Guy Meyers asks if it is a dream or possible reality.
Half a century after the term ‘paperless office’ was first coined, it seems that banks, insurance companies and even some retail stores are being highly successful in reducing and even eliminating their paper footprint. In light of this it seems reasonable to ask why the dental industry is falling so far behind and what being a paperless practice actual means. In reality, the possibility that a business can operate without the need for any paper whatsoever seems untenable, but in truth, the term owes less to a literal definition and more to an ethos and desire on the part of the dentist and staff, to embrace the efficiencies now made possible by full computer integration into many different aspects of practice life.
Many tasks performed in a dental practice are traditionally very time-consuming, particularly for the front desk team. Managing recalls, appointment bookings and short notice cancellations are all vital to the smooth running of a practice and anything that can be done to minimise the time required to complete these tasks adds to the productivity of the business. The elimination of paper records, the introduction of digital X-rays, the automation of communications and the provision of online booking are just some of the elements of practice life that can be streamlined by the introduction of new technology.
In the UK, the government’s drive towards a paperless NHS has been an on-going goal for a number of years and the pressure to use digital communications is growing. NHS claims will all need to be completed electronically by 2019 and regulatory tasks such as the Friends and Family Test are much easier to manage if completed and submitted without the use of paper.
But the desire to run a paperless practice is also coming from within the profession itself, with over 75 per cent of practices surveyed in Software of Excellence’s recent white paper Paperless Practice – dream or reality? (available to read in full at https://softwareofexcellence.com/uk/whitepapers) aspiring to this ideal. And, as increasing corporatisation starts to dominate the dental landscape, general practices need to be more aware of solutions that can help them create more efficient and streamlined businesses in order to compete.
Acknowledging the reality
According to the research, only 5.5 per cent of practices consider themselves to be truly paperless, but many more practices are making good ground in certain areas in which the paperless dream has been made possible by the introduction of some simple automated systems.
Appointment management
The majority of respondents in the research claim that certain aspects of their practice administration are paperless and top of the list is appointment booking, which is paperless according to 83.7 per cent of the total cohort. Short notice lists are used by 64.3 per cent of large practices (defined as having more than 5,001 patients), but by just under half of small practices (fewer than 1,000 patients). Forty-three per cent of the total cohort is failing to use paperless techniques for short notice lists, meaning that almost half of practices are still relying on handwritten notes, or even worse, the memory of their reception team, to remember which patients are most likely to fill appointments at short notice, leading to gaps in the diary and underused resources.
Patient data management
Seventy-eight per cent of practices admitted to collecting patient data manually, with 60 per cent saying that the process of inputting this data into their patient records takes about five minutes per patient. This means even with a conservative estimate, a practice with 4,000 patients, which takes 2.5 minutes to input patient data per patient and collects data once a year, will spend 10,000 minutes on this task per year. Ten-thousand minutes is 166.67 hours, which for an average seven-hour day equates to 23.8 days – a staggering total of ‘lost’ staff days per year on what is a basic administrative task.
Storage of paper patient records is another negative consequence of too many paper-based tasks. Alarmingly, 13.4 per cent of those asked admitted to not backing up records at all. From both a data protection point of view and also from a dento-legal standpoint, the consequences of lost data are serious. Any form of litigation or GDC investigation would require patient records to be produced and failure to back up records would not be well received by the regulator.
Patient feedback
Another important aspect of regulatory compliance is patient feedback, which has seen one of the lowest adoption rates for computerisation, with less than a third of practices carrying out this task using paperless methods. As collecting patient feedback is a regulatory obligation, it is likely that this task is being undertaken manually by over two-thirds of practices, at an unknown cost in terms of staff hours.
Treatment estimates, patient communication and practice marketing are all other areas in which practices are missing out on efficiencies by continuing to use time-consuming, paper-based, manual methods.
Achieving the dream?
Approximately 83 per cent of UK practices operate with a practice management system and many have adopted paperless systems for some administrative tasks. This is particularly the case for larger practices which have tended to cope with their patient bases by adopting more automated technology. However, most practices are not gaining the full benefits available from those systems and regardless of practice size, the efficiency gained by adopting paperless techniques and where possible by automating, are significant. With knowledge of what makes practices more efficient, and by applying best practice methodology practices can get closer to realising that dream of a paperless practice.