Management Office Design Paperless

Digital Workflow and Front Desklessness

Many years ago in the BC era (Before Computers) when office data was on paper, work flow meant; where does the chart go and who does what task.

Once a dental office develops a paperless system digital data can be accessed anywhere there is a computer, in the back, at the front or somewhere in the cloud.

This new pattern of doing things has been called Front Desklessness.

Does that mean there is no actual desk? No, Front Desklessness is not about tossing out a piece of furniture or eliminating a staff person. It is all about workflow, doing the non clinical business functions in a different way because technology allows us to handle data in a much more efficient manner.

For example, why make all the appointments at the front desk? If you use an electronic schedule with treatment room based computers why not schedule from the treatment room? Who better to make the appointment than the chairside assistant? She has just heard the dentist and the patient discussing the treatment. She knows exactly what needs to be done next. She knows if the patient is a gagger who needs extra time. She knows if there is lab work involved or any of the other clinical considerations, which would affect the appointment time. Just make the appointment.

Often work flow tasks with digital data do not need a person of any kind. For example making reminder calls, reactivating non compliant patients, sending bills or insurance claims are done in the cloud (online) with e-services, no human involved.


Paperless Records Tip

Insurance CDT codes are set up by procedure and are designed primarily to track fees. However, in real life in the dental office we work on appointments not just codes. Many procedures require multiple appointments to complete. For example a traditional crown (not CAD CAM) includes a preparation and then a delivery. A denture requires impressions then a bite, a try in and then a delivery. Root canals are often multiple appointments. Then there are follow up appointments that have no fee and no code such as suture removal, bite adjustments and such.

Set up additional appointment based procedure codes, just for your practice, to accommodate all the extra appointments that do not have an assigned CDT code. The most obvious being the delivery of a crown. Doing this makes using the software much more efficient; you can create procedure notes for each extra code. You can assign a default appointment time and you can treatment plan it.

Once you have set up the formal CDT procedures and created your own appointment based codes you can create digital procedure or progress notes for each one. These are the notes you used to scribble in the chart after every appointment. When you write your digital notes start with what you usually hand write in the chart but keep in mind that you can now add detail that it is impractical to include in manual notes.

More Paperless Tips

Management Paperless

Stuff vs. Solutions

A problem I see over and over again with high tech and dentistry is Stuff vs. Solutions. The most visible element of digital technology is the thing; that is the computer, the sensor the big monitor or even the web page. Because these things are so obvious the tendency is to think of technology in terms of these things, in other words “stuff”. If you have the stuff you are high tech.

Having stuff is nice but the real value of technology is when it can be used to provide a solution. Technology by itself has no value it only has value when it used to enhance our systems both human systems and clinical systems. Most of the time when dentists or team members are frustrated with technology it is not actually the stuff that creates the frustration. Frustration results when the team is unable to get the result, the solution, they need.

A human system for example is the work flow needed to schedule a patient, remind them of an appointment, and get the proper information to the dentist regarding that patient. A clinical system would be capturing a diagnostic aid like a radiograph or detecting decay.

If a dental office has a good PMS (Practice Management System) like Dentrix that is stuff. Following the human system example above many offices will use the PMS to schedule, then call the patient to remind them and then dig out a paper chart from the files to record and transfer information about the patient. They may have stuff, but do not have a good solution.

On the other hand if the office uses the PMS to make an appointment then connects to a web service to send an e-reminder and gets a complete patient record with a single mouse click from any computer in the office; that is a solution.

The office with good high tech solutions will get much more value from technology that those offices who just buy stuff.

Buying stuff is easy (as long as you have the money :-)) Developing and implementing solutions takes a lot more effort.

Want some help?

Dental Speaker Management Paperless

Person Place or Thing?

Is the Front Desk a Person, a Place or a Thing?

Once we transfer the data from paper to electronic paperless records, we no longer need a single physical place, like the front desk, to gather the information. An administrator can gather the data where ever there is a computer. That could be at the front, in the back or even in a different building! The computer becomes the Data Center of the practice. The practice is Front Deskless.

The term Front Desklessness is quite provocative but not very descriptive. The concept could be more accurately called: An Alternative Approach to Dental Office Management and Work Flow Using Integrated Paperless Records. That may be a more descriptive title but it sure doesn’t grab you like Front Desklessnes.

