Design Philosophy

The design of IntelliPract® / InSched is guided by the philosophy that software should make our lives easier and better, and allow us to do more with less.

In general, that means that the software may be complex to design, but should be easy to use, and should lead the user to do the right thing, but never prevent the user from doing what she needs to do.

Schedule Layout

For example, almost all schedulers other than InSched use off-the-shelf software components to show the schedule. That leads either to wasted space on the screen (if too much time is shown), or some events not being visible (if not enough time is shown).

As the schedule is central to the practice (because all you have to sell is time), InSched rejects that approach. In InSched's default view, each day is shown as a column, with the start and end time shown being dynamically adjusted depending on the events shown within the days that are shown. Days that do not have any events are not shown (because they would be wasted space). For example, if there is nothing on the schedule for Saturday, Saturday generally does not need to be shown. However, if you add an event on Saturday, now Saturday will be shown.

On the other hand, every aspect of the schedule display is adjustable, and users can save their preferred views, to be brought up with a single keystroke if they want.

Guidance and Flexibility

Another important matter of philosophy is that the software should guide the user to do the right thing, but not prevent her from doing what she need to do. A good example is double or triple booking, putting more than one event at the same time

The practice can turn on a notice to alert the user if she is booking two events that require the same resource at the same time (and shows it graphically on the schedule). Also, the practice can turn on a notice to alert the user if she schedules an event that extends beyond the block it is scheduled for.

But sometimes those rules need to be broken. Sometimes it is necessary to put two or more patients at the same time, and the software should not require the user to jump through hoops to workaround that limitation.

Audit Tracking and Initials

However, with power comes accountability. Mistakes will happen, so it is essential that practice managers and users can easily determine what happened when there are questions. Did someone accidentally remove an event from the schedule, or had it never been created? What did the schedule look like this morning, yesterday, or last week?

Tracking all changes to the schedule and other data tables is essential to answering those questions. When InSched was designed, none of the available scheduling systems handled audit tracking at all, although once InSched introduced it, others added it as well.

But just because there is an Audit Track does not mean it is easy to see the important changes that have occurred. InSched can quickly show you how the schedule looked at any time in the past, and has a Time Machine view that lets you step back step-by-step to see the changes that were made.

Tracking the initials of the active user is also an important feature of InSched. At some practices, staff go from station to station, making entries on several different computers. That is allowable for most Cosmetic Surgery practices which, because they do not bill Insurance, are generally not HIPAA Covered Providers. However, if the Audit Track is based solely on the station and logged-in user, it will not show who actually made the change. Because of that, and at the suggestion of one of Dr. Nachbar's staff, InSched collects the initials of the user actually at the keyboard whenever a change is made to any data in InSched. (Like almost everything in InSched, that can be configured by the practice.)

Avoiding Conflicting Edits and Lockout

It is not unusual for two staff members to simultaneously want to make edits in a patient's record when that patient is active. However, if they are both editing the record at the same time, the final result may become jumbled.

However, implementing protections for that is hard, and therefore most software packages do not have any protection to avoid that. Those packages that do lock out other users while a patient record is being edited are often subject to "lock out", where the user editing the record forgets to close thier dialog and therefore leaves the record locked.

InSched handles that by:

1. Creating a lock file to indicate that a record is being edited whenever a staff member opens a patient's information for editing.
2. Before that staff member has released the lock by closing the patient's information, another staff member trying to edit the same record will be presented with the information that the patient's record is locked.
3. The second staff member is given the option to either open the record read-only, or to "break the lock" of the first staff member, turning that first staff member's editing session to read-only.
4. Any attempts to make changes from a read-only session will fail, and that user will be shown a message that the edits cannot be saved.
5. After 15 minutes of the lock being created, if it has not been released, then any other staff member can open that patient's information without seeing the message, and the first staff members editing session will silently be converted to read-only.

In this way, the common situation of a staff member forgetting they have left a dialog open can be easily managed, and managed automatically if it has already been 15 minutes.

Handling Patient Name Changes

Patients often change their last name, sometimes for changes in marital status. InSched acknowledges that by tracking those changes, and automatically searc hing for patients by all their names.

Therefore, if a patient has changed her name from "Jane Smith" to "Jane Jones", even though her name is no longer "Smith", she will still be found searching by either "smi jan " or "jon jan ".

This feature requires that the name editing be done in InSched rather than Inform. If you edit the patient name in Inform, the previous names will not be sa ved.

Therefore, you should always edit patient names in InSched rather than Inform.

Paperless Charting

Charting is an essential operation in any practice, and was one of the earliest features to be added to eletronic management systems. However, the bureaucrats got there before the physicians, and they realized that computers could collect lots of data, far more than could easily be recorded on paper. EMRs, therefore, often require physicians to enter lots of information that is not really needed. Physicians often complain that record-keeping has become harder with EMRs than it was when the records are only on paper.

InSched handles eCharts, not be making your work harder, but by making it easier to manage what is essentially a paper chart online, so your charts are always available, but you have complete flexibility in creating them.