Part 3. Practice and communications systems: A word processor based communications system Martin N. Abelson, AB, DDS Rye, N.Y. The majority of computerized systems currently available for the orthodontic office have been designed for and aimed at those offices that have a volume practice and frequently have multiple practitioners. The stand-alone practitioner and the small office have been grossly ignored. Systems designed for large practices are frequently too complex, too involved in business administration, and too costly for the small office to use effectively. This article describes how an office communications system can be assembled by using commercially available programs. For background information and definition of terms used in this article, I suggest referring to "An Introduction to the Computerization of the Orthodontic Practice," in the Oct. issue of this JOURNAL. (AMJ ORTHOD DENTOFAC ORTHOP 1992;102:561-8.) T h e greatest benefit a small practice can derive from computerization is an immense increase in the efficiency and quality o f communications, rather than from bookkeeping and practice analysis. By computerizing, a small office can easily present a high quality image for communicating with referral sources and patients, equaling the most prestigious office. Letters concerning progress or problems can be well written quickly and, most importantly, in a timely manner.. Time-consuming process involving dictation, proofreading, rewriting, retyping, correction o f typographical errors, grammar or spelling, and addressing letters and envelopes cause poor habits to develop. Too many letters do not get written because o f the time and effort required. A good communications system will eliminate about 85% o f the work and increase quality and accuracy considerably. We live in an increasingly litigious society. The safest way to stay out o f trouble is to document problems when they occur. What is needed is a computer, a good word processing program, a printer, and a copy machine. Today all o f these are within the budget of a small office. I set out to develop an effective computerized office communications module, and not surprisingly, many. secondary benefits were uncovered.
METHODS AND MATERIALS Letter writing in the computer world is accomplished with a word processhzg program. Commerical word processing programs are available that will provide various levels of sophistication for the writer. They range from simple letter writing programs to those with capabilities for the production of complex newsletters and brochures that approach the quality of those that are typeset. There are many well-executed
programs available. I discovered that once a particular word processing program was learned, most people are reluctant to make a change because of the learning curve. This was interpreted to mean a careful selection had to be made, making sure the chosen program did not have any serious limitations for future expansion of the system. A number of easy-to-learn programs, with very friendly interfaces were thus eliminated because of limited capabilities. From the four top of the line contenders, I selected WordPerfect. Perhaps the most compelling reason for the choice was that the WordPerfect Corporation provides unlimited free support through toll-free telephone numbers. The support proved to be superb and explains why, though WordPerfect might not be judged the easiest of the top programs to learn, it has become the current default world standard. Product support is essential for any computer program. A novice to the world of computers will find that a high level of support is essential to success. WordPerfect is currently available in versions designed to run on most commonly available hardware, but I elected to use the version for the IBM DOS system because it had the largest base of software and hardware availability and repair. A lesser known product of the WordPerfect Corporation, WordPerfect Office, provided a shell which eliminated most of the hassles associated with the DOS operating system Fig. 1. The WordPerfect Office program also comes with a file manager, file and macro editor, calculators, a calendar program that can be configured into a computerized appointment book, and a notebook. The notebook proved to be a relatively hidden treasure. The shell also provides for memory management and program switching without the need to exit the program you are currently working in, plus an ability to move data to and from the word processor for merging or other uses. The latter function is accomplished with a clipboard. Also, data are saved in the clipboard and later retrieved for use in the word processor.
DEVELOPING THE COMMUNICATIONS MODULE Diplomate, ABO. 811136717
Some o f the benefits derived from using a word processor are its abilities to make corrections in written
561
562
Abelson
Am. J. Ortbod. Dentofac. Orthop.
December
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Fig. 1. Word Perfect Office original shell menu screen.
Rpl Title-- RpllstName-- RplLstname-StreetCity-, ST- ZipDear Rpl T i t l e - RplLstname--:
A
I have noticed that First Name-- has been having difficulty in keeping scheduled appointments.
^D
"F27 ^ ^F28 ^ ^F29" ^F8 ^ 9--, 10~ ll-Dear ^F27 ^ "F29":
B
I am quite concerned regarding ^F4^'s lax tooth brushing habits, and feel it is important that you are aware of this situation.
Fig. 2. A, Merge codes with field names. B, Merge codes with field numbers and WordPerfect v.4.2 codes.
