How paperless practice is like "Free Bird"

Lynyrd Skynyrd's "Free Bird" might go, "...I'm as free as a bird now, and this bird you cannot change," but I'm optimistic that with a little expert communication and a step-by-step training program, you can get paper-record lovers to be freeeee as a birrrrrrd. (Photo Getty Images)The owner of my hospital is a baby boomer and not the most computer-savvy. With years of experience writing records by hand, she sees paper as a more efficient and secure copy of the legally required medical records. So I'd like to remind those of us speeding into the technology age that we shouldn't leave these wonderful practitioners behind in the mad dash to paperless practice. Here are tips to make the switch carefully and sensitively and bring along the veterinarians who say they prefer the scratch of pen to paper.

Write first, type later

Writing the written record in the moment then typing it into the software is one way to make sure records go digital. This may seem like extra work, but this phase usually lasts a very short time and helps a reluctant paper-record lover dip a toe in the paperless pool.

Stop the repeats

Templates for standard physical exams as well as surgeries, common ailments and standard client instructions are a wonderful resource. Typing this all fresh for every visit every time can be time-consuming and tedious. Setting up these resources takes a little time but pays off in the long run. Even better, your practice software may already have predefined templates (I know Henry Schein Animal Health's AVImark and IDEXX's Cornerstone do). AVImark even has a “Glossary” section (watch a video about it here) to store templates you can import into exam room documents or an end-of-exam patient health report card.

Get into the flow

Flow sheets-simpler than a full medical record form-capture basic client and patient information. We created ours in a SOAP (Subjective observation, Objective observation, Assessment and Plan) format so doctors can take short notes about the exam on a templated form and put them into the computer later. (Clean up your visits with SOAP here.)

Many times we miss out on good client interaction when we worry too much about typing extended notes during a visit into an electronic medical record. Flow sheets can be printed during check-in using merge words (which allow you to automatically populate a Word document, for instance, with name, age and medical alert fields from the PIMS record). This allows for a personal touch in patient health report cards you send home-with no extra work on your part!

Be heard

Working with slow typers? Introduce them to speech recognition software and a microphone. It takes a little time to get used to the software, but many programs get smarter and better at understanding particular speakers over time. Our practice uses Dragon Software; it's quick to learn your speech patterns and learns big medical words. (There is a pricey human healthcare version, but we get by with the lower-priced one.)

Grab the technician

Most exam room technicians have already heard the veterinarian's exam findings and can move the process forward by typing up the first pass in the electronic medical record. After the doctor finishes with the client, he or she just reviews the record.

Taking an entire practice paperless can be hard, and those who are resistant to the change can make it even harder. So take it a step at a time. Prove to veterinarians that the system works. Offer templates and flow sheets to speed up things. The professional, 21st-century nature of your records, the faster time for input, the ease of record handling and the disaster-resistant data (you back up to the cloud, right?) far outweigh the tedium of the switch.

Lori has 15 years' experience in the veterinary industry, nine of those as practice manager and now human resource specialist at Northshore Animal Hospital in the Knoxville, Tennessee, area.