Since Front Desklessness is catchy but not well defined all kinds of misconceptions have come oozing out of the woodwork. The term does not mean that no one does the duties of the front desk. There is still a person. It doesn’t even necessarily mean the office doesn’t have a front desk. There is still a place. There is no one way to practice Front Desklessness. Front Desklessness is simply a way of managing the workflow of a dental office made possible by computers and technology. It is still a thing, just a different thing.

How to go Paperless:

Management Software


Another great online resource for Dentrix Users.

Source: DentrixDoesIt – YouTube

Internet Management Paperless

Patients Like E-mail

Did you know?

58% of consumers start their online day by reading their emails.

76% of dental patients said email is the best way for companies to communicate with them.

This is based on a 2008 Sesame Communications research paper. Most likely today even more of your patients prefer e-mail.

So the question is…are you using it? Or even better are you gathering patient e-mail addresses in order to use it?

Here is an example of how e-mail communication can be used effectively with e-services.

First you have to collect and sore the e-mail address. Most Practice Management Systems like Dentrix have e-mail address as a field in the patient information field. Be sure you get it filled in. It has to be on your intake form, if you are still using the forms you had in 1995 you need to update.

As all those existing patients who started with you last century and didn’t have an e-mail address need to provide it now. Make it part of your health history update. Ask for it and give the patient a good reason to provide it.

For example advise them that you will send e-appointment reminders rather than bother them with a phone call and most (76%) of patients will give it to you…but you have to ask. Another idea is to offer an incentive. For example: Dr. Digital has written a list of the five ways to save money on dental care. If you give us your e-mail we will send you a free copy.

Now that you have e-mail addresses how do you use them. The best way is with e-services. Again Dentrix provides a good example of these services.

Appointment reminders are an obvious use for e-mail. However you can also use e-mail to direct patients to your web site to fill out forms. NOTE: Online forms are not just for new patients, this is a great way to make sure all existing patients have up to date personal and medical information on file. And better yet it is on file in a digital format so you can eliminate those pesky paper charts.

Management Software

Dentrix Mastery Tracks

I just read an article from Sally McKenzie about finding great team members. Two things she discussed which dooms dentists to mediocre staff was settling for whoever shows up and failing to test for skills. The Dentrix Mastery program gives dentists a real life tool to evaluate a potential staff member’s Dentrix skill and it gives team members a powerful credential that proves they can do the job and that they are worth more to the practice.

Dentrix Mastery Tracks™ will make sure every member of your team is as prepared and capable as your technology—by giving you a fast and affordable way to test what they know about Dentrix and find out where they need improvement. It also directs them to the targeted training they need to enhance their skills and improve your practice.

via Dentrix Mastery Tracks.

What a great solution to a significant problem.

Lack of basic, ongoing training is one of the primary mistakes most dentists make with technology. Many dentists use a fraction of the technology they have purchased, complain that their system does not do something that it does or use awkward outmoded procedures to accomplish basic tasks.

Mastery training will help dentists improve the effectiveness of current team members, help them select new team members and will provide staff personnel with an authentic credential that increases their value in the marketplace.


General Management Paperless

Why go Paperless? What I have now works and doesn’t cost a thing.

SPaper charts don’t just appear in the office for free. The paper folder and all the other papers cost about $2.50 each. If you have 2500 charts they cost you at least $6,250 to create and every time a new patient walks in it’s another two-fifty; cha-ching.

Other chart contents, like x-rays and photographs can be even more costly. A set of bitewings with film, processing and mounts can be a dollar or two. A photo printed from the intraoral camera is $1.50 or more. It is reasonable to add at least another $2.00 to the cost of each chart for these contents adding another $5,000 to the cost.

Storing the records isn’t free either. A typical office with 2500 charts will need three or four full size lateral files to hold them all. Depending on how nice the files are they will cost about $4,000 and could be a lot more. They will take up office space costing another $550 per year. Plus all the “inactive” charts stashed away somewhere else?

So far our inexpensive paper files are costing us $15,800, but that’s not the total cost. There is the human effort to make the chart, type the label, arrange the contents, file new bits when they arrive in the mail, write the notes, pull the charts every day and then re-file them. And of course there is the daily ritual of the lost chart, which no one can find only to have it turn up days later either misfiled or hiding in a stack on the doctor’s desk. The human cost is at least $11,520 per year.