1168{END FIELD} 01/01/O000{END FIELD} Mr{END FIELD} Sam{END FIELD} Cruikahank{END FIELD} 1-99 Kenneth Avenue{END FIELD} Falrfield{END FIELD} NY{END FIELD} 2419{END FIELD} (914) 791-0759{END FIELD} 09/05/1971{END FIELD} O.O(END FIELD} M{END FIELD} Canter{END FIELD} Na~gi{END FIELD} Mr.{END FIELD} George G.{END FIELD} Crulkshank{END FIELD}
Fig. 3. Sample patient secondary merge file, WordPerfect v.5.1.
material on the screen before printing, thus eliminating most draft copies; spell checking and grammar checking; saving a well-written letter so it can be retrieved later without retyping; retrieve and edit a document, moving sentences and paragraphs anywhere desired without retyping; and to merge previously written letters with patient files. Merging involves the joining of a prhnaryfile that contains the letter or document to be sent and a secondaryfile containing the name and address of the doctor or patient or other pertinent information. The primary file is impregnated with merge codes that match those of the data in the secondary file. See Figs. 2 and 3. Fig. 4 shows the resultant merge. There is almost no practical limit as to how such data might be stored in a secondary file, so it does not have to be restricted
Volume 102
Special article
563
Number 6
Martin Abelson D.D.S. D~PLOMATEAMEI'~CAN BOARD OF ORTHOOONTIC.S PRACTICE LIMITEDTO ORTHODONTICS
September 16, 1992
Mr. George G. Cruikshank 1-99 Kenneth Avenue Fairfield, NY 24190 Dear Mr. Cruikshank: I am quite concerned regarding Sam's lax tooth brushing habits, and feel it is important that you are aware of this situation. As you know, orthodontic bands, bonds, and appliances are fo~l catchers. Itis therefore most important that the teeth be carefully brushed after each meal. In no case should any food or debris be allowed to remain in the mouth overnight. Debris which remains undisturbed for 24 hours or more will turn to ACID and will eat away at the tooth structure! Failure to keep the mouth clean increases the likelihood of dental decay and etching of the enamel adjacent to the braces. It is especially important that the areas between the brackets and the gums are shiny and clean. Gums that bleed generally need more brushing, not less. We will all be disappointed when the appliances are removed if there are decalcified marks on the teeth. I know you will cooperate in helping Sam realize the importance of good oral hygiene. Sincerely,
Martin Abelson D . D . S . MA:cl
Fig. 4. Resultant merge. to just a name and address. As previously indicated, the merge codes entered in the primary file select which data from the secondary file will be incorporated in the letter. If we take all of our letter files and place them in one directory, which acts like a computerized file cabinet, and put a number of secondary patient files in a second directory, we have built two data bases. Once a letter has been written and merge coded, it can be merged again and again, with one or more of the patient files. Once the two data bases are set up, keyboard macros can be used to speed up the actual merge process. A macro is simply a saved series of k e y s t r o k e s that can be replayed when needed. As stated previously, merge coding a primary file
is relatively simple, and once saved, the work does not have to be repeated. Manually coding hundreds of patient files proved to be quite a chore. A comparatively unknown feature of the notebook, which comes with the WordPerfect Office shell program, is that the notebook is designed to store data hz WordPerfect merge format/This means that notebook files can be imported into the word processor without doing any coding at all and will merge with letter files.
CONVERTING A NOTEBOOK INTO A CUSTOMIZED DATA BASE The WordPerfect Office program comes with sample notebook designs. Fig. 5, A and B show the two screens of the "contact list" notebook. One is called the list
564
Abelson
Am. 3. Ortho~t. Dentofac. Orthop. December 1992
Ps
I~st
Relationship
Home Phone
Work Phone
David
Meier
Helge Herman Ji~ Jonathan Rafael Sadie
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Book Dealer Illustrator European Contact College Buddy Attorney Book Dealer Frlend/Editor
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(718) (612) (076) (801) (208) (213) (503)
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555-9897 555-7711 72.89 42 555-4456 555-1313 555-7557 555-8854
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i Secretary/Aset
Introduced by
I
Soc Sec Number
Company Poeltion Affillatlon Phone Log
I I i I I
Spouse Birthday Anniversary Other
ZIP
Fig. 5. A, List display of contact list notebook. B, Record display of contact list notebook.
