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Path to Paperless 1/19/2015
Dayna Johnson - Rae Dental
Management 1
Dentistry’s Path
to Paperless
Presented by:
Dayna Johnson
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Today, you’ll take away
• How did we get here?
• The necessary steps to develop and
implement a chartless practice
Helpful resources
Tips on creating a timeline
Ideas from other offices that have been successful
How to avoid the pitfalls
Advice on managing your new inventory of digital
equipment
3
After 100 years of
paper…
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Presentation Outline
1. Foundations of Paperless
2. Practice Management Systems
3. Digital Imaging
4. Office Design
5. Computer Hardware
6. Implementation
7. Your Path
1.Foundations
of Paperless
Dayna JohnsonRae Dental Management
1996
Health Insurance
Portability and
Accountability Act
(HIPAA) passed
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How did we get here?
1965
National Library
of Medicine:
improve access
to biomedical
information
2001
HIPAA Privacy
Rule becomes
effective
1. Foundations
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2004
Office of National
Coordination for
Health Info
Technology
established
2009
President
Obama’s
American
Recovery and
Reinvestment
Act
2007
ADA formed
the Electronic
Health Record
Workgroup
2005
HIPAA Security
Rule enforced
starting in April
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Change is now accelerating
1. Foundations
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Benefits of EHR for patients?
• More secure
• Avoid duplicate testing
• Reduce costs
1. Foundations
• Reduce medical errors
• Easier sharing of
information between
health care providers
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Where do these charts go?
1. Foundations
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Benefits for Dental Office?
• easier, faster and more
consistent
• information is safer and
more secure
• meets requirements for
HIPAA, HITECH, PCI
1. Foundations
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Patient perception matters
1. Foundations
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Myths about the EHR
You will save money Your charts will be
mistake-free
1. Foundations
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The path to paperless requires
• planning
• implementation
• training
• on-going management
Federal guidelines are evolving, but
your infrastructure and training can start NOW.
1. Foundations
2.Practice
Management
Software
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A critical choice
2. software
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Quality of customer service &
support?
Is it compatible with 3rd party
companies (x-rays, cameras,
other eServices)?
Does it support apps like: MS
Excel, MS Word, Quickbooks?
Data conversion process?
How often do they upgrade?
Can we add more users in the
future?
Checklist of
Things to Ask:
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Down the Road…
Will it keep up with
you? E-mail appointment
reminders
Patient education
software
Store patient credit card
info legally
Send office newsletter
Add an office website or
integrate with existing
one
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You’ve made your decision - now what?
The Data Conversion
• How long will you be down?
• What info will be converted?
• Do you get any say in it?
• Who does the conversion?
2. software
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Training needs?
• How much training
will you need?
• Look for a trainer
with experience in
paperless offices
2. software
3.Digital
Imaging
Systems
Dayna JohnsonRae Dental Management
3. imaging
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Benefits of Digital Imaging
• No more lost x-rays!
• Improved treatment
planning
• Digital imaging is
“greener”
No chemicals
No lead to separate
Less exposure to toxins
for patients and the
environment
3. imaging
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Choosing a digital x-ray program
SENSORS PHOSPOR PLATE
Instant Requires development time
Infrequent replacementRequires replacement after X
uses
Requires new placement
techniquesVery similar to film
Larger initial investment Lower start up costs
3. imaging
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Three options for integration
1.
Seamless
Integration
2.
Bridge
3.
Third Party
(no integration)
3. imaging
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Does it have the tools you need?
Questions to ask
ALL:
can you easily send x-rays to your
referring doctors?
ENDO:
does it measure
the length of the
canal?
PERIO AND ORAL SURGERY:
can you measure for
implant placement?
PEDO:
will your patients be
compliant with the size
of the sensor or
phosphor plate?
ORTHODONTIST:
can you get
cephs & pano’s?
3. imaging
Research the software company
Training?
Service?
Upgradability?
3. imaging
4.office design
Dayna JohnsonRae Dental Management
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Office Design
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• Reception
Room
• Front Desk
• Treatment
Room
• Consult Room
• Conference
Room or Staff
Lounge
4. Office design
Reception Room
• Big screen for
looping:
patient education
video
before and after
photos
list of services
provided
• In-office wireless - do
you want to offer
internet services to
your patients?4. Office design
Reception Room
304. Office design
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Front Desk
• Position the
monitors for
privacy
• Install printers
within arms
reach
4. Office design
Front Desk
324. Office design
Treatment rooms
• Flexible monitor
arms can be
positioned for
viewing by patients
and providers.
• Dual monitors in
treatment rooms is
optimal.
4. Office design
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Treatment Rooms
Do not put the
computer in a closed
cabinet!
• Too hot
• Remember you need
room to plug
peripherals into the
computer (x-ray
sensors, wireless
devices, etc)
344. Office design
Treatment Rooms
354. Office design
Treatment Rooms
364. Office design
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Computers for other needs
• Consult room
• Conference
room for team
meetings or CE
• Lab for ordering
4. Office design
5.Computer
Hardware
Dayna JohnsonRae Dental Management
Managing your computer inventory
5. hardware
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Don’t forget your peripherals!
