Tech-savvy doctors aim to improve accuracy, efficiency
Computers, gadgets and gizmos are
revolutionizing the doctors’ office
by Lauren Kramer

Doctors these days fall roughly into two camps. There are those that stick with their trusty paper files for recording patient information, utilizing the same equipment they did back in the early 80s. And there are those that embrace technology head-on, using computers, software and the most up-to-date gadgets and gizmos to make their practice more accurate and efficient.
Which kind of doctor do you choose? Your trusty physician who hasn’t changed a thing in 20 years, or the doctor who tackles change with enthusiasm, equipping himself with the knowledge and machinery of today’s technological era?
“It’s important to keep up to date with technology, just as it is to keep current with advances in medical health, as the two go hand-in-hand,” says Dr. Mark Aginsky, an optometrist who owns Vision Plus in Bellingham, Burlington and Marysville. “The technology allows us to be more thorough with our patients, and also to practice in a time-efficient manner in today’s world of managed care, without sacrificing the patient encounter.”
Aginsky has held fort in a paperless office since 2000, using a windows-based software called I-File. The software allows him and his staff to use computers for everything, including exam records, billing, retail sales, inventory, accounting and staff management. “The software is easy to use and very forgiving if you make errors,” he says. “We never lose a chart or file now, and a file can never go home with anyone or be misplaced, because it’s on the hard drive and backed up daily. Having everything computerized solves issues with doctors’ illegible writing, and minimizes prescription errors, too.”
Apart from his five computers in each practice, Aginsky has equipped his optometric clinics with digital non-mydriatic cameras which can photograph inside a patients’ eye without requiring the patient to be dilated. Vision Plus also has computerized eye charts which can be adapted to display images for kids who cannot read, and questions for the deaf.
“The eye chart has a built-in kids’ cartoon to help keep children’s concentration during an exam,” explains Aginsky. “When we’re using a light to look inside their eyes, for example, they’re watching a cartoon and are easily distracted.”
“When we started Vision Plus, I noted that most practices were looking at going from paper files to paperless offices, - a long tedious process. So it made sense, when we started, to be paperless from the get-go, rather than having to make the transition later.”
Dr. Nannette Crowell, co-owner of North Cascade Eye Associates, which has clinics in Sedro Woolley and Mount Vernon, can testify to the expense and hassle of making a transition to a paperless office. “This process will have cost us $100,000 by the time we’re up and running electronically,” says Crowell, an ophthalmologist for the past 20 years.
She and her staff are working with NexGen Health Care to create software specifically for ophthalmologists, because “the best software we could find still wasn’t perfect for us,” Crowell says. She employed six teenagers who spent the summer working in her offices, scanning pages from old patient records to be added to the electronic database.
“With two clinics, we want to make it as convenient for patients as possible, so their charts can be accessible no matter where they want to be seen,” she says. “We hope to start entering new patients into our computers in the next couple of weeks, but initially, we’ll make print-outs of everything too, until our confidence is up,” she confesses. “I want to faze computers in gradually, because I’ve heard of disasters happening when doctors try to do it all at once.”
Apart from the challenges of converting to a paperless office, Crowell embraces technology in her practices, not out of a love for technology, but out of an admiration for the results it can produce. “We have a machine called a HRT, which costs $27,000 and is used for monitoring glaucoma on the optic nerve. A scanning laser passes across the optic nerve, makes a digital map of it and compares it to other people of the same age and sex,” she explains. “It then provides us with a statistical print-out on whether or not it assesses there is damage, and stores that information so we can test again later. It’s been very helpful to us.”
Another item that’s helping her diagnoses is a digital fundus camera that photographs the back of the eye. “It’s especially good for macular degeneration, in terms of detecting where the problem is and how bad it is,” she says. “I’m constantly going into debt buying new equipment like this, and though upfront it’s a pretty big financial hit, it pays itself off in the long run.”
How do patients feel about technology-savvy doctors? “For me, it’s all about relationships and building trust with patients,” says Dr. Janette Carroll, who practices cosmetic and general dentistry in Mount Vernon.
“People come here because they’re looking for great dentistry, and I don’t think I necessarily need bells and whistles for them to keep coming. For example, they’re impressed that I’ve managed to stay abreast with new developments, but no-one has left my practice because I don’t have digital X-rays. They don’t equate a paperless office with great dentistry. Rather, they want to have time with a dentist, and a great relationship.”
In many aspects, Carroll’s dental practice is on the cutting edge. “I have DVD glasses called Glasstrons, made by 3M,” she says. “Patients choose a movie and can watch it inside these glasses while they’re having a procedure.”
She purchased a Cadcam unit for crown preparations, which enables her to infrared scan a tooth, transfer that to a computer screen, fabricate a crown using a computer software package and have it milled in her office, rather than sending it away to a laboratory. “I can technically prepare and seat a crown in one visit, which saves patients time and doesn’t cost extra,” she says. And she invested in an endoscope, a tiny camera that gets inserted between the gum and tooth, permitting the dentist to see inside the gum and help control gum disease.
Carroll has kept her practice with paper files, though she puts all her prescriptions and treatment plans on computer. She says she’ll likely transition to paperless files in the future, but for now, enjoys holding a notepad in her hand and jotting down information manually.
At Squalicum Family Medicine, Dr. Richard Binder also holds a tablet to jot down notes – though his is a $2,500 digital version that comes with a stylus pen. “Eighteen months ago, our group instituted an electronic medical record which allows us to input patient information electronically,” he says. “Using GE Medical Systems’ Centricity, we type information in and it creates an immediate record, allowing us to fax prescriptions from our laptop to the pharmacy and print up instructions for patients as they’re leaving.”
Though the software and hardware configurations for a wireless office cost his practice $30,000, it’s paid itself off all ready. “One staff member left and we didn’t have to replace them due to a reduction in filing and medical record-keeping,” he says.
“Having a paperless office is allowing us to maintain better records, input data faster and access it with great ease. It’s the greatest single improvement in office medicine in the 12 years I’ve been in practice.”

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