display andthe other the record display. The list display automatic~iily alphabetizes whenever a new record is created. One can scroll through the list of records, or the program will find a record if you begin typing the name. When a name is highlighted, if you hit the Enter key or F8 key, the complete individual record is revealed. The user is able to select which of the record data is to appear on the list display. If the patient record contains telephone numbers and your equipment has a telephone modem attached, then the user is able to dial the telephone numbers from either screen by hitting the F4 key. The best part of the notebook design is that existing notebooks can be redesigned to suit your purposes or you can completely custom design your own notebooks. Fig. 6, A and B shows the list and record screens designed for my system. One keystroke, F9, creates a new patient record. All data are typed in the "conventional manner, tabbing from field to field. Once the file is saved, the addition is permanent. A patient record
can be cloned for a sibling by deleting the record then canceling the deletion twice. The second copy is then modified as needed. The current version of the WordPerfect Office program even provides the ability to do simple searches in the notebooks. This prompted me to consider adding a section to the patient records that would contain basic treatment data in the memo area. A primary merge file was designed to print cards for the office rolodex. To print one or more rolodex cards or patient letters, all that is needed is to mark those records with an asterisk * on the list screen and a shell macro I wrote, [Alt-Shft W], automatically transports the data to WordPerfect and prompts the user to select the desired primary file that will be merged with the imported files. Fig. 7 shows part of the letters directory that provides the choices. Once the choice is highlighted, tapping the Enter key produces the desired documents on the screen for prior approval. A macro, [AIt-P], prints the documents. An [AIt-M] macro was designed to print the document and also set up and print
rot,me ]02 Number 6
Special article
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Marasia Martinengo Massle Mastrogiacomo Mastroglacomo Matthews Maucleri May Menzi Collier Munter Munter Nakamura Nargi Parise Parise Parrelli Paul Petruzzelli Petruzzo Petruzzo Pietrafeso Powell Schmid Schnapp
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Due Date
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~ome P h o n e 835-1254 835-0446 997-2641 835 0224 835-0224 698 4563 835-3585 628-2780 381 6169 835-5297 835-5297 835-3377 835-5685 967-3205 967-3205 835-1451 698-8548 (203} 438-7043 698 7419 698-7419 835-1153 682-8582 835-3354 835-1832
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A a Title Nickname R.P. Street City State
PATIENTS
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Last Age
Sex
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Case No
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Family Dentist Due
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Home Phone Work Phone Home Phone 2 Work Phone 2
Zip
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B Fig. 6. A, List screen. B, Record screen.
an envelope from a second printer bin. [Alt-E] finds the name and address on a letter and prints only an envelope. I have two separate office locations with two sets of case numbers. The patient notebook design was cloned for the second office. It was decided to have separate data bases for active patients and inactive patients. Additional notebooks were cloned to store inactive cases for each location. A shell macro [Alt-Shft T] was then created to expedite the transfer of records from one office to another or from active to inactive files. A two-location practice can function by using . . . . either one or two computers with this configuration.
One or many records can be moved with the same effort. Separate lists of referring doctors resulted in two additional custom note books. A seventh notebook was created to provide information on suppliers and frequent contacts and was titled "office phone book." An index card was prepared that contained the merge code pattern for each type of notebook (Fig. 8). These cards are used to facilitate the writing of merge letters. This was accomplished by importing one of each type of notebook into WordPerfect, deleting everything but the field descriptions, and then removing the field location codes before printing. The notebooks were imported in WordPerfect 4.2 version format.
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Am
06-01-92 Document
Ii:49p size:
Current FILES ADDRESS .CRD BA .1 BA .3 BA&NO-PQ. BILL .AbR BIRTH BREAKAGE.ANS BRUSH BRUSH .2 BRUSH .4 BUREAU .EXT CIGNA .ADR CODES .MRG CSF-DRS .LTR DR-REF .THX DRS .LTR ELASTICS. ELASTICS.2 ELASTICS.4 EOF
0 1,924 805 1,025 1,531 397 9,767 4,309 1,419 1,698 1,505 906 437 889 1,200 556 649 1,835 1,932 1,348 1,763
Directory C:\WP51\DIR\OFFICE\*.* Free: 33,130,496 Used: 170,863 " .. Parent 02-21-92 0 5 : O O p ~ A4 .MRG 12-02-91 0 7 : 3 8 p ~ BA 02-07-92 10:52a ~ BA .2 02-07-92 i0:53a BA .ADT 02-07-92 10=54a BILL 02-07-92 I0:55a BILL-REP.RET 05-29-92 12:15a BOUNCED .CK 02-18-92 10=19p BROOKLYN.HOM 02-07-92 10=57a BRUSH .I 02-07-92 10:57a BRUSH .3 02-07-92 i0:58a BUREAU .DEN 02-07-92 I0:58a CHANGE .APT 02-07-92 10=59a CIGNA .REF 02-07-92 11=00a COMPLETE.DDS 02-07-92 ll:O0a DOCTORS .CRD 02-07-92 11:03a DRS .ENV 05-16-92 0 2 = 0 8 p DRS .MRG 02-07-92 11=03a ELASTICS.I 02-07-92 11=04a ELASTICS.3 02-07-92 ll:05a ELASTICS.5 02-07-92 11:05a E O F - T O O .SLO
Files:
J. Orthod. Denmfac. Orthop. December 1992
122
2,532 05-18-92 12:54 p 2,924 05-20-92 i0=53a 793 02-07-92 I0=52a 1,818 02-07-92 i0:54a 748 02-07-92 i0=55a 892 02-07-92 i0:56a 1,290 02-07-92 i0:56a 988 02-07-92 I0:57a 1,730 02-07-92 10=57a 1,487 02-07-92 lOt58a 500 02-07-92 I0:58a 707 02-07-92 i0:59a 1,063 02-07-92 i0:59a 801 02-07-92 ll=00a 488 06-04-91 i0:45p 782 05-16-92 03:32p 1,318 05-16-92 0 2 : 0 0 p 1,871 02-07-92 ll:04a 1,637 02-07-92 ll=04a 1,618. 02-07-92 ll:05a 2,693 02-07-92 ll:05a
1 Retrieve; 2 Delete; 3 Move/Rename; 4 Print; 5 S h o r t / L o n g Display; 6 Look; 7 Other Directory; 8 Copy; 9 Find; N N a m e Search: 6
Fig. 7. Letters directory (partial display). 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Case# lstVlsit Title F i r s t Name Patient Nick HI Last Name Street City ST Zip Hone P h o n e Home P h o n e 2 Work P h o n e Work P h o n e 2 Status Birthday
Age Sex Slbltng
Sibling 2 Family Dentlst R e f e r r e d By Memo Active Retained Rpl Tltle RpllstName RplLstname Due D a t e
Fig. 8. Index card with merge code pattern.