• Monitors
• Mice and keyboards
• Signature pads
5. hardware
415. hardware
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Three recommended backup systems
1. Online encrypted backup
system
2. In-office automated back
up to external hard drive
3. Off site backup
5. hardware
1. Online encrypted backup system
• Usually billed by volume of data, so use for most critical information
• Make sure it has
encryption
• Typically user friendly and
can be automated
5. hardware
2. In–office automated backup
• External hard drives
store TONS of data so
backup your entire
computer system
• Run daily, weekly or
monthly
• Look for a format that
can be easily restored
after an emergency
• Do a ‘practice restore’
at least once a quarter.
5. hardware
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3. Offsite backup
• Use a flash drive to
backup patient data
• Someone takes the
external hard drive off site
daily
• Send a monthly copy of
the backup tape to a
certified accountant or
attorney
5. hardware
Who is responsible for backup?
• How often is it running?
• What is it backing up?
• When was the last time
you did a practice
recovery?
5. hardware
Updates
• Designate someone in the
office to be the go-to person
for computer updates
• Don’t download everything
• Make sure the update only
downloads what you want
5. hardware
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6.implementation
Dayna JohnsonRae Dental Management
Implementation: A Three-Phase Approach
Phase I
Assessment, Goal Setting
and Planning
Phase II
The Electronic Health
Record
Phase III
Going Paperless with
additional eServices
506. IMPLEMENTATION
3-6 months
• Are your core systems running
well?
• Goal Setting and Planning
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Phase I:
Assessment of
Core Systems
6. IMPLEMENTATION
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6. IMPLEMENTATION
Phase II: Implementing the Basics
3 – 6 months
• Electronic Health
Record
• Forms and Signatures
536. IMPLEMENTATION
Phase III: Adding Bells and Whistles
3 – 6 months
• Electronic appointment
reminders
• Website enhancements
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• Using iPads,
touchscreens
or notebooks
6. IMPLEMENTATION
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1. Confidentiality
2. Integrity
3. Accessibility
HIPAA Security Rule
Dental offices are
responsible for
reasonable and
appropriate
safeguards
of the Electronic
Health Record
6. IMPLEMENTATION
HIPAA Security Manual
• Device and Medial
logs
• Data Backup Plan
• Testing Restoration
• Disaster Recovery
Plan
• Emergency Mode
Operation
• Education
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ADMINISTRATIVE
SAFEGUARDS
6. IMPLEMENTATION
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HIPAA Security Manual
• Physical location of
paper based and
electronic PHI
• Posting of PHI in the
office
• Conversations
including PHI
• Access to PHI
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PHYSICAL
SAFEGUARDS
6. IMPLEMENTATION
HIPAA Security Manual
• Computer
Workstation Use
• Device and Media
Controls
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PHYSICAL
SAFEGUARDS
6. IMPLEMENTATION
HIPAA Security Manual
• Access Control
– Receiving
– Sending
– Disposing
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PHYSICAL
SAFEGUARDS
6. IMPLEMENTATION
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• Security
Configuration
– Testing
– Inventory
– Virus Detection
– Updates
HIPAA Security Manual
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TECHNICAL
SAFEGUARDS
6. IMPLEMENTATION
Dayna JohnsonRae Dental Management
7.on your path
• Trust your computer system
• Trust your backup & recovery plan
• Trust your trainer
• Trust your hardware tech
• Most of all…
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Trust
Your
Team
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• Support the team, but
don’t overwhelm them
• Pay for training, not
toys
• Learn with the team
Be Involved
Great patient experiences
Patients refer like crazy
Happy team65
Remember
Your
Ultimate
Goals
Resources
• Security and Data Protection
– Your malpractice company
– www.dentalpracticecompliance.com
– www.ada.org
– www.hhs.gov
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Resources
• Team Training and HIPAA
– www.RaeDentalManagement.com Dentistry’s home page for
chartless and paperless resources, coaching and training needs and Dayna’s contact info.
– www.4MedApproved.com/education/raedental Your number
one resource for HIPAA team training and risk analysis.
– www.cms.org – The government entity for HIPAA documentation and rules.
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Dayna JohnsonRae Dental Management
References
• Dental Products Report – September 2010 Clinical 360 “Tech
Experts Chart a Digital Path”
• ADA News – June 21, 2010 Electronic Health Record, Dr.
Faiella
• ADA News – August 16, 2010 ADA continues to work on HER
development, implementation, Dr. Faiella
• Minimizing Liability in the Dental Setting – Nordic pgs 39 – 44,
61-64
• ADA Dental Records – 2007 pgs 7-8,
• www.ada.org/prof/resources/topics/hipaa/index.asp
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Dayna JohnsonRae Dental Management
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About Your Presenter
• Over 20 years in the dental
industry, including office manager
in two dental practices
• Member of Speaking and
Consulting Network
• Member of Academy of Dental
Management Consultants
• Author of The Dentrix Office
Manager blog
• Certified Dentrix Trainer since
2006