Clinic computers enter 21st century An interview with Dr. Paul Richardson by Christy K. Robinson The School of Dentistry is bringing its computer hardware and software from 1985 computerization to 1999 - 2001 capability. The original software program, written in MIIS, was self-written, self-designed, and worked very well during the eighties and nineties.   Paul Richardson, SD'72, MEd   "We had things that many dental schools didn't have," says Paul Richardson, SD'72, MEd, associate dean of clinic administration, "but we didn't have some basics like computer printed insurance forms -- we have done that by hand and typewriter for many years." One goal was to bring software into the 21st century, to make a springboard from which to digitize records. Says Dr. Richardson, "The first step is to use a software package that has the strength and robustness to carry us for the next five or six years without major intervention. The second step is to upgrade our desktop hardware to at least 1999 standards (which probably by the year 2000 will be well in the dust). We hope that we can go 18 to 24 months without having to do any major upgrades. The third is to enhance the dental school network to the point that it can bear the kind of traffic that we foresee for digital image transmission." The software package cost about $125,000. The next expenditure is for leasing 150 computers. "We felt that computers are so transient, that we'd try leasing this time," says Dr. Richardson. "On the network itself, fiber optic has been installed from the basement to all the main floors, hard wiring the entire clinic, and first and second floor offices." The materials will be viable for five to ten years, Dr. Richardson estimates, as far as their transmission capabilities. "The network can transmit 100 BaseT. At present the floors communicate a 10BaseT interfloor is at 100 BaseT. While we're about this with the main clinic, Dr. Caruso and his group in the orthodontic clinic are one or two steps ahead of us on the digitization side. They're beginning to test and find issues with our network that we hope to enhance as we go along, so when we transition toward that in a couple of years, things will be working well for us. "At this point, the only things that are going to go online that haven't before, are treatment plans entered directly in the computer by students. That is a step forward toward digitization. That starts July of 1999. If we don't do it this year, we're in trouble, because our dear old computer dies an unnatural death in 2000. Our old system is not 2000-compliant. There are sub-programs that will still remain functional for some time, but the main clinic will transfer July 6."   Computer stations in orthodontic operatories show approximately what main clinic operatories will resemble.   Dr. Richardson continues, "We've already started a pilot program where we have 30 students with about a thousand patients contained in this program. The students have had to endure some interesting glitches in software that's not quite there, but they've been very cooperative in getting us through this. We deeply appreciate the students in the pilot program." "I'd like to see us get to the point that each treatment site has a computer. We've wired a fair amount of the clinic already, so that students and faculty can directly access and update the patient records. We can track students, patients, time, and use of the clinic. It will be a pushbutton event then, not someone walking around making a list. "By the time we're through placing computers this July, there'll be 20 or better in the clinic, which is 20 more than we've had until now. There's a nine-station laboratory on Taylor Street (data entry area) available to students and faculty during the daytime. We use it as a teaching center for upgrades, or bringing people along in the program. There are also two student-lounge computers, and two in my office, so we've scattered them around strategically. There will be some in the laboratories." Could a patient's records just vaporize? No, because everything is still retained in hard copy, including the chart and treatment plan. There will always be hard copy backup. Dr. Richardson says, "We're not ready to make the jump to a paperless society: we have some security concerns, and concerns about maintenance -- we don't have servers large enough to maintain all that. We really need backup servers, and ways to put this on optical disks -- that's in the future. That's a fairly costly program (now), but within two or three years, will be relatively inexpensive."   Dr. Paul Richardson says that computer reporting will be will be "a pushbutton event" when clinic records are digitized.   He says that the School of Medicine is slightly ahead. The new Medical Center charts consist of a single sheet of paper which gives the name and number of the patient computer files. Most of their records are digitized right now. They made the decision to either digitize radiographs or buy another 200 miles of storage space. Meanwhile, back in the School of Dentistry, the staff who had telemonitors now have computers which enhance capabilities at their work station. They can do word processing and e-mail, and reporting on Excel or Access. "I do see us going to full digital in time," says Dr. Richardson. "There's plenty of evidence that that's the wave of the future. At a conference in Key Largo, one of the attorneys who spoke says that digitized records will be standard practice within five years, simply because once they're bound onto a CD or DVD, there's very little change you can do, with a one-way, writable-only disk. Courts are beginning to become comfortable with those types of records. There are ways now to verify whether a record's been tampered with, even to track the date and time. I think we'll go that way as soon as we can." Dr. Richardson says that at the moment, the School of Dentistry is in the throes of making the software work. The software is QuickRecovery, by General Systems Design. "We ran a fairly extensive search through five dental schools and two software companies. None of them met our needs exactly. This particular software program meets our needs better because we have access to the underlying codes, so instead of just seeing the screen, if I want to go back into the data file to extract data for reporting or tracking, I can do that directly without the program hindering my access to the underlying file base. That's done through Microsoft programs such as Access or Excel. "Reporting is the major enhancement right now, and you're allowed access into the database itself, in contrast to the old machinery where you can't access anything except paper reports. A report shows me everything a student's done as of today. If I want to drop into the software I can pull that out into Excel, then I can slice and dice and see where all this generated. If we find a program we like that stores digitization, digital images and compresses them well, its open architecture allows us to add it to this program. "There're ways to enable us to enhance it without having to write software that's specific to us." Christy K. Robinson, LLU CAS'80, is editorial coordinator for the School of Dentistry, and managing editor of Dentistry. She is an editor for the Association of Adventist Women, and contributes to several other publications. She now posts news and photos to the University website, a long journey from the typewriters and wax pasteup of journalism classes. University | Medical_Center | LLU&MC_home | Search | Employment | News_&_events | Academics | Our_mission | Admissions | Registration | Research | Alumni | Student_resources All contents copyright © 2001 Loma Linda University. All rights reserved. Revised February 28, 2001 Send comments and questions to webmaster@univ.llu.edu  URL: http://www.llu.edu