The seven notebooks created became my word processing data base. The next step was to customize the shell menu to provide easy access to the various data base files (Fig. 9). All the data bases or programs listed can be accessed and their files loaded by selecting a single letter. By using EMM expanded memory the operator can hot key from one application to another and back without losing his place. An autoexec.bat file is a set of directions that instructs a computer to automatically execute the following batch of instructions when the system is started up. This file is placed in the root director3,, where the operating system will look for it first. An autoexcc.bat file was configured so that when the computer was turned on, it would load the shell menu as its final step. The result of this configuration is that only one step would be necessary before operating the communications system. Turn the computer on! MACROS TO SIMPLIFY COMPLEX PROCEDURES Macros are stored sets of keystrokes or text that can be retrieved by simple keystrokes to reproduce complex procedures. The current version of WordPerfect permits the user to do extensive and complex procedures with macros and also provides for instructional prompts and user input. My favorite macro, [ALT-B], the birthday macro, retreives an entire notebook into WordPerfect, then saves it, sets up a search and sort, prompts the user to insert the month required and how many years back to go, then it produces envelopes for birthday cards (Fig. 10) using a cttstomized printer driver. Note that the patients' birthdate is printed ifi the area that will be
Volume 102 Number 6
Special article
Dr.
Martin
A
Ortho
B
Networth
C
Calendar
* W
Word
N.
Abelson
Friday,
*SHELL* L
Perfect
/ Appointments
Perfect
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1992,
6:29pm
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Patients
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* Q
Queens Active
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4 Setup;
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Fig. 9. Customized shell menu.
09/2#66
Ha4.rison, N y
10528-38 ] 9
Fig. 10. Example of customized font used for production of greeting card envelope, showing the birthdate, to be covered by a stamp when mailed.
567
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Am. J. Orthod. Dentofac. Orthop. December 1992
Abelson
covered by the postage stamp. Unfortunately, space limitations of this publication do not permit a detailed description of the construction of any of the macros mentioned. CONCLUSIONS
A computerized communications system can provide a bounty of benefits to the operator of a small practice. Although it takes some learning and effort, such a module can be successfully constructed with readily available commercial programs. By using commercial programs, a number of hidden benefits are gained. The proprietary word processors provided with orthodontic business programs usually offer a very limited range of capabilities. Some of the more advanced orthodontic business programs already integrate with mainline word processing programs. Orthodontic programs count their users in the tens or hundreds, whereas commercial programs have millions of users to help
improve and debug them. Commercial programs can provide extensive flexibility, unlimited free support, plus frequent and inexpensive upgrades. Most upgrades are carefully designed to be back3vard compatible, so you do not have to tediously reenter all your data when major improvements in the program are made. If you build your system around the right word processor, you can have a superior communications system that precisely meets your needs and at minimal dollar cost. If or when you integrate with an orthodontic business program, you should be able to salvage and use most of the work you have done. You will be way ahead of the rudimentary word processing system provided, and the learning curve of the new program will be easier because of the similarities of keystrokes. Reprint requests to:
Dr. Martin Abelson 165 Polly Park Rd. Rye, NY 10580
BOUND VOLUMES AVAILABLE TO SUBSCRIBERS
Bound volumes of the AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIALORTHOPEDXCSare available to subscribers (only) for the 1992 issues from the Publisher, at a cost of $53.00 ($67.71 Canada and $64.00 international) for Vol. 101 (January-June) ~ind Vol. 102 (July-December). Shipping charges are included. Each bound volume contains a subject and author index and all advertising is removed. Copies are shipped within 60 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Payment must accompany all orders. Contact Mosby-Year Book, Inc., Subscription Services, 11830 Westline Industrial Drive, St. Louis, MO 63146-3318, USA; telephone (314)453-4351 or (800)325-4177. Subscriptions must be !n force to qualify. Bound volumes are not available in place of a regular Journal subscription.
