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A&L Softwords Newsletter
October 1996
Health Care Reform
The fundamental principles and methods of health care delivery are under
siege. Every Province in Canada is facing the same problems, the same fight,
the same war. It is a battle ground on which issues of delivering affordable,
quality health care are decided.
To borrow and paraphrase from the Metro Toronto District Health Council
Restructuring Committee in their Directions for Change: We need to rethink
fundamentally how health care is delivered so that changes will preserve
what is valued and ensure a sustainable, affordable health care system.
At A&L we believe that there is a wide spectrum of stakeholders and
that the sooner and more substantial their involvement the better. The kind
of changes being considered at all levels of the medical profession will
result in a long and painful process of change. Without the involvement
and co-operation of those who live and work in the trenches there is no
hope of implementing needed change in any positive manner. Thus, co-operation
is a prerequisite.
If co-operation is a prerequisite, then to achieve an integrated health
care delivery system is one of the major goals of change. In the health
care delivery system there is no broad or significant integration between
different facilities, what is called Vertical Integration, or between similar
facilities, what is called Horizontal Integration. Medical delivery is not
an integrated system at all. We must begin to build an integrated, communication-linked
or networked health care system.
Of course it must be co-ordinated with what medical people in the trenches
do so that there is as a result, a continuum of care. In other words a seamless
environment of care across the spectrum of offered services. This means
having in place a network between all providers- acute care, chronic and
long-term care, rehabilitative care, palliative care, community services,
mental health, primary health care and even alternative health care. There
will be a shift from the compartmentalized care received today, to a comprehensive,
integrated health care offered tomorrow.
As well, the medical community must borrow from the retail and
business world and think of patients as customers... because... they are.
The health care model should work toward a comprehensive, customer-oriented
service and delivery care system. And although there have been changes made
and in place for a while, (shorter hospital stays, procedures done on an
out-patient basis, the use of technology, a shift from institutionalized
care to more community-based delivery and care, including a new emphasis
on the primary care physician) there is still a long way to go in attentiveness
to detail and a building of fruitful relationships with customers who are
in your office for the services you offer in light of your expertise.
But what is involved in reorganizing the health care delivery system as
we know it? How is it to address these changes and meet financial restraints?
How will we build an organized, co-operative and co-ordinated system built
on some kind of consensus and with a shifted emphasis on customer-orientation
or a customer-comes-first approach?
Information technology
At A&L, we believe this is exactly where private enterprise and technology
come to play a substantial roll. A&L HERO* is a transactional network
that allows everyone to plug in and take advantage of the latest in modern
technology. It is a system that integrates across all sectors of the medical
community. It has the capability to provide an infrastructure or back-bone
on which to build a co-ordinated, integrated health care system. We believe
it will knit together the medical community, still largely paper-based,
into an autonomous yet integrated, transactional network. The implementation
of such a comprehensive information technology network will alter the administrative
procedures as we know them today. It will allow offices to track patients,
expedite patient registration, track patient release, transfers, re-admittance,
outcomes and analysis, as well as improved window based billing procedures
that allow for electronic commerce, and shared information on a highly secured
communications network that integrates health care institutions, physicians,
care givers, the OMA and the Ministry of Health.
The A&L HERO* network can provide solutions only to the degree that is
it actually used by professionals in the trenches. At A&L, we believe
that one of A&L HERO*'s greatest strengths is that we ensure the usability
of it through helping our users learn and understand how the system will
and can be used both today and in the future. We are not naive. We know
that the resistance to implementing such technology is a battle to be won
in the trenches of each office. This is why we provide the amount of guidance,
instruction and transition time that is required to make your office accept,
embrace and then cheer our technological advancements. Indeed, the success
of such changes is measured in how the actual users are able to do their
work on a daily and on-going basis. Information technology changes the way
people communicate with each other, changes what a person does as part of
their job, and changes how productive they are in offering their expertise
and services in the work place.
In our opinion, implementing Information Technology is a foundational step
toward the development of an integrated and co-ordinated infrastructure
that offers solutions to the problems facing our medical community and the
professionals, upon whom we all rely, who thanklessly work in those trenches.
