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Compendium August 2010 (Vol 32, No 8)

In Practice — You Won’t Believe What’s Possible With Digital Technology!

by Nancy Dewitz

    The dictionary defines information technology (IT) as “processing of data via computer; the use of technologies from computing, electronics, and telecommunications to process and distribute information in digital and other forms.” The goal of using digital technology is data capture and use. Although you may not have the need or budget to implement a fully digital practice, when considering the introduction of IT into your veterinary practice, addressing the following questions may help you set priorities in determining which of the many available technologies to integrate:

    • How will this technology improve customer service?
    • How will this technology improve patient care?
    • How will the addition of this technology add to overall veterinary practice efficiency?

    Communicating Via Your Web Site and E-mail

    A great way to communicate with clients is through a practice Web site. Many practices choose to develop their Web sites on their own, while others select Web site development companies that specialize in veterinary hospitals. A Web site is a must-have tool to promote your practice to pet owners looking for a local veterinarian on the Internet. A Web site can showcase your mission, veterinary services, and practice health care team, as well as provide veterinary medicine information, including new patient interview forms and preadmission client consent forms. With today’s advanced technologies and networking capabilities, veterinary hospitals can allow clients access to their pets’ medical information and prescription refill services with the click of a mouse, 24/7.

    If your e-mail address doesn’t include your clinic name, consider registering your own domain name. Free e-mail might be financially attractive, but who does “drbob3456@aol.com” remind the client of: your e-mail provider, or your veterinary practice? Most veterinarians would prefer that their clients remember their practice and the great service they provide, and a unique e-mail address (e.g., “drbob@bobsclinic.com”) can help. Using e-mail to contact your clients regarding pet health care and to send medication and service reminders gives you more opportunities to improve client service and patient care.

    Patient and Client Data Capture

    Not long ago, computers and veterinary practice management software (VPMS) systems merely generated invoices and patient care reminders. What part can IT play in your patient care routine today? If we follow Jake, a golden retriever, through his typical annual visit to a fully digital practice, we can see the many areas where IT or digital information can affect patient care far beyond the invoice.

    Check-In

    Checking Jake in through the appointment book in the VPMS is the first example of how digital technology can affect patients’ care from their first few minutes in the practice. For many veterinary practices, the appointment book is often the most difficult VPMS module to implement. However, once this transition is complete, electronic appointment books are extremely rewarding in terms of managing doctor and technician time and related production.

    At check-in, important patient data are captured, including Jake’s name, date of birth, breed, sex, and current photo. Additionally, client contact information, such as home and cell phone numbers and e-mail addresses, current mailing address, and (if applicable) referral information, can be gathered and entered into the VPMS, allowing you to be in touch with Jake’s owner to report examination and diagnostic results, perform follow-up communications, and deliver important reminders.

    Client consent-form signatures can also be captured electronically at this stage of the appointment with a digital signature pad. This technology can greatly reduce the number of paper forms your practice generates and can be integrated into your existing VPMS. There are many sources of electronic consent forms for veterinary use that can be customized for your practice.

    How about your patient scale? Jake’s weight, via a digital scale with data capture features, can be automatically forwarded to his medical record through integration with your VPMS and its electronic medical record (EMR) capabilities.

    Electronic Medical Records

    When Jake moves into the examination room, a technician will record presenting complaints, a patient history, and important information such as heart rate, respiration rate, and body temperature to begin the examination process. An interview template built into your VPMS or EMR can increase technician efficiency and minimize the opportunities for missing important details during this process. Also, as the veterinarian performs Jake’s physical examination, he or she can dictate findings to the technician, who can enter them into the EMR using a computer workstation, tablet PC, or portable laptop computer. A pet health report card can be generated to summarize the findings for discussion with Jake’s owner before the appointment ends. This report card can be printed out or e-mailed to Jake’s owner for further reference.

    While a paper file can be viewed by only one person at a time, staff members with authorization can simultaneously refer to Jake’s record from multiple workstations in your practice. This also means no more production losses looking for misplaced paper files. Also, veterinarians can have remote access to Jake’s entire record through use of a virtual private network (VPN), whether at home or while traveling. This capability allows them to be in touch with the practice at all times and monitor their patients’ progress while increasing the efficiency of record keeping, retrieving diagnostic results, and client communications.

    Treatment or Procedure Area

    When Jake heads back to the treatment area for his annual blood test and radiographs to monitor his chronic elbow osteoarthritis, data need to be captured regarding the blood tests to be run and radiograph views to be captured, when the blood draw and radiographs should be complete, and the associated test results after completion. Having an electronic whiteboard feature within your VPMS can bring real-time visibility to Jake’s needs and his doctor’s orders. The whiteboard is an important functional and visual reference for the flow of patient care throughout the veterinary practice facility. Electronic boards can easily replace dry-erase, manually updated ones. As treatments and procedures are completed during the patient care routine, staff members can input the treatment details and associated charges, easily capturing charges often missed in a manual whiteboard system. This highly valuable software-driven equipment can be integrated into your VPMS and EMR. A large, wall-mounted TV screen can be installed to display the orders in the treatment area, while information for each patient receiving care will be available at every computer workstation throughout the practice.