METHODS AND MATERIALS Letter writing in the computer world is accomplished with a word processhzg program. Commerical word processing programs are available that will provide various levels of sophistication for the writer. They range from simple letter writing programs to those with capabilities for the production of complex newsletters and brochures that approach the quality of those that are typeset. There are many well-executed
programs available. I discovered that once a particular word processing program was learned, most people are reluctant to make a change because of the learning curve. This was interpreted to mean a careful selection had to be made, making sure the chosen program did not have any serious limitations for future expansion of the system. A number of easy-to-learn programs, with very friendly interfaces were thus eliminated because of limited capabilities. From the four top of the line contenders, I selected WordPerfect. Perhaps the most compelling reason for the choice was that the WordPerfect Corporation provides unlimited free support through toll-free telephone numbers. The support proved to be superb and explains why, though WordPerfect might not be judged the easiest of the top programs to learn, it has become the current default world standard. Product support is essential for any computer program. A novice to the world of computers will find that a high level of support is essential to success. WordPerfect is currently available in versions designed to run on most commonly available hardware, but I elected to use the version for the IBM DOS system because it had the largest base of software and hardware availability and repair. A lesser known product of the WordPerfect Corporation, WordPerfect Office, provided a shell which eliminated most of the hassles associated with the DOS operating system Fig. 1. The WordPerfect Office program also comes with a file manager, file and macro editor, calculators, a calendar program that can be configured into a computerized appointment book, and a notebook. The notebook proved to be a relatively hidden treasure. The shell also provides for memory management and program switching without the need to exit the program you are currently working in, plus an ability to move data to and from the word processor for merging or other uses. The latter function is accomplished with a clipboard. Also, data are saved in the clipboard and later retrieved for use in the word processor.
DEVELOPING THE COMMUNICATIONS MODULE Diplomate, ABO. 811136717
Some o f the benefits derived from using a word processor are its abilities to make corrections in written
561
562
Abelson
Am. J. Ortbod. Dentofac. Orthop.
December
-OffLce
Pcogra=s
-
-
a
~ppllcatlonl
B
DataPerfecr DrawPerfect
c
Calculator
D
t
Editor
P
PlanPerfect
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GO t o
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O:\OFFICE30 GO t o DOS:
Manager
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3 Other
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Setup;
5 ~m
1992
-
(dataBase)
DOS F O r O n e C o e ~ a n d
Pap:
6 Log:
--
(F7
-
Exit)
Fig. 1. Word Perfect Office original shell menu screen.
Rpl Title-- RpllstName-- RplLstname-StreetCity-, ST- ZipDear Rpl T i t l e - RplLstname--:
A
I have noticed that First Name-- has been having difficulty in keeping scheduled appointments.
^D
"F27 ^ ^F28 ^ ^F29" ^F8 ^ 9--, 10~ ll-Dear ^F27 ^ "F29":
B
I am quite concerned regarding ^F4^'s lax tooth brushing habits, and feel it is important that you are aware of this situation.
Fig. 2. A, Merge codes with field names. B, Merge codes with field numbers and WordPerfect v.4.2 codes.
1168{END FIELD} 01/01/O000{END FIELD} Mr{END FIELD} Sam{END FIELD} Cruikahank{END FIELD} 1-99 Kenneth Avenue{END FIELD} Falrfield{END FIELD} NY{END FIELD} 2419{END FIELD} (914) 791-0759{END FIELD} 09/05/1971{END FIELD} O.O(END FIELD} M{END FIELD} Canter{END FIELD} Na~gi{END FIELD} Mr.{END FIELD} George G.{END FIELD} Crulkshank{END FIELD}
Fig. 3. Sample patient secondary merge file, WordPerfect v.5.1.
