When Brett and Irene Druger -- both DMDs -- took over a 25-year-old family practice in Westfield, NJ, last November, they had a common goal: to invest in digital technologies to create a more efficient and organized office and improve patient care in the process.
Six months later, with the first pieces of the "going paperless" puzzle in place, things are running smoothly, according to Dr. Brett Druger.
While the process hasn't been entirely painless, he and his team have no regrets, he told DrBicuspid.com.
"For my front desk person and assistant, it was very frustrating at first. Even for me -- and I'm really good with computers," he said. "But now we love it."
Irene Druger, DMD, and Brett Druger, DMD. Photo courtesy of Dr. Brett Druger.Especially on snow days -- which New Jersey had a lot of this past winter -- or when there is an emergency, Dr. Druger added.
"We got snowed in a couple of times and just logged in in the morning and called all the patients from home to tell them the office was closed," he said. "And the other day, a Saturday, the mom of a patient called our emergency line -- her 8-year-old son had broken three of his front teeth in a bike accident, and she didn't know what to do. But I was able to look at her chart [remotely] and it turned out they were all baby teeth, and that really calmed her down."
Computers and cameras
Prior to installing their Dentrix practice management system and Dexis imaging system, Dr. Druger and his wife had some familiarity with digital technologies. Irene had worked with Dexis at her previous practice, which also was paperless.
At their Westfield practice -- The Dental Family -- they first installed a digital x-ray system, then put computers in their two operatories, plus one at the front desk, and networked them.
Then came the practice management software, which was "very overwhelming" at first, Dr. Druger said. The installation took about three days, which included 16 hours of training by the vendor. If he had to do it all over again, Dr. Druger said, he would have asked for more.
"The training is so critical and so frustrating at first because it's such a big learning curve," he said. "Better training would be helpful, and more of it. It took about a month [for us] to get comfortable."
Transferring the existing charts to the digital system has been challenging as well, Dr. Druger noted. But they're making good progress, he said.
"We are doing a six-month transition period, so every time we see a family, we transition from the paper chart to electronic," he said. "We bring up the chart, get familiar with it, then digitize it all and file the chart away. Six months from now, we think we won't have to go back to the paper charts at all."
The decision to implement digital technologies when he first took over an existing practice has helped his team create good relationships with patients who didn't know them last November, he added.
"A lot of the patients are really impressed," Dr. Druger said. "They really like the idea, especially less radiation from the x-rays. The previous dentist in this practice didn't use digital x-rays. And the intraoral cameras -- if you see they have a small cavity and you can blow it up and show it to them, that is huge. Especially when working with patients we haven't worked with before." In addition, insurance claims come back faster, he noted.
The entire process has so far cost the practice $40,000 to $50,000, Dr. Druger said. This month they are adding digital pano as well.
Can't eat the elephant
Dr. Druger's approach was a smart one, according to digital technology experts Martin Jablow, DMD, and John Flucke, DDS.
Getting the front desk and the operatories computerized was the logical starting point because it organizes the workflow, Dr. Flucke noted.
— John Flucke, DDS
And while many practitioners want to test the waters first with digital radiography -- especially with the rising cost of dental x-ray film these days -- "you can't go to digital radiography if you don't have computers in the operatories," Dr. Jablow noted.
If you're just beginning to consider making the transition to a chartless office, it is important to start with realistic goals, he added.
"Don't try to go completely chartless in a day," Dr. Jablow said. "Just like with Legos, you need to build one piece at a time. Take small steps, not large ones. Everything will come together in the end."
Dr. Flucke agreed. "I love analogies, and one of my favorites is 'You can't eat the elephant in one bite -- you eat it one bite at a time,' " he said. "You have to break it down into manageable pieces."
He also believes in setting a budget because it "keeps you from doing too much too fast," he said. "And you know what it is going to cost before you go into it."
Six months is a reasonable amount of time to implement a chartless system, Dr. Flucke added. And once it is in place, he recommends ongoing training.
"I am a huge fan of training, although I didn't use to be," he said. "I used to think it was just another way for them to sock on another couple of grand. But learning how to do it right and be efficient is so important. I'd rather spend $2,000 on training than $2,000 on Tums and Pepto-Bismol." His office -- which has been digital for well over a decade -- uses EagleSoft (Patterson Dental), and they bring in a trainer every year or two for a "booster," he added.
Approaching the process in this way can help dental practitioners overcome the fear of failure that Dr. Jablow believes is one of the biggest roadblocks to going digital.
"The problem with all the technology is that people are afraid of making bad decisions," he said. "They worry, 'If I take my office down a certain path, I am into it for thousands of dollars, and what if I don't like it?' "
For those practitioners who are already comfortable with computer technology, it might make sense to take a more "do-it-yourself" approach to some of the initial process, Dr. Jablow added.
"You can go over to Staples and buy a $300 to $400 computer for your office, but if you pay an IT guy to set it up, labor costs can push that to $700 to $800," he said. "And in terms of putting together a computer network, it's not rocket science anymore."
Or you can appoint one person in your office -- "the 'technical' one" that every office seems to have -- and let them oversee the project, he said.
"Nowadays, the technology is so good and so many people have done this, you're not inventing the wheel anymore -- you're just learning to roll it," Dr. Flucke said.
