Contrary to a decade ago, you would be hard-pressed today to find a dental office that does not use a computer to handle the accounts receivable portion of the practice. The old pegboard and ledger system has simply fallen by the wayside, mostly because computers offer a phenomenal increase in accuracy, efficiency, and ease in which the financial portion of the dental practice is controlled. However, one area of the dental software that is overlooked–or simply not put into use–is electronic scheduling. Since the advent of modern dentistry more than 100 years ago, the massive pile of paper bound together with glue or metal rings commonly known as the “appointment book” has been the core by which the dental office exists.
Big businesses such as airlines and package shipping companies have used electronic scheduling for years. So why are dental offices so slow to change? The bottom line is those who haven’t switched to electronic scheduling simply don’t understand what it can do to increase productivity and patient flow. Yes, the appointment book has been a faithful standby for decades, but electronic scheduling simply works better.
Figure 1. A simple click on the patient’s name pulls all pertinent information to the appointment, even a photo of the patient.
Figure 2. An appointment detail feature provides important information instantly, such as a “needs premedication” alert.
There are many dental software products available, including Patterson EagleSoft, MOGO, and PracticeWorks. Whichever you choose, in my case Patterson EagleSoft, it should contain many user-friendly features that make life simple for both front office and chairside personnel. Since the receptionist has many tasks that must be accomplished simultaneously (ie, answering the phone, making appointments, checking patients in and out, collecting money, and filing insurance claims), reducing the amount of time spent accomplishing repetitive tasks is crucial.
For example, when a patient calls to make an appointment, the receptionist can simply click on the patient’s name from an existing database and have all of the pertinent information related to that patient such as contact telephone numbers, insurance benefits, and even a patient photo automatically pulled to the appointment slot (Figure 1). The receptionist does not have to ask for a contact phone number to be used during a confirmation call at a later date. In addition, a color can be assigned to that appointment that identifies what type of treatment is to be performed during that visit. Scheduling a more even workflow for the doctor becomes a snap since visual identification of surrounding appointments happens in seconds without detailed reading.
When it comes to rescheduling a cancelled appointment, the process becomes a breeze. Simply drag the appointment to a different time or move it to a different day altogether. There is no longer a need to burn up erasers and flip pages back and forth to copy information to a different position in the appointment book. If a patient needs a specific time parameter such as Thursdays at 3 o’clock, simply type in the parameters and the required appointment length, and the scheduler will give you a list of the next available days matching those requirements.
For offices that are goal-oriented and wish to achieve a certain production per chair per day, an electronic scheduler can be an invaluable tool to achieving that goal with ease. Each chair can be set up with a certain production goal assigned to it, and then, as appointments are made, the scheduler will keep track of how much production in relation to the goal has been scheduled. As a certain chair fills for the day, the receptionist can easily see whether a higher production appointment can be placed in a slot or whether nonproductive “filler” work can best be inputted. As a result, the pace for the day can be evened out from a production and workload standpoint.
Other features that make the life of the front desk staff easier are the premedication and lab case reminder icons within the software. Once an appointment for a patient is made, an icon will appear next to the patient’s name if he or she requires premedication of any sort (Figure 2). The receptionist can immediately ask the patient if he or she has enough of the required medication for the upcoming visit or inform the doctor as to the need for him or her to call in a prescription for the medication. If a particular treatment such as a crown requires lab work, the system will automatically track the status of the case. Again, an icon will appear next to the patient’s name, indicating that the patient has a case that is being processed in the lab. When the case is returned from the lab, a simple click of the mouse will indicate that the case is back and ready for delivery, removing potentially embarrassing confirmation appointments of cases that are not truly ready for delivery. If a list of all outstanding lab cases for a particular date range is required, it can be printed with a few clicks of the mouse as well, making communication with the lab quick and efficient.
As part of your practice management software, many beneficial features can improve the flow in your office. The following are several features I’ve found to be useful in my own practice:
- Customize the schedule by creating individual hours for each chair but also for each provider.
- The schedule will tell you if a doctor is double- or triple-booked—in an attempt to keep the stress level to a minimum. This feature also allows you to denote doctor/assistant time, so everyone involved knows how long they have to accomplish their tasks.
- To assist in filling cancelled appointments, your scheduler should be able to put patients on a short notice list—preventing you from having to comb through your database for possible fill-in patients.
- Are they late? Not showing up? Or perhaps already in the chair? A patient arrival indicator (red, yellow, green) lets you know the status of the patient just by checking his or her color on the screen.
- Tired of re-keying data? With your scheduler, you can add services so they are automatically posted on the walkout. In addition, you can walk out patients directly from the scheduler.
THE PAPERLESS OFFICE
As the push for a paperless office grows more inevitable, electronic scheduling again becomes the core of the entire process. In the old scenario of patient folders and appointment books, the doctor and treatment personnel are totally reliant upon the front office to pull and release a chart when the patient arrives. In addition, the front office must hand-copy a schedule for the following day, make copies for each operatory, and then update it during the day as changes occur. If there are multiple operatories or there is more than one doctor, this can become an arduous task for the receptionist or other front-office team members. With electronic scheduling and a computer system that is networked to the treatment operatories, these tasks are completed by the receptionist within seconds without her ever leaving her chair. This feature allows the receptionist to stay on task as well as provide real-time updates for back-office personnel.
HIPAA compliance becomes less of a concern once electronic scheduling is implemented. No longer will there be an appointment book for anyone without proper authorization to view. When the office is closed for the day, all users are logged off and no unauthorized access can be gained. In addition, our software has a feature that allows your appointment schedule to be uploaded to a site away from your office. With proper authorization, the schedule can be retrieved after office hours by accessing the site online from home or elsewhere. If inclement weather or other emergencies keep you from going to the office, patients can be called from any location and the appropriate rescheduling accomplished. Of course, daily backups can be made and taken off site as well, protecting your information from fire or theft.
Without change, there cannot be the possibility of moving forward. The tools for a more efficient and productive practice are widely available to the modern dental office. Taking the first step into an area that is somewhat foreign to us is the hardest of all tasks, but once the improvements are implemented and the routine established, few look back and wish they could return to the “old-fashioned” way of doing things.
I have laughed with several of my receptionists 6 months after converting them to electronic scheduling as I threaten to take it all away…it just isn’t gonna happen. Just as the old black address book that we all had around the house containing vital information about relatives and close friends became cluttered, messy, and inefficient, so has our old trusted partner the appointment book. It is time to retire them both, remembering them as a stepping stone to a better and happier life.
Dr. Baxley obtained his undergraduate degree from Baylor University in 1982 and his DDS degree from Baylor College of Dentistry in Dallas in 1986. He has since owned and managed large, multi-chaired offices in Austin, TX and the Dallas/Ft. Worth area. He currently operates a high-tech, 8-chair, solo office in Arlington, Texas.