the path to paperless
Office Network Creates Benefits
Our network is the source of many new efficiencies.

By Peter J. Polack, M.D., F.A.C.S.

Even if you are not ready to implement an electronic medical records (EMR) system, your practice can derive many benefits by having an office computer network.

	ILLUSTRATOR: MARK HEINE/ DEBORAH WOLFE, LTD

Although we expected to see improved communication due to a more robust e-mail system, we also encountered unexpectedly pleasant surprises. Often, what would start out as what appeared to be just a clever idea from an employee has resulted in a practice-wide application that has allowed our practice to function more efficiently.

This month, I will discuss some of the time- and money-saving programs that our network has enabled us to implement.

Enhanced Communication

The EMR implementation plan designed by our EMR committee, made up of certain key personnel and our IT staff, is a multi-stage project to familiarize our staff with a computer "environment" while preparing the office infrastructure for increasingly complex systems. First, the LAN (or local area network) was set up, followed by the conversion to the new EPM (enterprise practice management system) and then the EMR system (yet to be launched). Along the way, we found that the basic network has facilitated enhanced communication between personnel in ways that were previously not possible. Following are several examples:

Triage processing. Even while we were still using our old EPM system, our IT director wrote a triage program that allows our telephone operators to register calls electronically and then hand off patients to a medical assistant. The program assigns "ownership" of the patient's issue to a staff member. The issue stays open until the problem is resolved. Each time a call is made to the patient, a time stamp is created. Supervisors can monitor the flow and delegate calls to additional staff if the triage team is falling behind.

As a result, we no longer have patients waiting to have their problems addressed.

Office e-mail. Our mail server handles our internal e-mail. Administrators can quickly disseminate information to the doctors and also get a quick poll on important issues which cannot wait until everyone can meet face to face. This saves time that would be wasted making multiple phone calls and tying up our phone lines during business hours.

Employees are also required to check their e-mail at least once a day as important information is sent to them from their supervisors. Another benefit is remote access using Microsoft Exchange. Doctors can check their office e-mail privately via the internet from anywhere in the world. Important financial data can also be sent to the partners securely by our accounting firm, reducing massive amounts of excess paperwork.

In a multipart series, Dr. Polack is describing how a seven-partner practice, Ocala Eye in Ocala, Fla., with five locations and 140 employees, makes the major transition from paper medical records to EMR. During the course of the series, Dr. Polack will provide readers with a "real-time" look at how the implementation is progressing. This is part 9 of the series.

Document repository. Public folders on the exchange server are also used for accessing information, such as the employee manual and other important documents, vacation and call schedules, a social calendar and calendars for reserving resources such as LCD projectors or meeting rooms. The folders can also be used by staff to store personal files in a secure location.

Networked applications. In addition to the usual standard applications such as word processing or spreadsheets, we can also access such programs as the American Academy of Ophthalmology Basic Science Course Books on CD-ROM, which are available with a network license. This is a great clinical resource available from within the office, or from home via Remote Desktop Services. In this manner, pictures from our digital slit lamp camera can also be viewed and e-mailed as attachments.

Custom Programs

We have also designed some programs in-house that help us manage specific tasks.

The first is a program that electronically calculates our prescription capture rate for our optical; this can be broken down by location and doctor.

Another custom program is our work-order system: this runs on the network and is used by many departments including IT, Human Resources and Facilities. If a piece of equipment is broken or supplies are needed, a staff member can enter a work-order and it is sent to the appropriate person. It adds a full circle of accountability and manages the chain of custody for support departments. Our HR staff is currently working on a new program that would facilitate enrollment paperwork for new employees via an electronic interface.

In addition to the programs described above, installation of our network has also enabled our practice to implement other efficiencies, which are resulting in savings in both time and money. Paperless faxing and electronic time clocks/payroll are now part of our everyday office routines.

Paperless faxing. Network faxing services allows our administrator to electronically review documents faxed to the office from his desk or home. Then, he can decide whether to print them, e-mail them or delete them. Our networked multifunction printer can also take paper documents, scan them to a PDF format and e-mail them to any number of staff, cutting down on paper faxing.

Electronic time clocks/payroll. Electronic time clocks, which we are gradually rolling out, use a pin code and biometric fingerprint analysis to track employee time. The fingerprint scanner ensures that everyone who clocks in also clocks out and prevents one employee from clocking in/out another employee. The data is then sent via the network to our bookkeeper for payroll. The information is then exported to our payroll outsourcing firm.

We strongly believe that our network will permit us to introduce a number of additional time- and money-saving office procedures in the near future.

Next: Managing Through Unanticipated Delays

Peter J. Polack, M.D., F.A.C.S., is co-managing partner for Ocala Eye, PA, and a specialist in cornea, external disease and refractive surgery. Founded in 1971, Ocala Eye is a seven-partner, multisubspecialty ophthalmology practice located in Ocala, Fla. The practice, which has five locations including an ASC and laser center, has 140 employees. He can be reached by email at ppolack@ocalaeye.com.