From Paper to Cloud

I’m excited to put pen to paper and write the first DVMA “blog” and I hope we will have some other willing bloggers in our local veterinary community to share their stories/anecdotes/interesting cases/exciting adventures with the rest of the group.

I thought I would share our recent experience with converting from a paper-based medical record system to a cloud-based system.

As if July wasn’t a busy enough month for our hospital, we decided that this was the perfect time to “Go Live” with our new, cloud-based practice management software (PMS). The implementation process started in May (training, upgrading and adding computers, phones, printers etc.). We then had a tech support “implementer” (Thomas was his name) on site for the first week after we went Live to help us through the process. And then Thomas left and we had to fend for ourselves. It was like getting kicked out of the hospital with a newborn in your arms to somehow “work it out!” It was only after we broke up with Thomas that we realized just how much we didn’t know about the system!

It is now almost November (can you believe it??) and we are finally starting to feel comfortable with it (even our 4 baby boomers!) and starting to really understand its benefits and also some of its limitations. Although with every 2 steps forward we still seem to take 1 back. I am thinking 3 more months and it will be second nature!

Before the switch we were a chart-based hospital and used DVM Manager (a dinosaur of a program) as our PMS. When brainstorming about a new PMS, my goals – in no particular order – were to:

1. Become technologically current
2. Upgrade our clients experience and access to their medical records
3. Improve client education and therefore client compliance
4. Become more efficient, stop wasting time looking for charts and spend less time inputting records.
5. Improve our medical record keeping and billing continuity and consistency amongst Doctors and staff
6. Integrate reminders, inventory, labs and imaging.
7. Be able to access the program off-site (this was a big one for me)
8. Shelve the charts, reduce the clutter and become a “paper-light” practice

The options were either a server-based system (DVM Manager, Avimark, Cornerstone etc) or a cloud-based system. I had used many server-based systems and although robust I was not impressed with their flexibility or functionality and was frustrated with shoddy tech support, seat license fees, server problems and contracts and had concerns about the safety of my data in the event of fire, flood or felony!

A Cloud-based software system fit our goals and is a game-changer for us.
• No expensive and frustrating server maintenance/upgrades/replacement.
• Data is constantly being backed up to the cloud (don’t ask me where or how but this is actually a much more secure way of storing data – even with cyber crime threats – it is much safer than on site storage.)
• Updates are automatic and constant – and usually done while you sleep!
• Integrates with Labs/Merchant service/Imaging programs/MWI etc.
• Allows for email and text reminders/communication with clients

Your software is only as good as you make it i.e if you only want a system to perform billing and keep track of clients/finances and you’re still going to use paper records then you will be paying a lot of money and won’t be getting much benefit. However if you want your software to do most of the work for you and you can take advantage of even only a few of the features available, then you will wonder what you were doing before you switched!

Yes, but that all sounds expensive! That’s because it is! But if it allows me to spend more time educating my clients and less time chasing and inputting into charts, then, like any good piece of equipment, it will pay for itself. Cloud-based systems are generally paid monthly at a rate that is dependent on number of “users” (staff that use the system). This cost is not cheap but includes all updates/upgrades, technical support, requires no server upgrades or hard-drives and therefore no memory increases as you run out of space. There are no “licenses”, it can be run on any device (i.e. it doesn’t matter how many computers/stations/devices you want the price is the same).

Remember, cloud-based means it is all run on the Internet, so you need a reliable connection. This was my biggest concern early on. However, we have only had 1 break in service, which – as can be expected caused us to go into cardiac arrest – was due to an automatic update and by the time I had a representative on the phone and she was logged into our system (10 minutes) it had rebooted and all was well again. So far (knocks loudly on wood) we haven’t had any more issues. We seem to have reliable Internet but if the connection does go down we can – theoretically – still access our records from a mobile hotspot on a phone or tablet

We are only 3 months in and that may be early days, but so far we are happy!

1. Just do it!
2. Ditch the server (and expensive IT guy that is attached to it!) and rise to the Cloud!
3. Be OK with compromise (the perfect system does not exist)
4. Be prepared to be paper-light
5. Invest in good internet and hardware (computers, a dedicated scanner, laser printer)
6. Ensure you are able to integrate with your vendors (MWI etc), Labs (Idexx vs Abaxis vs Antech), Imaging, Accounting software, Merchant Service
7. If switching from paper charts to computerized records, don’t pay to scan in paper charts, just keep them handy for a few months and then you will find you use them less and less.
8. Find a “champion” who can be the go-to person for troubleshooting/training/communication.
9. Be prepared to keep a light schedule the first couple weeks after the change
10. Try and focus on the positives!

Please feel free to call/email or chat with me about the specific system we chose and why.

Hayden Webster
Owner, Lodi Veterinary Hospital
DVMA Vice-President

{A Year from now you will wish you had started today – Karen Lamb}