    Laboratory

    Jake’s blood sample can be analyzed in-house or at a reference laboratory of your choice. The decision of which method of processing blood samples is best for your health care environment depends partly on how quickly the results are needed—for example, are they going to be shared with Jake’s owner during the appointment? With either option, digital data handling needs to be addressed. Input of test requests and labeling of blood samples are often taken care of through computer workstations linked with in-house analyzing equipment via your network or with the reference laboratory via the Internet. Most VPMS systems currently import in-house or reference laboratory results. Each software product varies in its ability and mode of capturing results data. Some products capture a “snapshot” of the report. Other products transfer the digital data, allowing graphing and analysis of individual values to permit evaluation of changes or trends in current test results compared with test results in the patient history.

    Radiography

    Today, digital radiographs, including those generated by dental and stationary table systems, are becoming the norm. Many articles in the veterinary medical literature have described the benefits that adding this technology to your health care services can bring to your patients, staff members, and veterinary practice. However, an important, less publicized fact is that when considering the introduction of digital radiography, veterinary practices need to give attention to how the information they obtain will be captured, viewed, shared, and stored (BOX 1). Images should be able to be integrated into your VPMS and EMR and shared with clients, either at a viewing station or in the examination room (e.g., on a laptop computer or tablet PC with network capabilities or USB access). Digital radiographs can be automatically filed in patient records through integrated systems or retrieved from a master file of images for manual filing. The radiographic image available for viewing in the examination room does not need to be of diagnostic quality, but it does need to be easy to retrieve and use for client communications. Think about the impact of being able to send home Jake’s radiographic images on a CD!

    Using DICOM (Digital Imaging and Communications in Medicine) standards in your practice will let you use telemedicine to communicate with radiology specialists. These specialists are as close as your e-mail account. When the radiologic findings report comes back, it, too, can become part of the EMR and discussed with—or e-mailed to—the client.

    Client Education

    Several forms of technology can be used to customize your patient care education and client communications. After completion of Jake’s diagnostic tests, Jake’s owner is presented with his diagnostic results, radiographic findings, and treatment recommendations through a combination of communication tools, including verbal communication from the veterinarian, visual presentation of printed test results, digital radiographic images, and branded client information handouts.

    When employing client educational materials, whether handwritten or VPMS generated, it is important to keep them short and informative. All staff members should be very familiar with each handout so that follow-up conversations can be carried out and client questions answered promptly and accurately. Additional technologies to enhance your patient care routine and client education include video recordings played on televisions in your reception area or examination rooms and references that you can provide on your Web site for clients’ review. Remember, education leads to better compliance, and better compliance leads to better pet care.

    Pharmacy

    Before Jake heads home, his heartworm preventive and osteoarthritis medication prescriptions need to be refilled. The digital practice can simplify this task by integrating pharmacy transactions with the EMR. A clearly printed prescription label and medication-driven client information handout or invoice notation can accompany Jake’s heartworm preventive product and any other medications dispensed. All fees associated with the prescription preparation are automatically captured. Inventory counts will be updated accordingly by the system as the prescription is filled and the label is printed.

    Boarding Area

    When considering digital applications for your veterinary practice, do not forget the boarding area. Many factors need to be considered for this area of your practice. The most important is the environment. Make sure that anything electronic is protected from the elements. Having the computer workstation near the kennel sink is not an option!

    Electronic whiteboards and a computer station tied to your VPMS, similar to the treatment area, contribute greatly to the management of kennel guests and medical patient boarders. Your staff efficiency and animal care will be improved with the visual references provided by the information display and its integration with your VPMS and EMR. Facility scheduling, boarding charges, and medical treatments can be tracked and captured with ease.

    Video cameras can be placed in the boarding area, exercise area, or individual cages for monitoring the activity of boarded animals. The images not only provide valuable information to veterinary practice staff members but also can be entertaining for clients in the reception/waiting area or reassuring to owners who can access them via a portal on your Web site. These images give your clients a way to feel connected with their animals while they are away from home. Video cameras are readily available at affordable prices and come with software that can allow you to set up and monitor several cameras from one location.

    Checkout

    As Jake moved through the digital practice, his EMR was created and updated at every step. Medical examination notes and orders were entered while Jake was in the examination room and the treatment area. With the help of the VPMS, Jake’s reminders are automatically updated to match the services and treatments performed during his visit. Doctor callback reminders are generated. Jake’s health care invoice reflects all of the charges associated with his examination as well as his medication. Jake’s owner leaves the practice with a great impression of its services and a healthy pet.

    *  *  *

    Set your veterinary practice apart from the one down the street. Careful selection of hardware and software and the integration of diagnostic equipment can increase practice productivity, enhance client experiences, and improve patient care.

    NEXT: Research Recap: Abstracts from Veterinary Therapeutics, Summer 2010, Vol. 11, No. 2

    didyouknow

    Did you know... There are now 11 recognized veterinary technician specialties with the addition of The Academy of Veterinary Clinical Pathology Technicians (AVCPT) in December 2011.Read More

    These Care Guides are written to help your clients understand common conditions. They are formatted to print and give to your clients for their information.

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