Software Options for Doctor’s Offices: A Review of Office Automation and Group Colloboration Tools

There are several software programs that are used in a doctor’s office. IDX, Stars, Meditech, and Eprescriber are just a few of the programs that are use daily. Some standard Office Automation that is used in a doctors office include but are not limited to:

– Email using outlook express
Microsoft Office for documents and letters

Group Collaboration that is utilized by some offices include:

– IDX
– Stars
– Meditech
– Eprescriber

Every doctor’s office uses a different system of setting appointments, saving patient data and going about their day to day processes. As long as the system is tailored to that specifics office needs then any system can work anywhere.
IDX is the primary software utilized in the office that I manage. This web-based program is used to schedule appointments, register patients, create schedules, review patient insurance information and also to process billing. This program was recently updated; however, the end users were not brought into the process so the updates that were made were minimal and not very useful. Overall the system works well and functions at good speed. It is preferable to doing things the old way-scheduling appointments in a book that is passed around the office by the secretaries. When working for multiple doctors this can not only be very confusing but very messy as well. Since everything is logged into the patients account it is possible to view a patients previous appointment history which is very useful in determining future appointment needs. Each office has different needs and there is a very strong encouragement to use the automatic scheduling function that is built into the system, this is supposed to make things easier. It does not make things easier though it makes them much more difficult. Manually scheduling a patient allows you to view the schedule for the full day that you are attempting to book.

Advantages
– It is web based and accessible from anywhere-when there is a storm during the winter I can cancel and reschedule patients from home instead of having to remember to bring home a formal schedule
– It allows for a computerized schedule instead of one written on paper or in a book, which allows anyone in the office to book an appointment at any time
– Looking up addresses and phone numbers is easier than before

Disadvantages
– Now that it’s online it’s more prone to hackers and identity theft
– The new updates do not allow for manually scheduling patients as easily as the older version
– It takes longer to book appointments with the new system

Stars is a referral system that is used for Tufts, Blue Cross Blue Shield, and Secure Horizons. Any and all referral’s for those three insurances are processed via this system. The process to obtain and create a referral is as follows: the patient calls the office and requests to see a specialist. The secretary will determine if the patient needs to come in prior to being referred out, if it is determined that they can go to the specialist without seeing the doctor the patient is then given several names that they can choose from. The patient then calls the specialist’s office, schedules an appointment and then calls the Primary Care Provider (PCP) back with the appointment date and time and reason for the visit. The requested information is documented and given to the patients PCP, once approved by the doctor it is entered into the Stars system using the patients insurance ID number and date of birth. The system is available to all specialists located at the hospital and is also registered with WebMD and other point of service systems. These systems enable other providers to view a patient’s authorization. Once the information is entered in the system it gets approved or denied by the insurance company. If it is approved a fax is sent to the specialists office by the insurance company. If it is denied the insurance company calls the providers office.

Advantages
– Instant approval/denial of referrals
– Ability to look up specialist information
– Keeps track of all of the patients referrals for last 3 years

Disadvantages
– Specialists that are not at the hospital do not have access to Stars
– Specialists do not check the system regularly they depend on the fax to show up and assume if they do not have a fax that the referral was not done, this is not always the case
– Fax numbers are frequently updated as they typically do not change but sometimes they do

Meditech is an old form of email for the hospital, instead of email we send “Moxes”. This system is also used to up to the minute information on patients that are seen in the emergency room and walk in clinic, as well as any procedures that they have done at the hospital.

Advantages
– It is an internal system so there is no external maintenance cost
– It is easy to look up recipients address and phone numbers
– Patient information for testing done at the hospital is easily accessed and printed

Disadvantages
– It is outdated
– It is not as quick to reply or send messages to others
– There is no spell check
– Reports could potentially be printed to wrong place if the incorrect printer number is entered

Eprescriber is a web-based system that was created by the company Zixcorp. At its launch the company taped into our IDX system and downloaded all of our patient information into their system. Address, phone numbers, insurance etc, everything for existing patients was transferred to their website. Prior to getting this system the process for a prescription was that a patient would call the office requesting a refill, the secretary would take down all the information and write it out on a prescription form. The form was then given to the doctor who would authorize it and give it back to the secretaries. Throughout the day the secretaries would take turns call in the prescriptions to the pharmacies. This was a very time consuming task as it takes several minutes just to get past the main prompt at the pharmacy, not to mention wait time and then the task of repeating everything to the pharmacist several times. The other issue with this system was that prescriptions were only trackable by calling the pharmacy, or by looking up the last note made in the prescription folder on the patient. That folder was cleared out monthly because of the shear volume of refills that are done each day. The other issue was that at times one particular doctor would lose the slips or would simply keep them for 2-3 days at a time. With the new system two out of the three secretaries have access to input the prescription request into the database. All prescriptions now go to those secretaries instead of to the doctors. They are entered into the system and the paper is filed away or shredded depending on the type of drug. Once the prescription is entered it can’t be lost. If the doctor does not get to them on a certain day, they will still be waiting for them the following day. Once the doctor logs into his queue and approves the pending prescriptions all the approval data is sent to the pharmacy via fax. This has drastically cut down on phone calls to the pharmacy and has saved quite a bit of time each day. It also makes refills much easier because the system keeps each prescription on file so that if it gets requested again the user can simply hit the “refill” button and it goes straight to the doctors queue.

Advantages of Eprescriber
– Saves at least 1-2 hours each day on phone calls to the pharmacy-which counteracts the monthly fee
– Allows for automatic tracking of a patients prescriptions
– Refills are as simple as hitting a single button
– Soon all the pharmacies will be linked to Eprescriber instead of having to use the fax it would be directly loaded into their computer system when theirs a authorization
Disadvantages of Eprescriber
– There is more room for human error since the secretaries are entering in the prescriptions from a list of drugs-its very easy to select the wrong one
– There is a monthly fee to the program
– Since most of the systems are currently set up on faxes its easy for a pharmacy to say they have not received a prescription even when it shows its been sent

Aside from these systems we also regularly use outlook express, Microsoft Word and Excel for inventory management, and a copy fax machine combo. Microsoft Word is used often to create letters for patients and most recently was used to recreate the annual recall cards that are mailed to patients. Each computer station within the office has email and Microsoft Office on it, as well as Internet access for easy searches on Google and Yahoo. These systems allow the users in the office to communicate with each other regarding the ongoings within the office.

Without these communication devices the offices would have a very difficult time sharing patient related information. Much more time would be spent on the phone requesting data and having to have things mailed instead of faxed would cause a big delay in treatment. Being able to access patient information in multiple locations allows for easier faster more efficient patient care. There are risks involved with any and all electronic devices, however, many safeguards are taken to assure patient privacy is secure.

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