material on the screen before printing, thus eliminating most draft copies; spell checking and grammar checking; saving a well-written letter so it can be retrieved later without retyping; retrieve and edit a document, moving sentences and paragraphs anywhere desired without retyping; and to merge previously written letters with patient files. Merging involves the joining of a prhnaryfile that contains the letter or document to be sent and a secondaryfile containing the name and address of the doctor or patient or other pertinent information. The primary file is impregnated with merge codes that match those of the data in the secondary file. See Figs. 2 and 3. Fig. 4 shows the resultant merge. There is almost no practical limit as to how such data might be stored in a secondary file, so it does not have to be restricted
Volume 102
Special article
563
Number 6
Martin Abelson D.D.S. D~PLOMATEAMEI'~CAN BOARD OF ORTHOOONTIC.S PRACTICE LIMITEDTO ORTHODONTICS
September 16, 1992
Mr. George G. Cruikshank 1-99 Kenneth Avenue Fairfield, NY 24190 Dear Mr. Cruikshank: I am quite concerned regarding Sam's lax tooth brushing habits, and feel it is important that you are aware of this situation. As you know, orthodontic bands, bonds, and appliances are fo~l catchers. Itis therefore most important that the teeth be carefully brushed after each meal. In no case should any food or debris be allowed to remain in the mouth overnight. Debris which remains undisturbed for 24 hours or more will turn to ACID and will eat away at the tooth structure! Failure to keep the mouth clean increases the likelihood of dental decay and etching of the enamel adjacent to the braces. It is especially important that the areas between the brackets and the gums are shiny and clean. Gums that bleed generally need more brushing, not less. We will all be disappointed when the appliances are removed if there are decalcified marks on the teeth. I know you will cooperate in helping Sam realize the importance of good oral hygiene. Sincerely,
Martin Abelson D . D . S . MA:cl
Fig. 4. Resultant merge. to just a name and address. As previously indicated, the merge codes entered in the primary file select which data from the secondary file will be incorporated in the letter. If we take all of our letter files and place them in one directory, which acts like a computerized file cabinet, and put a number of secondary patient files in a second directory, we have built two data bases. Once a letter has been written and merge coded, it can be merged again and again, with one or more of the patient files. Once the two data bases are set up, keyboard macros can be used to speed up the actual merge process. A macro is simply a saved series of k e y s t r o k e s that can be replayed when needed. As stated previously, merge coding a primary file
is relatively simple, and once saved, the work does not have to be repeated. Manually coding hundreds of patient files proved to be quite a chore. A comparatively unknown feature of the notebook, which comes with the WordPerfect Office shell program, is that the notebook is designed to store data hz WordPerfect merge format/This means that notebook files can be imported into the word processor without doing any coding at all and will merge with letter files.
CONVERTING A NOTEBOOK INTO A CUSTOMIZED DATA BASE The WordPerfect Office program comes with sample notebook designs. Fig. 5, A and B show the two screens of the "contact list" notebook. One is called the list
564
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Am. 3. Ortho~t. Dentofac. Orthop. December 1992
Ps
I~st
Relationship
Home Phone
Work Phone
David
Meier
Helge Herman Ji~ Jonathan Rafael Sadie
FJelsted
Book Dealer Illustrator European Contact College Buddy Attorney Book Dealer Frlend/Editor
(518) (612) (074) (801) (208) (213) (503)
(718) (612) (076) (801) (208) (213) (503)
Mewes
Olson Hansen Nunez Jackson
555-2390 555-9023 02 14 41 555-8989 555-6658 555-1223 555-9843
555-9897 555-7711 72.89 42 555-4456 555-1313 555-7557 555-8854
A First
Title Home
Phone Address
City
B
Last
Phone Address City
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State
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Fax
State
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Relationship
i Secretary/Aset
Introduced by
I
Soc Sec Number
Company Poeltion Affillatlon Phone Log
I I i I I
Spouse Birthday Anniversary Other
ZIP
Fig. 5. A, List display of contact list notebook. B, Record display of contact list notebook.
