adult vampire bat will consume about five teaspoons of blood a day. A colony has about 100 to 6,000 and they nest in hollow dead trees or in various types of caves. There are three known species of Desmodus rotundus. Not to worry, they do not make it further north than Mexico.

Then click on text details and learn all you want about the vampire bat. The information seems endless. You spot the word Human... it is highlighted. You click on that. Yes, it is true... Vampire bats have been known to feed on sleeping humans... There are case studies... infectious diseases... the danger of rabies...

Okay, enough of that. How about something different... like Music.
A search of Music simply lists too many topics that go on forever. So, how about... Jazz?
Eight headings are listed. Click on Historical Introduction.
Read while early Jazz is playing. The starting point for modern jazz history is in the licensed brothel district of New Orleans, known as Storyville and was founded in 1897 as a social experiment in legalized prostitution. Here Negro musicians played to entertain the customers; these jazzmen were largely musically illiterate improvisers, with background of playing in street marching bands, on instruments that were often the relics of the Civil War. When the naval police closed Storyville in 1917, the Jazzmen dispersed to Chicago, Kansas City and elsewhere...

The earliest records of jazz were made around 1916 and by the 1920's the jazz craze replaced the era called Ragtime. (Which was essentially composed music usually played on the piano and characteristically consisting of regular melodic lines, simply syncopated over a four-square march-style bass.) The popularity of jazz spread and began to seriously influence composers of Opera and Classical Music as early as 1920's. To some degree the amazing success story of jazz was undoubtedly due to the desire for distraction of a war-wearied world. No other successful music has ever had so ephemeral an existence as the average piece of successful jazz... Okay... how about something completely different again...

Look up the latest on breast feeding. You probably know that infants who are breast fed contact fewer infections that those who are given formula. It was always presumed that breast-fed children fared better because milk supplied directly from the breast was free of bacteria. But that is not the reason. It turns out that mothers milk actively helps newborns avoid disease in a variety of ways. After ingesting a microbe, a new mother manufactures antibodies called secretary IgA that enters breast milk and helps protect breast fed baby from pathogens in its environment. In mother's M cells (cells in the epithelial lining of the digestive tract) it is passed to immune cells known as macrophages. Here the pathogen is broken down and other immune cells are activated, T lymphocytes and B lymphocytes, that result in plasma cells travelling to epithelial tissues in the breast and release anti-bodies. Some of these molecules enter the milk and are taken in by the baby. The infant's digestive tract protected now by anti-bodies, prevents microorganisms from penetrating the baby's gut lining. How long is it suggested that new mothers should breast feed? Well, most suggest...

You gotta do it. It's the easiest thing in the world and one of the most educational and fun for the whole family. Get a CD ROM. The sky is the limit. And with a sound card and sound blasters, it is just such a full-sense experience of what ever it is you are working on, looking up or just plain doing. From vampires to composing your own Jazz tune (there are score sheets that display what you have written) to the benefit of breast feeding, it is such an interactive way to work, learn and play. And many people simply like to play audio CD's while they are working at other tasks on their computers. CD ROM does this and so much more... seeing, hearing and being at the helm is believing. If you have a 386 or higher... You gotta do it.

The User's Corner: More and More...

Offices are upgrading their computers. Newer technology is not only much better and faster, it is cheaper than trying to upgrade and\or repair existing hardware. Many offices simply replace the old equipment at some point with newer or even the latest technology. You don't always need every aspect of what is the latest... but with any recent technology the increased speed and data storage size is a tremendous benefit, not to mention the improved Windows based programs and the possibility of getting an amazing CD ROM. (Please see, Ya Gotta Do It.)

The fact of the matter is that we all have to upgrade or go with newer technology at some point. At A&L, we simply say, "Welcome to the future." What machines can do today was barely imaginable even three or four years ago. And software is written with the modern world in mind. From the HERO program to Personal Finance Software. (For example, did you know that HERO and programs like Microsoft's Money 95 or Intuit's Quicken Deluxe 5 for Windows allow you to do your finances at your home or office? Banking, paying bills... all on your computer. Of course relationships with banks and financial institutions are a necessary part of the programs.)

The technology just keeps blazing a trail to follow that sets the standards for years to come. Look at the number of services that are available while sitting at your computer. Tasks that took ages at one time can now be done with the touch of a button. Just compare one of these Personal Finance Software packages to a book and ledger system. Man created technology, but a lot of this technology sets a pace that is difficult not to follow.

Except on fishing trips in the wilderness, have you ever tried to do much without a phone?

Technology is all around us whispering to us... "Try me, you will never go back..." And we never do. But there is something you should know. When you upgrade or buy a newer or the latest technology be sure that you have installed or re-installed programs that you need to do all your tasks, especially the BACKUP.EXE program. If you don't, you will of course discover that backing up onto Diskette will be a lot of work.

This BACKUP.EXE program is a part of DOS 6.0 or higher, usually included in the Supplement Diskette that comes with the program. You could copy it from there, or make a copy of it from your version of DOS that you were running and re-activate it with the SETVER.EXE command. If you are changing your hardware or upgrading, you may want to consult your Hardware Service Company and get them to do it for you.

Of course we happily offer this service both on-site and over the phone. Our on-site cost is $150 plus tax or $55 plus tax for over the phone service. Have you upgraded your system? Things aren't quite right with your backup program?

Give us a call...

Softwords is a bimonthly newsletter published by A&L Computer Software Ltd., (905) 886-8066. © Copyright. Reproduction of Softwords without written permission is strictly prohibited. For information, questions or suggestions concerning the publication, please contact or write the Editor, Daniel St. Amant at the address above or at dstamant@anl.com.