What we have is a paper chart system that is really quite expensive costing $15,800 to create and $11,520 per year to maintain for a total of $27,320.

Help with “Going Paperless”


Dentrix Tip Document Center

The Document Center allows you to view documents for a single patient or an entire family. Use Views to see a list that contains all documents for every member of the family without having to select a new patient and switch between patients.

Doc Center

via Dentrix Tip Tuesdays: Viewing Documents for an Entire Family in the Document Center.

I believe Document Center is one of the most useful features of Dentrix and yet it is very often not used by offices or else used very inefficiently.

e-Services Management

New or Re-Activate?

Many dentists spend countless hours and tens of thousands on marketing efforts chasing the elusive new patient while sitting quietly on a fortune.

The ADA estimates that the average dental practice generates between $700,000 and one million dollars’ worth of incomplete diagnosed treatment per year. 20% to 30% of your current patients are non-responsive yet most of them probably still consider you their dentist. Your existing patients are a rich vein of gold just waiting to be mined.

My favorite re-activation e-service is Action Run.

Dental Speaker General


“Until one is committed, there is hesitancy, the chance to draw back, always ineffectiveness. Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, the providence moves too. A whole stream of events issues from the decision, raising in one’s favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way.”

William H. Murray

Hardware Office Design

Guide to “Computers in the Back”

Are you planning to remodel or upgrade your office? Technology has become and integral part of any modern dental office. Where you put the computers, the monitors and the inputs is just as important as where the chairs and handpieces go.

Many dentists just stuff the computer somewhere between the sink and the glove dispenser … then wonder why it doesn’t work very well.

My comprehensive technology guide, “Computers in the Treatment Rooms” lists the six keys to computers in the operatory and it will answer the basic question…Why bother?  It then provides step by step help in setting up the computers, including the four access points, avoiding mistakes and resources for hard to locate parts and accessories.

“Computers in the Treatment Rooms” will answer all your questions, provide a plan and show you how to save money… all delivered in a fun and easy to understand style.


Follow the link to order your copy today.

Internet Software

Dentrix Ascend

From Henry Schein: Cloud Based Dentrix Ascend has completed Beta Testing.

— Henry Schein, Inc. (NASDAQ: HSIC), the world’s largest provider of health care products and services to office-based dental, animal health and medical practitioners, today announced the availability of Dentrix Ascend, its first cloud-based practice management system.

Having completed beta testing, Dentrix Ascend features a web-based practice management system that enhances dental practice efficiency by providing the benefits of the cloud, including automatic data backup, upgrades delivered in small, easily learned modules, and round-the-clock access from any model of computer—Personal Computer, Macintosh or tablet.

“Dentrix Ascend provides a completely new experience in dental practice management,” said Kevin Bunker, President, Henry Schein North American Dental Practice Solutions.  “Not only is it cloud-based, but it also improves workflow and practice efficiency with an entirely new, easy-to-learn interface that we created based on hundreds of hours of usability research.” …

The Dentrix Ascend website is linked below:

With Dentrix Ascend, you get a fresh new interface that packs the most advanced clinical, front office and business management capabilities into a surprisingly easy and intuitive new user experience. You gain the freedom to use whatever devices make sense for your practice—from PCs to iPads. And you tap into all the advantages of a secure, web-based architecture that gets better and smarter every time you log in.

via Dentrix Ascend.

Internet Management Social Media


econexisA new patient communication system:

eConnexis breaks down most barriers to communication by allowing your patients to contact you at their convenience, using the method they prefer. Whether they’re making an appointment online or text messaging a cancellation, we make sure the two of you get and stay in touch.

via eConnexis|HealthCare Features.

eConnexis is similar to Smile Reminder or Demand Force. It integrates with your practice management system to send reminders and generate user reviews. It is feature rich and offers reporting options that the others do not. Two features which set it apart from the others.

Quick synchronization: With some systems when a patient confirms an appointment using text or e-mail it takes hours for the information to get back to your office. With eConnexis it happens in minutes.

Text Reply: When a patient gets a text from you using eConnexsis it comes from a number specific to you. The patient can text you back or call with a single click. Other systems use a generic number and patients can not respond.

At this time the system works with Dentrix and Eaglesoft other systems and additional features are planned for the future.

