If you’re like most doctors these days, you’re pretty savvy with a PC. At home you have a sharp, new, screaming-fast computer and you surf the Net with aplomb. At the office you probably have a much older system, possibly a different brand.

Today, you’re faced with a new challenge: You’re going to start dispensing eyewear, or you’re thinking about computerizing your existing dispensary. The big questions: Do you need a software system to help run your dispensary? If so, what should you buy?

The good news: Computer software today is more powerful than ever. The bad news: You’ll probably want to re-computerize your whole practice when you see just how powerful it is!

If you’re just creating your dispensary, you may be thinking that a computer system is too expensive an investment.

Is it? Consider how much you’re spending to create the dispensary. Perhaps you’re acquiring a new patternless edging system for around $25,000, or investing $20,000 for expensive new displays to hold 500 frames. You may be preparing to employ two highly skilled opticians at a total annual income of nearly $80,000 – plus benefits. And then, of course, there’s the $28,000 worth of eyewear.

If you’re spending this much money to get your dispensary up and running, it makes no sense to refuse to spend the money to make the dispensary an effective, profitable operation. And that’s just what a computer system can do.

Once you have a dispensary operating in your practice, you’ll have a huge new mountain of information to track. Chances are your practice administrator is already stretched thin. You could hire an assistant administrator to track the data, but payroll costs will go higher, and you’ll be paying for a staff member who doesn’t directly produce any profit. If an optician tracks your data you’ll have a major security concern, and this isn’t an effective way for a profit-producing member of your staff to spend his or her time.

On the other hand, a good computer system can handle the two main dispensary challenges with ease:

• Tracking inventory. All inventory items (including frames, lenses, chains, cords, cleaners and magnifiers) need to be accounted for.
• Tracking performance. You need to monitor the effectiveness of the optical staff and outside sources connected to your dispensary, as well as how different items are selling:
• How many prescriptions were filled? What was their average price? Which doctors wrote them?
• Are prescriptions from outside the office coming in? If so, how many, and from whom?
• Are your advertising and promotion efforts working?
• Which optician handled the most prescriptions? Who had the best average sales numbers?
• Which frame lines return the best profit numbers?
• Which lenses, from which labs, consistently result in great financial performance?

O.K. Let’s say you’re convinced. What should you buy?

Odds are good that you already have a computer in your practice. Should you use the system you already have, expanding its capabilities to include tracking dispensary information?

If you’re like many doctors, the hardware and software you use at the office are getting a little tired. (Remember your staff complaining about how hard it is to get useful information out of the system?) And upgrades may not be feasible.

"Wait a minute!" you say. "We spent a lot of money on that package just a few years ago!" I’m sure you did. But 3 to 5 years ago is the computer equivalent of the Stone Age. (Besides, what are tax write-offs for?)

Current hardware and software have eliminated many of the disadvantages of older systems. Older systems were far slower than today’s systems, and would often get even slower when you added a terminal to your network. Modern PC-based networks don’t "slow down" as you add terminals.

Even more important, older software could only manipulate data in limited ways, making it extremely time-consuming and work-intensive to organize patient data or produce reports. (See "Relational database" at the end of this article.)

Given the advances in technology over the last few years – even in the last few months – the time couldn’t be better to update. There are many reasonably-priced 500 MHz PCs and Macintosh computers on the market. (Yes, Macintosh. Many people are very happy with these elegant and colorful machines, and some great ophthalmic software programs are available for them.)

Suppose your practice consists of a single location. Do you need to have a "network" of computers within your practice? What about just buying a single computer to use in the optical?

The problem with using a single computer is that it can become cumbersome if more than one person at a time needs access to it. You may very well have one person looking up records, entering data, printing out insurance forms or ordering while your opticians are trying to enter data at the point of sale.

Ideally, software for dispensing eyewear should be part of a software package that you use to run your entire practice. This will benefit your practice in many ways. Certainly one major benefit is that new software is likely to be more efficient than any older system you may already use.

If you recently installed a Windows or Mac system, check with your vendor. Modules may be available to integrate the dispensary into the overall practice. If not, it’s probably time to move into a new system that can run your whole practice, including managing inventory control and interpretation of sales and utilization data.

Also, a single computer may force you to treat the dispensary as a separate entity. Your bookkeeping staff may prefer to have the dispensary under their control, which is much simpler to manage with a network.

The first rule to remember when choosing a computer system is this: Make software decisions first – then get the hardware that works best with the software you’ve selected.