The New VP of Marketing: Mr.
Haisell Joins A&L
As President of A&L, it is my pleasure to let you know that David Haisell
has joined the A&L Team. He has written a letter a to introduce himself
to you, but I couldn't resist saying at least a couple of things that I
know he will fail to mention. So, allow me to tell those of you who do not
yet know David, that he has tremendous expertise, qualifications and experience.
From graduating with a B.Sc. degree at the University of Toronto, to becoming
a Professor and Chair in Ontario's College system, from working in Physiological
Hygiene and Cancer research to being an author, photographer and musician,
his breadth of knowledge is remarkable and it is coupled with a wonderful
ability to bring a fresh perspective to whatever he undertakes. At A&L,
we invite you to get to know him. Over the years, David has been a colleague,
a friend and someone I deeply admire. I hope you take the opportunity to
contact him and find out why.
Alex Yuan
Dear A&L Users,
I'd like to take this opportunity to introduce myself. As the new Vice-President
of Marketing, I come to A&L Computer Software Limited at a challenging
time for the medical profession in Ontario, and in fact in all of Canada.
All of us at A&L recognize the demands being placed on physicians in
this province and will work together with you in whatever ways we can to
help you achieve your objectives.
As a former Information Systems Professor and Chair in Ontario's community
college system I have been dealing with a rapidly changing environment during
the past few years. Change is a fact of life but there are times when it
comes more rapidly than we would like. There are some who would say that
"if it ain't broke, don't fix it." There are others who would
disagree and claim that if it IS working well you don't have to direct your
energy to fixing it, but instead can concentrate on making it even better.
There are probably times when each of these approaches has its place, but
whatever the case we have to deal with the consequences.
Our current environment finds us dealing with several aspects at the same
time. Major efforts in medical research are being directed at such debilitating
diseases as AIDS and cancer in its various forms. New and deadly strains
of bacteria continue to evolve and pose challenges for control. The social
and cultural fabric of our population is undergoing change. More emphasis
is being placed on wellness, staying healthy and disease prevention than
ever before. The technology we apply on a daily basis to deal with every
aspect of life has never changed so rapidly as in the past decade. And weaving
through all of this is a political environment which fluctuates from what
seems like one extreme to the other every few years.
Turning problems into challenges, and then rising to the challenge to create
solutions, has been characteristic of the medical profession since its origins
in our distant past. The current situation is another series of such challenges
which I am certain will be solved, only to be replaced by others as we enter
the new millennium.
For the past decade A&L Computer Software Limited has been an innovative
partner in helping you deal with technology as it evolves, a technology
which we believe has helped you achieve your objective of improved office
operating systems at a reduced cost. We will continue to refine and expand
the capabilities of our software to provide you with even greater efficiency
and effectiveness with each new release. And we will continue to make available
the training necessary in order for you and your personnel to easily adapt
to the new techniques we present.
Please feel free to contact us with your comments and suggestions. Our objective
is to help make your day to day operations run as smoothly as possible and
I welcome your input at any time as to how we may accomplish this end. My
first month at A&L has convinced me that everyone here is dedicated
to serving you well, and I look forward to being able to do just that in
the years to come.
David A. Haisell, B. Sc., I.S.P., V.P. Marketing
David can be reached at dhaisell@anl.com
The Query Utility:
Aye, Captain, Full Speed Ahead
In the last two issues of Softwords, we discussed how to use the Query Utility
to request a Simple Query and/or Link Compound Queries without having to
know the Query Language. This time we will take a look at what is involved
in Making a Custom Report.
First, in the main menu, select #12 Query Utility and press the ENTER
key. We start each query by highlighting the target of the search, PATIENTS
or CLAIMS. Last time, we selected multiple conditions for a search concerning
Spock and his friends. To do this, we explained how the program needs to
setup a logical relation between what it is to search for and the exact
nature of that search.
We explained the use of the logical condition of AND as well as the
logical condition of OR. Once this relation is set, we can select
what particulars will be included in the Report to be printed.
