The monster in the server room

Dermatology Nursing, August, 2008 by Roger Gentry

Don't you love the part of the movie where the angry villagers converge upon the caste where the doctor/mad scientist (sometimes known as Dr. Frankenstein), his assistant (often named Igor), and surly, fight-lipped housekeeper (I've decided upon Helga) make haste to get the monster up and running out the back door. Ah, those angry villagers, torches in hand, sometimes braving a storm, some fog, or fierce terrain to stop the monster's rampage. Now that's entertainment.

We, of course, have constant remakes with shifts in time, place, and character. However, the core remains: the creator and assistants, the monster, and, again, those villagers.

I may have come up with a great remake idea. Why not set the scene inside a dermatology office? Perhaps, Dr. Frankenstein and Associates, Dermatology. We have the doctor, or team of doctors. Igor, the strange, perversely demented assistant could become the IT guy. The housekeeper, Helga, has now become the practice manager. The villagers, those fine hard-working villagers, will be played by an assortment of schedulers, receptionists, business office personnel and, of course, nurses and medical assistants.

Naturally, there is no film without the monster. Our monster is particularly scary. In this remake, the monster reaches his fiber thin arms out to every work station, drawing the villagers into his world. Its heart and mind are situated in a cold, dark place--the server room. The monster is your computer system.

Getting to Know the Monster

Actually, we could have a much happier movie and perhaps a little less drama in the workplace if everyone could get to know the monster a little better. We might be able to turn our horror movie into a smart, light, and breezy monster comedy, where efficiency and ease replace frustration and stress.

I have had the opportunity in my work life to experience a great variety of monsters/systems. I have survived several computer conversions. I have been a very happy villager. I have been an exceedingly unhappy villager.

One of the first steps toward a happier ending is to allow the villagers to get a little closer to the monster. This holds true whether you are dealing with your current monster/system or your practice has begun the search to find a bigger, better, faster creature.

Assuming your practice is working with a system that you will be keeping for the foreseeable future, do you feel you and your fellow villagers are proficient on all aspects of your program? I'm sure we can agree to share things we know rather than inform others of our ignorance in specific areas (monsters). In getting to understand the monster, it really does help to be able to articulate those things which still confound us. Of course, there are some things the villagers don't know. It is a monster after all.

A Low-Tech Solution

There are various approaches to exploring the mysteries surrounding the "Monster in the Server Room." Most solutions can begin with a low-tech approach--simple communication.

Talk is a good start. Meet and talk. If you feel a moderator would keep the talk on track, perhaps Igor or Helga would be happy to join in. Team leads from various areas within your practice can also work. Bring ideas. What is working? What isn't working? Staff/villagers feel a sense of empowerment when they know they are part of a solution. Bring ideas. Have the villagers keep notes for a week and meet again. Most of us have friends or acquaintances in other practices. Talk to them. Do their monsters do things ours don't?

It is always a possibility there are functions or programs that simply haven't been "switched on" or implemented. If you believe there are some additional unused functions, take your concerns to Igor or Helga. The practice may wish to followup with software technical support to find out if there are any available upgrades to the programs.

Do a walk through. Find the time for the villagers to experience your facility so they might better understand the work flow. This is sort of like an in-house field trip with a focus on your computer system and its functions. See how the monster works.

On your tour, discuss marketing, patient scheduling, appointment confirmation, check-in procedures and collection of data, rooming, intake of medical histories, the exam, prescribing, dispensing of samples, use of materials, patient education, treatment plan, scribing, attesting, checkout, and yes, claims and billing functions. Another area which can be very important is communication with patients and providers by letter, fax. and email. Imagine what could be. At each juncture ask if the monster could better help with procedure and work flow.

If your villagers are truly engaged, it may take more than one session to make it all the way through. The time will be well spent.

Assuming your practice has embarked on finding a new system, one of the best ways to ensure villager buy-in is to make sure all ideas, needs, and wishes are heard and addressed clearly.

When staff ideas become part of a selection process, all staff members will have a greater feeling of ownership. If you had a hand in constructing the monster, you will definitely be more engaged in enabling it to come to life.