The Paperless office Part 2

It took the better part of the first half of last year to get our Accounts Receivables area working the way we wanted it to with the new version of Medisoft. I am sad to report that after extensive study and searching I was unable to come up with an Electronic Medical Records System that worked the way I do. The software documented lots of things that are irrelevant to me, and failed to document the things that are vital to me.

One of the key things was simply that after every 12 visits, we re-check the patients objective findings, and make a graph of the progress. It is of course not a perfect system. It is not weighted as to whether one objective finding is more significant than another one. For instance if the top vertebrae is out of alignment, in my opinion it can cause massive changes to ones neurology, above and below the bottom of the skull. On the other hand a stuck toe joint would count on our system as just as significant.

Also of course I am not a perfect machine, and although I consider myself to be one of the better more conscientious chiropractors I have ever met, mine, and every other doctors ability to use our hands to determine which bones are out of alignment and stuck has some variability to it. For the record, my theory is that chiropractor to chiropractor there is a variance of skill in feeling asymmetry of the spine. There are of course bones that are asymmetrical from side to side that can throw one off. There also is another point that I have never heard brought up from chiropractors, and that is the fact that the greater the distance the bone has become fixed from its central position, the easier it is to feel.

I have discovered this after inviting people to feel their own misalignments and decide for themselves, or by having parents check their children or visa versa. Even for myself, the greater the degree the bone is displaced from its center resting place when it becomes stuck, the more certain I am of the result. As the bone becomes close to being perfect, it is harder to measure the fact that it is out of alignment, and more the fact that the bone simply does not move well.

Back to paperlessness!

After having Reagan who had been with us for half a decade leave and get married. Mazel Toff! (That is congratulations in hebrew) the patient treatment area has suffered in its following up on patients who have fallen off from their ideal treatment plan. As you probably know, we pride ourselves on getting results that often vastly exceed those of other chiropractic offices, so this problem is totally unacceptable. One of the required pieces of getting patients better is that they show up exactly per their treatment plan until they get to their peak recovery.

So after trying to get a few people in to replace Reagan, and so far failing, I have stepped in the past few weeks and taken on the job myself. Many of the patients have been very surprised to hear my voice saying “Hey, didn’t we have a visit scheduled for you today? What’s going on?”

I actually love my patients a lot, so it is fun to be on the phone with them.

I have found that the current software we use called Office Hours, misses many features that I consider basic in doing the job of hunting down wayward patients, and getting them back on the treatment plan that we agreed to at the beginning.

One thing is simply that it would be nice to see their face. I remember people by their faces, much sooner than I do by their names. I also want to have lots of room to write details about them, staying of course within all of the privacy laws. Also, when I look at the schedule, color coded appointments speak to me much quicker than any other symbol. Red means they missed. Yellow or Green means the patient showed. I also want colors that mean we called and reminded them and spoke to them and they confirmed they would be in, versus we called and reminded them and spoke to them and they said they would probably be in today.

I want this position in our organization to be super efficient and easy to do.

So I am currently looking at two different options. Both options involve getting custom made software made. None of the E.M.R. (Electronic Medical Records) software could even come close on this.

Option 1 – Have it made using FileMaker Pro. Thank you to Sarah for turning me on to this amazing software. It is pretty much moron proof. You open it up, decide what info you need on a page, and within seconds you have created a database. It took me around 10 hours of study to get the basics of what it is. It is simply a fancier and more customizable version of Microsoft Excel. It can have a big box full of a bunch of smaller boxes of information. You can customize how it looks. You can write little mini programs to tell it what to do with all this information. To create what I want will make our office almost paper free. So even though I understand the software now, I would like to higher a professional FileMaker Pro person to make our contact management/ scheduling / EMR / Coding / Patient Treatment software.

Option 2 – When I get done with writing all of the exact requirements of the software, I will ask Ray, my super programmer who I have hired here and there to see what it would cost him to  make the software from PHP or some other programming language. Easier? Harder? I have no idea.

So for the past three weekends, I have been carefully writing a technical description of what I want the software to look like and do.

Then I will hit up Ray, a few cool FileMaker pro sites I saw, and my favorite programmer swap meet Rentacoder.

Also after many years I was finally able to purchase I will be getting that up and running for my internet marketing consulting and pearl tile business. I will probably put links on it that point to this and all my other sites so there is one central place to get to all the other ones.