display andthe other the record display. The list display automatic~iily alphabetizes whenever a new record is created. One can scroll through the list of records, or the program will find a record if you begin typing the name. When a name is highlighted, if you hit the Enter key or F8 key, the complete individual record is revealed. The user is able to select which of the record data is to appear on the list display. If the patient record contains telephone numbers and your equipment has a telephone modem attached, then the user is able to dial the telephone numbers from either screen by hitting the F4 key. The best part of the notebook design is that existing notebooks can be redesigned to suit your purposes or you can completely custom design your own notebooks. Fig. 6, A and B shows the list and record screens designed for my system. One keystroke, F9, creates a new patient record. All data are typed in the "conventional manner, tabbing from field to field. Once the file is saved, the addition is permanent. A patient record
can be cloned for a sibling by deleting the record then canceling the deletion twice. The second copy is then modified as needed. The current version of the WordPerfect Office program even provides the ability to do simple searches in the notebooks. This prompted me to consider adding a section to the patient records that would contain basic treatment data in the memo area. A primary merge file was designed to print cards for the office rolodex. To print one or more rolodex cards or patient letters, all that is needed is to mark those records with an asterisk * on the list screen and a shell macro I wrote, [Alt-Shft W], automatically transports the data to WordPerfect and prompts the user to select the desired primary file that will be merged with the imported files. Fig. 7 shows part of the letters directory that provides the choices. Once the choice is highlighted, tapping the Enter key produces the desired documents on the screen for prior approval. A macro, [AIt-P], prints the documents. An [AIt-M] macro was designed to print the document and also set up and print
rot,me ]02 Number 6
Special article
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Marasia Martinengo Massle Mastrogiacomo Mastroglacomo Matthews Maucleri May Menzi Collier Munter Munter Nakamura Nargi Parise Parise Parrelli Paul Petruzzelli Petruzzo Petruzzo Pietrafeso Powell Schmid Schnapp
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Due Date
Work P h o n e
~ome P h o n e 835-1254 835-0446 997-2641 835 0224 835-0224 698 4563 835-3585 628-2780 381 6169 835-5297 835-5297 835-3377 835-5685 967-3205 967-3205 835-1451 698-8548 (203} 438-7043 698 7419 698-7419 835-1153 682-8582 835-3354 835-1832
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A a Title Nickname R.P. Street City State
PATIENTS
*
M A M A R O N E C K WI
First Birth Date
Last Age
Sex
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Status
Case No
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Referred by
Family Dentist Due
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Home Phone Work Phone Home Phone 2 Work Phone 2
Zip
Ist V i s i t
-
Sibling 2
Sibling
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B Fig. 6. A, List screen. B, Record screen.
an envelope from a second printer bin. [Alt-E] finds the name and address on a letter and prints only an envelope. I have two separate office locations with two sets of case numbers. The patient notebook design was cloned for the second office. It was decided to have separate data bases for active patients and inactive patients. Additional notebooks were cloned to store inactive cases for each location. A shell macro [Alt-Shft T] was then created to expedite the transfer of records from one office to another or from active to inactive files. A two-location practice can function by using . . . . either one or two computers with this configuration.
One or many records can be moved with the same effort. Separate lists of referring doctors resulted in two additional custom note books. A seventh notebook was created to provide information on suppliers and frequent contacts and was titled "office phone book." An index card was prepared that contained the merge code pattern for each type of notebook (Fig. 8). These cards are used to facilitate the writing of merge letters. This was accomplished by importing one of each type of notebook into WordPerfect, deleting everything but the field descriptions, and then removing the field location codes before printing. The notebooks were imported in WordPerfect 4.2 version format.
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Am
06-01-92 Document
Ii:49p size:
Current FILES ADDRESS .CRD BA .1 BA .3 BA&NO-PQ. BILL .AbR BIRTH BREAKAGE.ANS BRUSH BRUSH .2 BRUSH .4 BUREAU .EXT CIGNA .ADR CODES .MRG CSF-DRS .LTR DR-REF .THX DRS .LTR ELASTICS. ELASTICS.2 ELASTICS.4 EOF
0 1,924 805 1,025 1,531 397 9,767 4,309 1,419 1,698 1,505 906 437 889 1,200 556 649 1,835 1,932 1,348 1,763
Directory C:\WP51\DIR\OFFICE\*.* Free: 33,130,496 Used: 170,863 " .. Parent 02-21-92 0 5 : O O p ~ A4 .MRG 12-02-91 0 7 : 3 8 p ~ BA 02-07-92 10:52a ~ BA .2 02-07-92 i0:53a BA .ADT 02-07-92 10=54a BILL 02-07-92 I0:55a BILL-REP.RET 05-29-92 12:15a BOUNCED .CK 02-18-92 10=19p BROOKLYN.HOM 02-07-92 10=57a BRUSH .I 02-07-92 10:57a BRUSH .3 02-07-92 i0:58a BUREAU .DEN 02-07-92 I0:58a CHANGE .APT 02-07-92 10=59a CIGNA .REF 02-07-92 11=00a COMPLETE.DDS 02-07-92 ll:O0a DOCTORS .CRD 02-07-92 11:03a DRS .ENV 05-16-92 0 2 = 0 8 p DRS .MRG 02-07-92 11=03a ELASTICS.I 02-07-92 11=04a ELASTICS.3 02-07-92 ll:05a ELASTICS.5 02-07-92 11:05a E O F - T O O .SLO
Files:
J. Orthod. Denmfac. Orthop. December 1992
122
2,532 05-18-92 12:54 p 2,924 05-20-92 i0=53a 793 02-07-92 I0=52a 1,818 02-07-92 i0:54a 748 02-07-92 i0=55a 892 02-07-92 i0:56a 1,290 02-07-92 i0:56a 988 02-07-92 I0:57a 1,730 02-07-92 10=57a 1,487 02-07-92 lOt58a 500 02-07-92 I0:58a 707 02-07-92 i0:59a 1,063 02-07-92 i0:59a 801 02-07-92 ll=00a 488 06-04-91 i0:45p 782 05-16-92 03:32p 1,318 05-16-92 0 2 : 0 0 p 1,871 02-07-92 ll:04a 1,637 02-07-92 ll=04a 1,618. 02-07-92 ll:05a 2,693 02-07-92 ll:05a
1 Retrieve; 2 Delete; 3 Move/Rename; 4 Print; 5 S h o r t / L o n g Display; 6 Look; 7 Other Directory; 8 Copy; 9 Find; N N a m e Search: 6
Fig. 7. Letters directory (partial display). 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Case# lstVlsit Title F i r s t Name Patient Nick HI Last Name Street City ST Zip Hone P h o n e Home P h o n e 2 Work P h o n e Work P h o n e 2 Status Birthday
Age Sex Slbltng
Sibling 2 Family Dentlst R e f e r r e d By Memo Active Retained Rpl Tltle RpllstName RplLstname Due D a t e
Fig. 8. Index card with merge code pattern.
