Dentrix Ascend: Thoughts on Clinical Notes
Love ’em or hate ’em. That’s how most offices feel about their clinical notes. Either they feel proud of the templates they’ve created and believe there is nothing better, or, they absolutely despise them and use clinical notes as the easiest dog-to-kick when schedules run behind or staff aren’t trained.
What do you think of your clinical notes?
I’ll preface the rest of this article by saying that I am not a clinical professional – total business and admin background all the way. So, as I’m beginning to work with Dentrix Ascend’s clinical notes, I’m looking at the ease of use and functionality for setting up the templates as well as entering the data. Here are a few items I’ve found that I like – and a few things I’d wish for.
What I like about Dentrix Ascend Clinical Notes
- Template is easy to learn – I dug into clinical notes to create a training video for my group having zero experience with creating clinical notes in Ascend. I have created them in Dentrix G4-5, but honestly, that’s been years ago, so I was walking in blind. Within one day – really, more like 4 hours, I had learned how to use the existing templates, existing quickpicks as well as how to create my own from scratch and my video was done. I thought that was pretty fast. Since my goal was training, not doing – I didn’t start to measure how quickly I could make my own, but I would say it’s easy to learn and work with.
- Existing templates & Existing QuickPicks are a great start – Once you understand the concept that the clinical note template includes the text you want – and the QuickPicks are the questions you create, it is nice to just scroll through the existing templates for both to see if something is close to what you’re looking for. I often found an existing template that I thought looked good – and made minor modifications.
- Cool how the doc signature is inserted – This may be a little goofy, but I like how the doctor’s real signature can be inserted into the clinical note – and that’s saved along with the doctor’s typed name and date. Since I spent 16 years dealing with paper charts in my original group practice, it was just nice to see real handwriting for a change.
- Prescription refills auto create clinical notes – This I thought was brilliant. Of course I want documentation that we gave our patient a refill – and when you already have the prescription set up, the refill will automatically enter the clinical note. Total timesaver. Great idea.
One thing I’d change
The only downside I see is that you can easily skip the QuickPick questions. Now, in some respects, maybe that’s a good thing if you’ve created poor choices and you didn’t leave an option for other or none. But for the most part, I think the point of clinical notes is to make sure that the clinical team is “forced” to answer every question. So, if you ask for the result of a pulp test inside a clinical note for a limited exam – it forces the assistant to stop, run the test and then enter the answer.
The way it works now is that you can skip any question (or all of the questions) you like and it will leave a blank. The problem with that is that the font is reasonably small and it can be easy to miss. So, if the assistant skips a few questions in the clinical notes – and the dentist is reviewing them and signing them at the end of the day – it would be easy to miss these blanks inside a paragraph, or even on a separate line. In fact, as I was reviewing a few random clinical notes today, I noticed that one that was skipped was the medical history update – it was on it’s own line:
Medical history update:
So, maybe one idea would be if we continue to allow the assistants/hygienists to skip questions – what if the software turned that section red? I think that might make it easier for the clinical staff to catch their own skips – and then go ahead and fix them right away. And, if they didn’t – the red would stand out and grab the doctor’s attention – and she/he could edit those later as well.
And a money-maker opportunity
I found out that the existing clinical notes templates and quickpicks were the contribution of some helpful and generous doctors – and I certainly appreciate their efforts! However, that means that you can’t just assume that by using the existing templates, you are following malpractice and HIPAA charting official guidelines. This makes total sense to me that a software company can’t stray too far away from creating the product to take the time to lay out every single template including every question we should be asking and every option we should be including.
So, I think this leaves a money-making opportunity on the table. Perhaps there is an enterprising compliance company that is willing to tackle the challenge of not just recommending what content should be in the templates, but they could go ahead and create the templates and quickpicks for Dentrix Ascend incorporating the official requirements! For any office that has been through the process of creating clinical notes, you know what a giant project this is. In my opinion, the doctor must provide the content for the clinical notes – but sometimes this responsibility is left to the staff, who feel unqualified and uncomfortable. From a malpractice standpoint, it’s also just plain dangerous.
Over the years, I’ve seen clinical notes recommendations from a variety of malpractice and compliance companies – and in my opinion they are crazy long and detailed. I understand that this is what is necessary to keep doctors out of court and as safe as possible from unfair lawsuits, but they just aren’t reasonable. There needs to be a balance between dotting every i and crossing every t – and actually completing an accurate record for the patient in a timely manner. As a culture, we’re already bent over our cell phones 24/7 – who wants to watch the dental team spending our entire appointment (that we’re paying for!) pecking at the keys on a computer! By having a compliance company take on the challenge of taking their own recommendations and turning them into functional clinical notes – I think they would realize it’s not possible to spend 10-15 minutes entering clinical notes when a child’s cleaning under age 10 lasts 30 minutes!
Overall, I’m a fan of the Dentrix Ascend clinical notes. Once you learn only 2 features – clinical note templates and quickpicks, you are off an running. I appreciate the existing content provided and I would bet that over future years of development, this program will continue to look for “auto” clinical notes functions just like the prescription refill. That just makes our lives easier and the clinical chart more accurate.
At the same time, creating clinical notes templates is still a big job that will take several hours to handle correctly – whether you’re using any dental compliance resources or not. The more I think about it, I like my idea of changing any skipped questions to red so they can be answered later – and maybe Dentrix Ascend will pick that up for the future!
Please feel free to share your comments about clinical notes – and especially, if anyone knows of a company that’s willing to create clinical notes that are “officially approved by a compliance company” because I’d love to learn more about them. Also, if you have other suggestions about how to catch the skipped questions in Ascend, please share those as well.
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