The benefits and challenges of paperless practice

Here are some of the advantages I see in paperless practice vs. using traditional paper charts. Are there drawbacks too? Yes. Those follow, but for me they don't outweigh the positive aspects.

Benefits

> Organization. No more lost charts! Every doctor and team member knows how frustrating it is when charts mysteriously disappear. When the charts are on the computer, not only can you locate them instantly, but multiple people can work on them at the same time-the doctor types notes while the receptionist checks the client out, for example.

> Legibility. Everyone can actually read the records, which is rather important when it comes to medical care. This quickly converts into better client communication, too. For one, the client sees you as organized, and his or her wait time is diminished when you can answer questions at the click of a key.

> Efficiency. Paperless practices don't waste time looking for charts, refiling charts, or culling old charts (computer settings automatically inactivate outdated charts). In addition, clinics that fully computerize their medical charts save space and supplies.

> Management from a distance. If you're like me and your facilities are spread out over several locations, remote access to client and patient records is a huge advantage. Even if you have a single site, it's much easier to travel for work or personal reasons if you can access your veterinary software from anywhere. Or you may simply want to eat dinner with your family and enter the rest of your notes at home.

> Thoroughness. A template-based approach means you're less likely to skip important steps in your protocols or blow by top-level care recommendations.

> The green factor. Less paper means less consumption of natural resources-something more and more consumers are considering when they decide where to spend their money.

Drawbacks

> The need to type. For some, typing notes seems time-consuming and tedious, and hand-writing in a chart is just more comfortable. These doctors often do write in the exam room only to retype the same information later. And scanning an external report into an electronic format can be more time-intensive than simply dropping it in a paper file.

> The potential for a crash. It's one thing to lose a chart or two in a paper-based practice, but if the whole system goes down, there go all your records. It can be very difficult to conduct business before the backups are restored-and backups are imperative (see my Practice Tips article on this subject in the January 2008 issue). Also, natural disasters such as fires and floods can destroy paper charts with no possibility of replacement. Which is a greater risk? You decide.

> Security issues. I know of many practices that have shied away from paperless practice because they question whether the records will hold up in court. It's more difficult to tamper invisibly with a paper chart than it is an electronic record. If you're ever in court, you must be able to prove that you have a security protocol in place that won't let anyone modify a record at a later date.

> Expense. Computerized practices require lots of computer stations and usually the latest technology, so they can be costly to maintain.

As I said before, the pros outweigh the cons in a big way for me. The latest advances have made it far easier to be truly electronic than in the past, and human medicine is making tremendous strides that hopefully will be picked up by the veterinary software developers. The future is bright-and there's less paper in it.