Duane Schmidt, DDS
It has been estimated that in more than 20 percent of medical-malpractice cases, flawed or incomplete medical records have made it impossible for the accused physician to defend himself. If dentists think we have a higher standard than that, we deceive ourselves. The percentage of inadequate records, if anything, is apt to be higher. Why does it matter?
In terms of health history, errors can be life-threatening. Regarding billing address, telephone contact, change-of-insurance status and change-of-marital status, inaccuracies can be costly. Mistaken ledger information may have dental-legal importance that can profoundly affect the dentist`s future.
While most team members try to routinely update and correct office records, the job can be trying and difficult. During a busy day, confirming data can be a formidable barrier to getting the job done. Once the team makes corrections, entering them into the chart can be just as much of a hurdle.
While there is no easy solution to the task of keeping patient data current, used in a proper scenario, the computer may offer a window of opportunity. That opening comes with the convenience of printing daily, "fresh-baked" patient-care forms or PCFs.
Each day, in the EDO (electronic dental office), the system prints a page or two of data for each scheduled patient. The data includes all ledger information, name, address, telephone number and other coded, personal data that the dentist wishes to note. This may include hobbies, psychological status-such as apprehensive-and conversational clues such as special interests.
Following the personal information, the form lists notes that require special attention. These notations may include medical alerts-allergies, premedication requirements and current drugs. The form lists other personal alerts-such as time constraints (Bill is leaving the country Friday), personal preferences (Always wants Nitrous)-other data that can influence the outcome of the appointment.
Next in order, staff can see insurance or third-party payment credentials. These usually include such reminders as: Insurance does not cover prostheses, annual maximum is $750 and pre-auth required for all procedures.
These clues help chairside staff compute a useful payment schedule and allow team members to be more patient-sensitive.
Following insurance information is a sequence of data that the office believes important to track. This data may include, for example, bite-wing X-rays, panoramic X-rays, prosthetic seats, last prophylaxis and other tracking facts that the staff have decided merit surveillance.
Family data then lists the last visit and prophylaxis appointment for every member of the family. This information triggers staff concern to ask after other family members, "Helen, your husband, Joe, is overdue for his recall."
The final piece of the data map reveals the treatment plan presented to the patient, which becomes part of today`s appointment. All of this information is crucial to the proper conduct of the day`s appointment.
Hanging Out the Laundry
How does the patient-care form help us update patient records? While a patient is sitting in the chair, the form is placed so that he reviews its content. He has time to assess everything while he awaits either the dentist`s presence, impression material to set up or an anesthetic to become profound.
There are few patients who can resist the urge to read all the facts our data banks contain about them. We want them to succumb to the temptation to read every word of their personal form. The office team also encourages patients to read and update their data. "Please tell us if we have something wrong!"
Without fail, patients call new addresses and telephone numbers, changed medical alerts, altered treatment plans and family concerns to our attention. "Yes, I know Joe is overdue for his appointment. Can you make one for him, now?"
When the chairside team member learns of changes needed, she updates the data in seconds. The next time we print a patient-care form, it contains corrected information.
Correct data helps the staff team serve the patient better. Importantly, the data is clean, fresh, relevant and real. The next PCF then prints fresh new facts, which allows the staff to treat the patient with deserved intelligence. Our patients deserve no less.
Next Month: A Credit Card Peripheral.
The author practices dentistry in Cedar Rapids, IA, in an electronic dental office. He has written three best-selling, practice-building books. He also lectures frequently on profit-building with dental computers. Address E-mail commentary to [email protected].