Often there are basic elements you want included in any report, and we have
set up Default Reports for this reason. It has a fixed format. But sometimes
your office needs something quite unique in order to keep the office moving
at Warp speed. So, to take full advantage of the Report Module, choose CUSTOM
at the Report Option field.
If you highlight and select CUSTOM, the screen will display many
data items. It is here that you can choose what data items will appear on
your report. Use the Arrow keys to move from item to item on the screen.
Highlight the items you wish to include in the report and press the ENTER
key to select each one. A small square will appear in the column next to
the selected data item and this lets you know that it is included as part
of the report. You can cancel a selected item by highlighting it and pressing
the SPACEBAR.
Given the dynamics of any screen, printer or computer, there are a limited
number of data items that you can include in a report. The width of 80 characters
is the limit that your screen or printer can handle. The program has intelligence
and calculates how much space is required to display each data item on your
screen or page. If your selections have exceeded the maximum, then the program
will beep and inform you that there are too many items included.
When you have selected the data items that will appear on the report, press
the TAB or F9 function key to highlight the box marked CONTINUE.
You can return to the list of data items by pressing the TAB key again.
When you are finished, highlight CONTINUE and press the ENTER
key. The program returns to the Options Screen.
The program will ask you if you want to PREVIEW the query or START
the query. The preview shows how the query looks in the actual Query Language
Syntax. After previewing it, highlight START and press the ENTER
key. Because Scottie keeps the engines in peak performance, the Warp Speed
kicks in and the report is displayed or printed in moments.
User's Corner: Hares,
Scares and TnT
We knew what would happen the morning of August 22nd, and September 22nd,
calls would come in from users and friends wanting to know how they could
protect themselves from the Hare virus that was to go off on those days.
Our general advice is basically the same for everyone. Get anti-virus software.
In truth there were very few complaints regarding the Hare virus even though
it is capable of wiping out all the data on your hard disk drive.
Virus alerts occur several times a year. March 6th is a big one because
that is Michelangelo's birthday, the day the virus is 
set to strike. And although Hare and Michelangelo are not usually reported
in the top 10 viruses found, it is important to take precautions against
them and others.
Viruses come in various forms and sizes, and range from being an annoyance
to causing significant damage. Technically speaking, viruses are programs
which replicate themselves or spread to other files or programs. Merely
having an infected program won't necessarily trigger the virus. Usually
it is triggered and spread when you run the program. However, some viruses
attach themselves to the boot sector of disks. If you place an infected
floppy diskette in drive A: and start your computer, the boot sector virus
can spread to your hard disk drive's boot sector. It may do little initial
damage, but can infect other files and eventually destroy files.
It is true there are also other ways of getting viruses without running
the infected program. Viruses can be attached to data files, like the Concept
Virus. It attaches to data files from Word and Excel and is set off by a
macro that is embedded in a document and runs automatically when the file
is loaded.
There are several ways to protect yourself. Get; Use; and Update. First,
get an anti-virus program, (Norton AntiVirus, McAfee Virus Scan, Dr. Solomon's
Anti-Virus Toolkit) and install it. These programs are usually less than
$75 and scan your computer memory and hard disk drive for infection. Second,
when you use these programs they remain in memory while you are using your
computer. Most protect your computer as you download files from the Internet
or from a diskette. Third, update regularly. Most of these programs have
Web sites that allow you to download their latest update, sometimes released
just in the nick of time.
addition to buying, using and regularly updating your anti-virus program,
you should have a systematized back up procedure. Store at least one backup
off-site and re-new it every month. When these nasty bugs enter your computer,
your anti-virus software will be better than Raid, it will kill these bugs
dead by erasing them into oblivion... where they belong.
TnT Announcement.....
Teach & Train has been postponed until a future date due to the many
requests we received from offices who found September inconvenient given
the current medical climate. Most commented that they have too much on their
plates right now.
The Canadian Internet and You:
The Age of Information; Playing to Win
A thought leaps across the ocean, thousands of miles across land, speeds
beyond time zones and provinces at near the speed of light, in a world where
isolation and borders are shrinking. Travel a time-line of thought to anywhere
in the world, right now using the communication frontier... the Internet.
