Dental School Replaces Problematic Signature Pads; Boosts IT and User Efficiency

John Powers

By John Powers, CEO, Scriptel Corporation.

Between patient registrations, treatment-plan sign offs, payments, and patient check-outs, a lot of signatures are required at East Carolina University’s School of Dental Medicine. So, you can imagine how Phillip Allen, director of informatics and tech services felt when his team was sending five or more signature pads out for repair each week. And then there was the time they lost electronic signing capabilities altogether—for a year—while two software companies and the signature pad manufacturer blamed each other for the outage.

In addition to hardware issues like inconvenient watch-batteries used in the pens and a weak connection between the USB cord and the unit that caused breakage, there were software and support issues. The school uses iMacs, Apple laptops, and iPhones throughout its 188,000 square-foot teaching facility in Greenville, NC and eight regional satellite offices. They run axiUm’s EHR in a Citrix environment, and the signature pads they purchased in 2010 didn’t work well with Citrix.

Allen explains that setting up a pad required a technician to initially plug it into a blade server in the main data center. Once it was moved into production in the clinical unit, each pad had to be unplugged and plugged back in each morning. Additionally, if a unit was unplugged while in an axiUm session, you had to log out of the session, plug the unit back in, and log in again.

The electronic signature system was unwieldy. Some students became so frustrated they began stashing a signature pad in their laptop bag in the hope that using the same device would allow easier hardware recognition…but it didn’t. This led to a shortage and the remaining students started competing to get their hands on a pad. Allen and his team knew they needed a new solution.

Fully supported, durable, plug and play

Today, the school has deployed new signature pads in each department at every facility. Allen says his team’s experience had been the opposite of the last one, noting that the cost of the new devices is significantly lower than the old. In fact, the cost is only slightly higher than to repair the old devices. The pads are highly durable, do not require batteries, and are completely plug and play, he says, noting that even clinical units that resorted to paper forms during the signature pad outage are now coming around to using the signature pads.

Instead of getting daily calls about broken devices, Allen’s team has had to send fewer than five out for repair since purchasing 300 of them in 2019. “Not hearing the phone ring about a signature pad issue has been phenomenal,” he says.

The initial rollout was fully supported by the signature pads’ team. “They said: ‘We know how to make these work in your environment,’” says Allen, adding that the pads run fine in the school’s older Citrix 6.5 version. They’re easily moved from desktops to laptops, quickly recognized each time they’re plugged in with no need to log out and back in. That dovetails with the needs of the teachers and students as they move from chair to chair getting patient and supervisory sign-off on each treatment plan. At the end of the day, all units are returned to the dispensary and sterilized in preparation for the next day.

Dental students spend the first three years of their program in the main building in Greenville. During their senior year, they spend a six-week rotation in each of the eight community service-learning centers in the state. “The idea,” says Allen, “is for students to get to know the communities and consider relocating there for an existing practice or open their own in an underserved area. It’s been a great model for us.” And having the same physical layout, software, and hardware at each location, including signature pads, makes those rotations workable.

“The pads are now virtually everywhere in every building, being used in every facet of the school from patient check-ins and checkouts to cashier stations and every dental chair,” says Allen.

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