That’s it. If you are a reader of this site, and you read this, please leave me a comment. I find that like one out of every 5,000 readers leaves a comment, seriously, and I would love to hear who is stopping by!

13 Replies to “The Paperless office Part 2”

  1. Dr. K !

    I have a couple words of encouragement … you are the best chiropractor in the universe! I have no doubt about that. Thank you for caring about us.

    And Roseanna is the best case manager in the history of case managers. Simply put she is da bomb! Plus she is super hot ;]

  2. there was a lot of thought and detail put into this blog, i’m excited to see where your ventures go in the future

  3. I just found your blog today while looking for EMR solutions. We have used Medisoft and Office Hours for several years, (just upgraded to version 11 this year) and I manually change the color of the appointment if it is missed, etc. and add notes. That way, I can tell at a glance if the client missed, rescheduled, was contacted to reschedule, etc.

  4. hey, im just a student! studying paperless office yawn yawn we stay up late to read material………………….. only commented caus of your last sentance!

  5. Just stopping by to see the struggle of your paperless office journey.

    I’m researching it myself on a broader scale and discovered your link in google.

    It was intriguing to say the least. Your commitment to setting up the system must be reflected in every aspect of your practice.

    It’s good to see that kind of dedication.

    Keep up the great work.

  6. Found your blog while searching an information about paperless office in google.
    Keep us informed about your progress!
    I will sure come here after while to reader part 3 of that text.

  7. I read your paper with interest here in London. I’m a lawyer and I started my quest for the paperless office by establishing five principles:

    1. Paper files are essential for all client matters.
    2. Editable e-documents must be readable as part of the e-file without conversion to PDF, JPG etc.
    3. I must be able to read the whole of any e-file in date order, regardless of the format of each e-document.
    4. I must be able to move from one e-document to the next with a single click.
    5. Each e-document must be readable on screen without zoom adjustment or magnification.
    6. I must be able to highlight text and subsequently erase the highlighting.

    I’m sure there are other essential principles I haven’t worked out yet. However, it’s clear that nothing in Windows XP or in Office XP will enable me to meet principles 2 to 6, so I am looking for suitable software. Problem is, it will probably be very expensive.

  8. I think one thing that gets neglected a lot is the issue of backups. So many electronic media are very sensitive or easily damaged, if you go paperless but don’t backup your data, you are screwed.

  9. Mr. Paperless,
    I could not agree with you more. My first computer job around 1983 was backing up a computer onto reel to reel tape. I have been backing up ever since!

  10. Just a few thoughts here;
    I also ran across your comments looking for paperless office solutions as a “sub-quest” on total electronic organization. I have been an IT professional over 16 years now, and I am looking for solutions that assist me in organizing all aspects of an electronic life, in such a way, that I can organize all the electronic information that I need in the way that I think, that is “interoperable” between my work office, and home office.

    To me, paperless office solutions are really the input, a method to a means. Getting all of your needed information into an electronic format to live in a large electronic “pool” of data.

    how you organize and access that data is the key. And since we have the capability these days with our programs, e-reminders, etc, how that data can act and react to your needs, or your business needs is key as well. For instance, for patient appts. wouldn’t it be nice to have a smart system that sent an automatic voice-mail reminder to patients, and keep reminding you about the status of their visit as you described earlier with color coding?

    As far as organizational tools for multiple types of e-media that you need to sort, refer to tag, store etc. I am looking into mind mapping tools to sort out how to organize my work in the way that I think, that may include wrapping together emails, with web research, with documents stored across several different network locations.

    just some additional thoughts to consider on the journey.

    From a technical perspective, not only back ups using some sort of NAS network attached storage, but also you should take a look at security concerns as well, certainly with the privacy laws that govern records.

    They have had document scanners out for a while that are duplex – scan both sides at the same time, in both color and BW; that have high page per minute counts, and will store them in PDF formats, and also Perform OCR, such that you can begin tagging the scanned docs for ease of search and retrieval later.

    back to my smart system, with the scanner, I would personally like some software that I could use to select a document type profile, auto scanned and tagged the document, and stored it in the right place on the network, and then was somehow connected into my office/home organizational workflow system such that I was notified of status of the data, and what action I needed to take on it, review, FYI, follow up etc.

    just some thoughts

  11. Thanks for your blog! It’s fun to see how it goes and learn about how to create a paperless office 🙂

Leave a Reply

Your email address will not be published. Required fields are marked *