The Internet is the world's largest community and it has no membership restrictions
and it is available to all. In Canada, we have a special place in the world
Internet, because as a nation our very existence has been defined and depended
on our ability to communicate with each other across vast distances.
You can't escape or get away from one fact about the world today. We are
entering the Information Age. At the center of this Age or development is
what has been termed the Super-highway, or the
Information Highway. For our part we are sick to death of hearing the term
Super... anything, so we will just simply call it the Information Network
or Highway when we have to refer to a network of communications linked together
and offering various services. It could include telecommunications, cable,
computer and other modes of communication. But whatever it includes... play
to win.
Fact is that many people have various uses for access to such a knowledge-based
network. Some to communicate with associates and friends, some to explore
new electronic frontiers, some to enhance their abilities and professional
skills, others to debate and discuss issues, seek knowledge, entertainment,
or different approaches. And there are many, many other reasons as well.
This flexible knowledge base is what the Internet is all about. And for
most people, it is accessing this knowledge base that is exciting. It can
be accessed in various ways that we will try to discuss in an on-going series
of articles. But for most people, this electronic mode of communication
is simply a way to communicate with other people around the world and across
this country via the computer. And frankly, it is the cheapest way to do
it.
Through the Internet people are involved in discussions on every imaginable
topic. As well, people subscribe to electronic journals on a vast array
of issues. Still others check weather reports, academic papers, recipes,
scientific reports and yes, even local traffic reports before heading into
work. And basically the Internet is a growing storehouse of information
and global knowledge, accessible to anyone with a personal computer or work
station, a modem and a curiosity or need for some type of information. So,
why should you care, you ask?
There are many potential reasons why you may want to use the Internet. As
a medical professional, you may use e-mail to establish a closer working
relationship with hospital staff, clinic staff, office staff, even other
doctors in your office, as well as the staff of the laboratories you use.
It offers you an unintrusive means of communication when you are in the
other room, office, at the hospital or clinic, or on holidays or just at
home.
Or, you may wish to obtain a second opinion, whether from a doctor working
in your office, or one in another part of Canada or the world. Or, maybe
you want assistance for something totally unrelated to your medical practice.
Say, you are having car trouble or trouble with some software you use.
Maybe you wish to stay better informed about medical procedures and practices
that are changing all the time. You could be on an e-mailing list of articles
to do with your specialty. Or, perhaps you are interested in a recent drug
that may help a patient who just visited your office. Or, perhaps you are
a rural professional who so often feels the loneliness of professional isolation
so wish to keep in touch. Or, you may wish to research or get more information
on a particular problem. Perhaps you are curious and want to explore the
limits of this new technology that is so easy to use, but an art or skill
to use well. Or, maybe you just enjoy the technology or do it for fun or
you don't care to be embarrassed or left behind by your children or worse,
grand-children.
Whatever the reason, to make the most of your efforts, it is useful to understand
that the Internet is a powerful communications medium that is an on-line
community with its own unique culture and spirit of co-operation. Understanding
this and the technology is a part of being successful in your adventures
on the Internet. In this series of on-going articles, we will help you explore
and discover the world of the Canadian Internet.
E-mail....
Electronic mail, known as e-mail, has proved to be one of the success stories
in the information age, and on the Internet has proved to be the most popular
and useful of tools. All of us at A&L included; anyone who begins to
use e-mail will wonder how on earth they ever functioned without it. E-mail
within and outside of Canada has exploded in use. Internet e-mail has become
so pervasive that an Internet address is as necessary as a fax
number if not more so. It simply offers significant new capabilities that
were not possible before, and it is easy to use. Type in an address, create
a message and send it off without a stamp or picking up the phone, all from
your keyboard. Try that for starters and you too will be sold.
Next Time: Networking: Ask a Question, Get an Answer.
Softwords is a bimonthly newsletter published by A&L Computer
Software Ltd., 175 West Beaver Road, Suite #6, Richmond Hill, Ontario L4B
3M1 (905) 886-8066. 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. A&L Computer Software Limited
October 1996
* HERO is a registered trademark of HTN Inc.
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