Management Office Design Software

Opera Communication

NoLightsMinnesota dentist Dr. Bryan Laskin was looking for a communication system for his new office. Old fashioned light systems were tried and true but are also extremely expensive. Newer digital systems were better but none seemed to fit his needs. So he invented a brand new tablet based system he calls OperaDDS. Now he has bundled additional communication systems into a suite of products.

The original product is OperaPager. You can customize OperaPager to your needs, creating user profiles for everyone on the team and single-touch messages or individual and group notices that will work best for your office. Or you can choose from a set of predetermined messages and options.

The two new services are free HIPAA compliant encrypted e-mail called OperaSend and a system to collaborate with colleagues called OperaChorus.

OperaChorus is a secure online communication portal that allows you to communicate in real time. If a specialist across town needs to ask a quick question about a case, you can simply collaborate instead of engaging in a complex, mind-numbing, time-wasting, old-school game of phone tag.
It can also be used to check in with your labs, fill out a script, and track a patient’s progress. Records are stored securely and cheaply in the cloud.


e-Services Internet Management

Digital Dental Specialist Referrals

Dentat workIn case you missed it: Dentalcompare article from June:

Despite advances in digital records and communication, the majority of specialist referrals still follow this old paper-based system. However, paperless digital referrals are possible, have already progressed through two generations and promise to be even better in the near future…

A third generation system will upload all the appropriate patient data from the paperless record to the online referral forms automatically with no additional typing. In other words, the patient name, the tooth and the treatment would not need to be re-typed but would be extracted from the exiting digital record.

But that’s not all. With a digital referral you are not limited to the minimum information we used to scribble on the paper form. You can automatically upload all the patient information the specialist’s office will need such as address, employment, contact numbers and the other things needed to create a patient record.

via Emmott On Technology: Looking Ahead to 3rd Generation Dental Specialist Referrals |

Transferring patient information using the Internet is faster and more accurate than sending notes and copies. A copy of a digital radiograph is exactly the same as the original. A copy of a film radiograph is significantly degraded.

A primary obstacle to better sharing of medical dental information is the incompatibility of various systems. Even basic patient information like a patient’s name and phone number will not readily transfer from one management system to another. Until the dental profession demands interoperable systems the vendors will attempt to control us with closed proprietary systems.

Sending patient information including radiographs as an e-mail attachment has significant security and HIPAA issues. The best way to send patient data to another dentist is by the use of an encrypted web site.


Dental Speaker Internet

ADA 2013 New Orleans


I will be presenting at the ADA this  week Nov. 2:

Google Juice Beyond Facebook: Using the Internet Effectively

Course Code: 7710

Sat., Nov. 2  10-11 a.m.

CE Hours: 1.0

In 2013, a practice Web page is no longer optional. Like it or not, people will judge you based on your Internet presence and online reputation. This course will show you how to use Google, Web pages and social media to generate positive user reviews and safeguard your online reputation.

After this course, you will be able to:

  1. Improve professional communications
  2. Work effectively with search engines
  3. Manage your online reputation

ADA 2013 Meeting

Management Software

Phone Integration

Broadview Networks integrates your phone system with Dentrix G5. When a patient calls into your practice a window instatntly pops up on the desktop display before you even answer the phone. The pop up displays patient records, including family history, appointments, clinical details, prescriptions and account balance information. By having all this data at their fingertips, the staff can create, confirm or reschedule appointments in seconds for the patient and the patient’s family—and can even answer questions about their prescriptions and treatments or collect overdue balances.



Splitting a Primary Insurance Claim

Dentrix Tip

 At times, insurance carriers will send a partial payment for an insurance claim. You can post the partial payment while still keeping track of the unpaid procedures by splitting the claim. Once the original claim is split into two or more separate claims, you still have all the reports and options available with any unpaid claim.

Dentrix Tip Tuesdays: Splitting a Primary Insurance Claim.


5 Quick Tips For Website Improvement

…rather than trying to do a complete makeover, consider these five quick minor improvements for your site. It is amazing how a few small improvements can put you on the path to greater goals

via 5 Quick Tips For Website Improvement – Modern Practice.

The five Quick Tips are:

  • Visual indicators:  Icons
  • Thumbnail images for your posts
  • Quick fix SEO
  • Use a favicon
  • Use a footer