Online transmission of digital patient information
As a dentist you have a professional as well as an ethical duty to refer a patient to a specialist for diagnosis and treatment as needed. In the past, with paper charts that would mean the dentist, scribbles a note on a card, sometimes copies an x-ray and tells the patient to call the specialist.
A paperless referral does not start with a scramble through the referral pad box looking for the right pad and a dash to the dark room to copy the radiograph. It starts with a visit to the specialist's Web site; a smart interactive Web site.
When you log on as a referring dentist the system will recognize you and automatically know all the basic details about you and your office, such as address and phone number. As a referring dentist you will have access to an online appointment book showing open appointment times available for new patients over the next several weeks. You can secure an appointment for your patient immediately. Then you can fill in the referral information.
First generation attempts to create digital referral slips simply recreate the paper form in an electronic format. The dentist still needs to fill in the information (patient name, practice information, tooth #, diagnosis etc.) by hand with a mouse and keyboard.
More than Paperless
Second generation digital referral slips are smart and interactive.
The dental software system will upload all the appropriate patient data from the paperless record. This would include the minimum information we now scribble on the paper slip; patient name, the tooth and the treatment.
But that's not all. With a smart interactive referral you are not limited to minimums. The online digital referral system will upload all the patient information like address, employment, contact numbers and the other things we need to create a new patient record. The system will upload the patient's insurance information including plan and group numbers, contacts, and benefits. The system will upload the patient's health history with areas of concern noted.
In other words, all the information a patient usually needs to spend time writing onto an over copied form on an old brown clip board is sent automatically before the patient even arrives for the first appointment. Rather than spending time typing and clicking the information from the handwritten form into the computer chart, the data automatically fills in the computer chart.
Digital communication is very fast (virtually instantaneous) and very inexpensive. However, there is an even greater benefit that is so obvious it is often not appreciated and that is that digital communications allows us to transmit digital data. And it is now possible to turn virtually everything we do (photos, radiographs, pocket probings and even impressions) into digital data.
Using a smart interactive referral system you will upload diagnostics like photos, x-rays and probings. These will be available to the specialist before the patient arrives, they are the same quality as the originals (unlike a conventional copy of a model or a radiograph) and they can be enhanced with diagnostic software.
Adding in the Details
As the referring dentist you will then be prompted to fill in details using a decision tree. A decision tree is an interactive system that guides the user through various selections with each new decision based on the previous answer. For example the system could ask, 'Is the patient experiencing pain?' If the answer is yes then a new and different set of questions is launched. 'Is the pain constant?' 'Is the pain mild, moderate or severe?' and so on. If the answer to the first question is no, then the system jumps to a completely different symptom, 'Is there any swelling?'
Once you have made it through the decision tree you will have a blank page on which to type all the detailed notes you wish.
At this point the specialist's Web site could launch a pop-up window to introduce a new procedure or technique. The dentist could ignore it or follow through the links to learn more about the procedure. This could lead to diagnostic criteria, photos, testimonials and even a chance to sign up for an upcoming CE course.
When you submit the referral, the specialist will acknowledge receipt, confirm the appointment and contact the patient. The specialist will also add your new referral to your account noting that you are a 'Gold Elite' client. This will prompt all kinds of special treatment, perks and goodies to fall your way.
Paper's Hidden Costs
Dentists often take the attitude that paper charts and paper communications (like lab and referral slips) work fine and they don't cost anything. However the fact is that these systems are not all that great and the actual costs can be significant. But we often don't see it because it is hidden in the process of doing business.
A typical dentist will spend five and a half months filling out lab slips during his or her career. That is more than five months of your professional career doing the same tedious task over and over. If you consider your professional time the monetary cost of filling out lab slips is an astonishing $264,000.
The total reality is even worse; these numbers are just for lab slips. What about other professional communications? That is referrals to specialists and others; the numbers could double.
Not only is the typical dentist spending way too much time and money on this paperwork but they are usually doing it poorly. Most lab prescriptions and referrals are scribbled notes with minimal communication.
Digital Records are Key
Online digital lab slips and digital referrals will reduce the time and expense of filling out the forms and it will provide higher quality communications. However, all of this is possible only if the dentist is collecting digital data to begin with.
If for example the health history or the perio probings are not created and stored in a digital format as part of an electronic record but must be copied, input or scanned before they can be uploaded then there is no savings in time and money.
Common concerns regarding online digital communications are privacy and security. Just as you have an obligation as a dentist to refer you have a professional as well as a legal and ethical duty to protect patient information.
Using an interactive Web site with a secure logon is one of the most secure means of electronic communications. It is much more private and secure than simply sending the information in an e-mail. After all, if banks and brokerages can safely use similar Web systems for sensitive financial information we can use them for protected medical information.
Hand scribbled referrals and lab slips were OK in the past. However, the future is digital. The future is coming and it will be Amazing!