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Advantages & Disadvantages of Paperless Operations in Orthodontics

Author: Charles A. Lewis

Orthodontists increasingly hear the buzzword ‘paperless’ in connection with practice operations. Yet my daily experiences in talking with orthodontists reveal that few of them actually know what is involved in being paperless. Of course this makes it difficult, if not impossible, for them to discern the advantages and disadvantages of such operations. And if they don’t know whether being paperless is good or bad, how can they rationally decide if it is something they should consider for their practice?

Attendees of my lectures at seminars and dental colleges often ask about the biggest advantages and disadvantages of operating in paperless mode. For that reason, I decided to provide some brief written answers that will hopefully assist doctors in their evaluation of whether or not to ‘go paperless.’ Although my purpose is not to educate readers about all the particulars of each facet of paperless operation, a concise example of each advantage and disadvantage is listed.

As we embark on this endeavor, it is important to answer two vital questions about paperless operation:

1. What is it? Paperless operation means that electronic functions and records replace all those involving paper and, in the case of models, plaster.

2. Is a completely paperless orthodontic practice achievable today? The answer is No. Some of the activities still required in orthodontic offices rule out the total elimination of paper usage at the present time. However, the term ‘near paperless’ just doesn’t have the same pizzazz and is rarely used; so this article will continue to use the phrase paperless.

Advantages

The major advantage of paperless operation can be summed up in just four words: increased functionality and efficiency. This is accomplished due to the following:

• Easier access to patient records
• Patient records are more portable
• Patient records are more secure
• Improved communication capabilities
• Increased awareness of treatment status
• Reduced office space requirements
• Office design can be enhanced
• More efficient use of staff
• Augmented management capabilities
• Cost effectiveness
• Enhanced emergency operation capabilities
• Easier operation of multiple office locations

Easier access to patient records. When the records are electronic, they are available to the doctor and staff at every workstation on the office computer network, simultaneously. Conversely, paper charts are ‘single user’ devices.

Patient records are more portable. With electronic records, it is much easier to transport patient files to a satellite office in order to see patients.

Patient records are more secure. As long as the practice backs up the system daily and stores the backup copies offsite, destruction of an office by fire, water, etc. will not result in the loss of patient records.

Improved communication capabilities. When a referring doctor or parent calls to discuss a patient, the orthodontist can go to any workstation and access all the records necessary to answer questions.

Better awareness of treatment status. Customizable electronic treatment charts can make all the information available in summary form and can automatically keep track of such important information as the remaining time left until the braces are to be removed, etc. It is also easy to query your treatment data for research purposes.

Reduced office space requirements. Eliminating developed x-rays, printed photos, paper treatment records, plaster models, etc. can substantially decrease the storage space required in the office.

Office design can be enhanced. Having access to all the patient information at every workstation can help remove the front desk as the focal point of operations. Procedures such as check-in, scheduling, checking out, answering treatment or billing questions etc. can take place at alternate locations, allowing the patient flow in the office to be redirected for greater efficiency. Eliminating the aforementioned storage areas also contributes to design changes.

More efficient use of staff. Paperless operation does away with finding (no more lost charts), pulling and re-filing charts, plaster models, and x-rays, which can be a big chore in large, busy practices. This frees up more time for interacting with patients.

Augmented management capabilities. Management reports can be run and then stored on the computer, instead of printing them out. They are then available for review at any time without searching through a file cabinet.

Cost effectiveness. There are myriad ways in which paperless operation can be cost effective and this is especially true for new orthodontists who are just entering practice. They can minimize the amount of required office space by eliminating the areas needed for storing patient charts, developing and storing x-rays, and for plaster model storage. It can also help to delay the need for additional staff.

Enhanced emergency operation capabilities. If electronic patient records are regularly backed up and stored offsite, it is easy to quickly get back into operation after the catastrophic loss of an office due to fire, hurricane, etc. Most orthodontists have arrangements with colleagues to share office space in such instances and with a PC and the database backup, they can treat their patients with all the records available.

Easier operation of multiple office locations. Orthodontists with multiple offices can connect satellite locations to the server in the main office; carry the data back and forth on a notebook PC, etc. This allows them access to all the necessary patient records.

Disadvantages

The disadvantages of paperless operation can be summarized as follows:

• Requires a larger investment in system hardware and/or software
• Increased workload and stress for staff during conversion process

Requires a larger investment in system hardware and/or software. The efficiency brought about by paperless operation requires having an adequate number of strategically located workstations; chairside workstations are essentially mandatory. Although digital imaging and radiography systems are desirable, photos and x-rays can be scanned into the patient record using a flatbed scanner.

Increased workload and stress for staff during conversion process. For existing practices with a large patient base, converting to paperless operation can take a significant amount of time and effort.  All the existing treatment charts, x-rays and other images, even plaster models, must be scanned into the computer system and these extra activities often create additional stress.

Summary

Even a cursory glance at these lists reveals that the advantages of paperless operation far outweigh the disadvantages! As orthodontists are made fully aware of all the benefits of each aspect of the paperless process, these operations will quickly become customary; many practices already operate in this environment. In addition, an innovative new method of delivering orthodontic software is now increasing the benefits of operating in paperless mode, while concurrently diminishing one of the disadvantages.

For additional information on the new delivery technique mentioned, read ‘Using Internet-Based Software to Operate Paperless Orthodontic Practices’. You will find it and additional articles (and links to articles) on paperless operation at www.Advanced-Ortho.net/articles/asp. 

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