The seven notebooks created became my word processing data base. The next step was to customize the shell menu to provide easy access to the various data base files (Fig. 9). All the data bases or programs listed can be accessed and their files loaded by selecting a single letter. By using EMM expanded memory the operator can hot key from one application to another and back without losing his place. An autoexec.bat file is a set of directions that instructs a computer to automatically execute the following batch of instructions when the system is started up. This file is placed in the root director3,, where the operating system will look for it first. An autoexcc.bat file was configured so that when the computer was turned on, it would load the shell menu as its final step. The result of this configuration is that only one step would be necessary before operating the communications system. Turn the computer on! MACROS TO SIMPLIFY COMPLEX PROCEDURES Macros are stored sets of keystrokes or text that can be retrieved by simple keystrokes to reproduce complex procedures. The current version of WordPerfect permits the user to do extensive and complex procedures with macros and also provides for instructional prompts and user input. My favorite macro, [ALT-B], the birthday macro, retreives an entire notebook into WordPerfect, then saves it, sets up a search and sort, prompts the user to insert the month required and how many years back to go, then it produces envelopes for birthday cards (Fig. 10) using a cttstomized printer driver. Note that the patients' birthdate is printed ifi the area that will be
Volume 102 Number 6
Special article
Dr.
Martin
A
Ortho
B
Networth
C
Calendar
* W
Word
N.
Abelson
Friday,
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Perfect
/ Appointments
Perfect
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RESTORE
* M
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Patients
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* Q
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Fig. 9. Customized shell menu.
09/2#66
Ha4.rison, N y
10528-38 ] 9
Fig. 10. Example of customized font used for production of greeting card envelope, showing the birthdate, to be covered by a stamp when mailed.
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covered by the postage stamp. Unfortunately, space limitations of this publication do not permit a detailed description of the construction of any of the macros mentioned. CONCLUSIONS
A computerized communications system can provide a bounty of benefits to the operator of a small practice. Although it takes some learning and effort, such a module can be successfully constructed with readily available commercial programs. By using commercial programs, a number of hidden benefits are gained. The proprietary word processors provided with orthodontic business programs usually offer a very limited range of capabilities. Some of the more advanced orthodontic business programs already integrate with mainline word processing programs. Orthodontic programs count their users in the tens or hundreds, whereas commercial programs have millions of users to help
improve and debug them. Commercial programs can provide extensive flexibility, unlimited free support, plus frequent and inexpensive upgrades. Most upgrades are carefully designed to be back3vard compatible, so you do not have to tediously reenter all your data when major improvements in the program are made. If you build your system around the right word processor, you can have a superior communications system that precisely meets your needs and at minimal dollar cost. If or when you integrate with an orthodontic business program, you should be able to salvage and use most of the work you have done. You will be way ahead of the rudimentary word processing system provided, and the learning curve of the new program will be easier because of the similarities of keystrokes. Reprint requests to:
Dr. Martin Abelson 165 Polly Park Rd. Rye, NY 10580
BOUND VOLUMES AVAILABLE TO SUBSCRIBERS
Bound volumes of the AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIALORTHOPEDXCSare available to subscribers (only) for the 1992 issues from the Publisher, at a cost of $53.00 ($67.71 Canada and $64.00 international) for Vol. 101 (January-June) ~ind Vol. 102 (July-December). Shipping charges are included. Each bound volume contains a subject and author index and all advertising is removed. Copies are shipped within 60 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Payment must accompany all orders. Contact Mosby-Year Book, Inc., Subscription Services, 11830 Westline Industrial Drive, St. Louis, MO 63146-3318, USA; telephone (314)453-4351 or (800)325-4177. Subscriptions must be !n force to qualify. Bound volumes are not available in place of a regular Journal subscription.