Most ophthalmic software will provide you with:

• patient databases for tracking and organizing data
• claims-processing functions
• billing functions
• resource scheduling (useful for analyzing your resource utilization and making management decisions)
• utilization reporting (for reviewing managed care performance and making management decisions)
• electronic records (to eliminate paper shuffling)
• financial reporting
• practice management tools
• point-of-sale functions (for managing dispensary operations)
• inventory control
• customer support options.
• Some of these functions may be "modularized," so you can add functionality to the system as you grow.
• Other helpful characteristics:
• Most modern software has data entry pages with con-venient pop-up lists, so frequent entries don’t need to be typed in every time.
• Customizable data entry screens can allow you to personalize the program to your practice’s needs.
• Software that offers interactive help and prompts the user can minimize expensive calls for customer support.
• Two things to watch out for:
• Avoid software that creates "a priest in the temple" employee – a single person who’s the only one in your practice who understands the software. This can really hurt you when he or she leaves the practice.
• Companies whose reps talk endlessly about customer support may be saying that their software is too complicated for normal humans to comprehend.
• The bottom line? Each software package has its own unique characteristics and level of sophistication and must be evaluated against your needs.

Once you’ve decided to upgrade or replace your system:

• Start checking with your peers at medical meetings. Ask what they use and whether they’re happy with it.
• Spend some time with software vendors who have displays at your regional meetings.
• Look up potential vendors on the Web.

Once you have a direction in mind, call a staff meeting and build a wish list of the features and functions you and your staff feel are most necessary to meet your needs.

The next step is to check out software demos, which most software companies have available. (If they don’t, that says something about them.) Try out the demos of the most promising software yourself, and then with staff members.

Choose two software systems that are best designed, easiest to use, well documented and make complex tasks easy. Then ask for a full review of each of them – in your office – by an expert from each company, again with your staff present. Now is the time to pull out your wish list and reconcile it with reality. How do the two systems you’ve selected stack up?

Some software can be purchased outright, or paid for over a period of months; other companies will lease their products. Prices typically run from $1,000 to $1,000,000.

Once you’ve selected a software system, buy the hardware that the software developers suggest. The hardware can be obtained through reputable mail-order houses, online from Dell or Gateway, or through a nearby retailer, who may also provide installation services.

Opening a dispensary can be a very smart move in today’s economic and political environment. Just make sure you have the tools you need to run it effectively and help you use the information it generates to your advantage.

To decide which of today’s systems is right for you, you need to familiarize yourself with current terminology:

• Peer-to-peer network
. This is a simple setup in which independent computers are connected so they can communicate with each other. Peer-to peer-systems are good if you’re just beginning to network your practice (or just switching to a Windows environment).
• Client-server system.
This is the data system most favored today for managing enterprises. In this system a "central" server computer holds and manages information, acting as a data source for satellite "client" computers. The server allows many computers to work with the data simultaneously, so files remain accessible to others while you’re using the data.
Local area computer networks (LANs) with a server can be tied together into a wide area network (WAN) to serve multiple locations. LANs and WANs can be set up in many different ways, but the biggest decision you’ll need to make will be whether to have separate databases at each location, or one big database at a single location. Separate databases make it difficult to combine data across the whole practice. Conversely, with a single, central database the cost of the connections and the security of the system become concerns.
• Relational database.
Relational databases are the key to modern software. In these databases all information is connected, and data can be related in whatever way you require. For example, you might wish to look up all patients between the ages of 33 to 41 with a certain type of insurance who live in a specific ZIP code, for a targeted mailing.
• Ethernet systems.
Ethernet is the most widely installed LAN technology. Simply put, it’s the way you’ll hook your system together. It uses either coaxial cables or twisted pair wires to connect your computers through hubs.

Once you’ve decided which computer system makes the most sense for your dispensary:

• Be sure to install back-up devices
. This is absolutely crucial (although they won’t help unless you remember to use them). Computers – even today – are notorious for suddenly "freezing up" or losing power, and work that hasn’t been backed up may be lost forever. (Most of us have already had this unpleasant experience at some point. If you haven’t, count yourself lucky and take steps to make sure it doesn’t happen to you somewhere down the line.) Many back-up schemes exist:
-removable media, such as one or two gigabyte jaz drives, 100 megabyte zip drives, or tape back-up
-Redundant Array of Independent Disks (RAID)
-recordable CD ROM (around 650 megabytes can be stored).
• Install non-interruptible power devices
. A non-interruptible power source is a battery that automatically kicks in if power drops or is cut off. This gives you time to save data and shut your computer(s) down safely.
Note: This is not the same as a "surge protector," which can be bought at any hardware store. A surge protector simply protects your system and its components from sudden increases in voltage over your power grid.
• Check Y2K compliance
. It goes without saying that your system must be Y2K compliant, so you won’t have a disaster on your hands when the year 2000 arrives. (You’d have to be living in a cave not to have heard about this!) Most new systems are compliant; Macintosh computers have been compliant since they first appeared on the market. Check with your company rep to make sure your choice of system is compliant. And if you have an existing office computer system, get this problem checked out immediately!