How a computer dream can turn into a nightmare
How a computer dream can turn into a nightmare
How not to go paperless
When Kathy Coleman, office manager at the Petersburg, AK, family practice of Walter Fernau, MD, took on the challenge of opening a new practice, one of the most exciting aspects was the chance to create a completely paperless office that used a state-of-the-art computer system.
Eight months later, the practice has been through two failed systems and is looking again for a practice computer system. Instead of being paperless, they have had to rely on old methods of charting and keeping records. In one case, the practice lost all patient records to a computer glitch and had to recreate them.
The good news is Coleman has learned from her errors and is confident the practice can find a system that will meet the needs of the physician, two nurses, two receptionists, and herself.
"I had a pretty strong computer background," says Coleman. "I knew what to research." She looked on the Internet and found some great resources through the American Academy of Family Physicians’ Web site (www.aafp.org) which had a vendor study — albeit a little outdated — that pointed her to vendors’ World Wide Web sites. She was able to provide her physician with detailed information on various systems.
Initially, Coleman and Fernau thought they found a winner with a program from a company based in Los Angeles. "It was a nontemplate-driven system that was exactly what he wanted," she says. What she didn’t know was that it was a work in progress. After starting in October with the program, continued problems added up to $3,000 per month in technical support costs to the $15,000 system. "Sometimes, we had tech support here all day."
After several months and many calls to the company, the practice finally returned the system. The next purchase, a template-driven system, wasn’t much better. "We might as well have been writing chart notes," says Coleman. The system wouldn’t interface as promised with her billing system, and the batching process for moving information between the two systems caused a loss of all patient chart notes. "We had to recreate all of those from scratch," she says.
Talk to someone
Coleman again is looking for a new system. Almost all of the money spent on the systems and associated technical support was refunded. And she has learned some valuable lessons. First, she knows she needs to talk with people in offices that have gone paperless. "No one in Southeast Alaska had done this before. They all talk about front-office billing, but none of the doctors are paperless."
The closest she has come is a hospital in Juno, "but that’s like comparing apples and oranges. We can’t afford a $100,000 program." This time, she will try to network beyond her immediate area.
Second, although the initial system she tried remains her doctor’s dream program, she knows better than to try a system that isn’t perfected. "Every problem we had was something they were working on. They were quick about responding, but while they created a fix, we were dead in the water." Next time, Coleman says, she won’t choose a program that doesn’t have a proven track record with other users.
Third, she will make sure that even though she is in a remote area, the vendor she chooses will come to her, set up the program, and work with her office or her local technical support person for training — "and at their cost, not mine. We were naive about who should pay to get their program running."
Coleman says she is much more computer savvy now. "I know how to talk with these people. Maybe I won’t have to use so much technical support. And there really should be someone in the office who knows the program inside and out."
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