Chapter 15: Going digital - using computers to enhance your efficiency
|"Artificial Intelligence usually beats natural stupidity."
- Elbert Hubbard.
Why use a computer in the first place ? You don’t have to. But then you also don’t really have to use a telephone either ! The truth is that a computer can tremendously improve the quality of your practice – and actually give you more quality time to spend with your patients. Most doctors even in the US have still to realize this, although almost 75 per cent of physicians use computers in some form or the other. In India, the number is growing rapidly but we are still far behind the Americans. However, you cannot afford to remain computer-phobic anymore, and for most doctors, the question should not be, " Should I buy a computer ?” but rather, "Which computer should I buy " ?
Just for example, do you know the precise number of patients that you examined and treated last Thursday ? Would you able to find out how many of them have paid you, and how much? And who should have come for a follow up visit this week, but didn’t show up? Most of us would have no clue – or it would take several days of wading through old notebooks, receipts, prescriptions, rough notings on slips of paper,
and God knows what else! Is it better to go on doing that for the next twenty years or would you like to switch to a computer? The same thing applies to your clinical research and analysis, whether it comes to collating your data or preparing your presentation. And then there is today’s "killer application” – the internet. This is such an important area today, that we have devoted a full chapter to this subject.
Computerizing your clinic is not an easy task. If you run a disorganized clinic, the computer will multiply this disorganization a hundred-fold ! Make sure you have paper backup records for at least the first year; and that you have data backup and storage systems to deal with the inevitable computer glitches which plague all computer-users ! Since this is such an important investment, buy the best computer you can afford; and ensure that you have efficient and reliable technical assistance which is a phone call away. There is no substitute for having a comprehensive maintenance contract for your computer – if the system goes done, it can paralyse your clinic, and you simply cannot afford this ! Decisions as to which system to buy and whether or not to go in for a local area network (if you have a large clinic ) should be made only after talking to other doctors who are happy with the computer system you are planning to go in for.
Of course, a computer is just a dumb box, and you need software programs for it to perform useful functions. Generic programs such as word processing, spread sheets, databases and presentation software are useful to everyone , including doctors. Most doctors, for example, still use their computer primarily as a glorified word processor, for printing out patient’s discharge summaries or referral letters. Others have been more innovative, and use their computer to automate some of their office functions – for example, to record the telephone numbers of incoming voice mail; or as a FAX machine. However, a computer really shines in helping you manage your medical practise when you equip it with a practise management program, also called Electronic Medical Record ( EMR) programs. These are meant to cater to general medical practice tasks , like keeping patient records, scheduling appointments, and billing patients. These maintain accurate & detailed medical records which you can retrieve at the touch of a button.You can also analyse your practice, for example, to find out how often you see patients with a particular medical problem, and what their response to treatment is.
Many of these programs also allow you to instantly print out customised patient educational handouts which you can give to your patients. Many of these programs are "intelligent” and will check your prescriptions for drug interactions, for example. Which programme to buy is a very important decision; and the more user-friendly your EMR programme is, the more likely it is that you will use it to improve your productivity ! Insist on a working demo in your clinic which you can try out for a week, before making a final purchase decision. It’s also a good idea to talk to other doctors who have been using the program for some time, to ensure they are happy with it. A good program will minimise the typing you need to do; and should be able to adapt to your practise’s needs. While these programs are often quite expensive, the good news is that many computer programmers and doctors are now developing "open-source software” for medical practice management. These programs often run on Linux, and are free, so you don’t need to pay for them !
Unfortunately, the sad fact is that even doctors who do have computers in their clinic do not make optimal use of them. While buying the computer is easy, training your staff to use it properly is a difficult task. Hopefully, the new generation will be more computer-literate , and doctors will be able to integrate the power of computing into the medical clinic more efficiently.
Many doctors now also use handheld computers or PDAs. These act as portable brains, and allow them to improve their efficiency considerably, because they can carry important data with them ! If you need to travel to different clinics or various hospitals, this can be an excellent investment !
The best way to decide about how to use a computer in your practice is to talk to a colleague who uses computers extensively. Ask him to convince you how a computer can help to improve the quality of your life !