Access and Tablet PC Working Well Together

By Grant Fjermedal

Applies to
Microsoft Office Access

Dr. Schwieterman Medicine' s past and future coexist nicely in the offices of Dr. Thomas Schwieterman, a fourth-generation physician working in the same medical office his great grandfather established in 1896 in the town of Maria Stein, Ohio. From those same historic environs, Schwieterman has used Microsoft Office Access to create his own physician assistant application.

Schwieterman was one of 10 healthcare professionals recognized in a Microsoft-sponsored competition to honor healthcare professionals making innovative use of the Microsoft Office family of products. The results were announced May 12 in San Antonio at TEPR 2003, the 19th annual Toward an Electronic Patient Record (TEPR) conference and exhibition.

Schwieterman' s use of Office is so complete that after colleagues suggested that his Access-based application was so significant he should try to market it, he created a Microsoft Office PowerPoint® presentation describing what he had done, and he landed a partnership agreement with a major healthcare supply and services corporation to market his Chartscribe solution.

The story of how Schwieterman came to create Chartscribe ( can be traced back to his youth. " I grew up as a doctor' s kid knowing I wanted to be a physician, but I also fell in love with doing computer work in High School, and taught myself programming on my old Apple II computer," Schwieterman said. " In college I double-majored in software engineering and pre-medicine." After college he completed a residency in family medicine, and then decided to, along with his physician brother, provide the fourth-generation of family physicians and join his father' s practice.

The problem, the solution

The Schwieterman Family Physicians practice kept him so busy that he was wondering how he could keep up with his patient caseload. Schwieterman wanted a faster way to handle prescriptions, provide medical information, and record data for his patient records.

He walked into a MacDonald' s restaurant one day and had an idea.

" I ordered a cheeseburger and fries and watched the person at the counter touch the screen of the cash register a few times, and realized the order was getting transferred back to the food preparation area, and that by the time I paid, my order was ready. I thought to myself: ' That' s what I need!'"

Schwieterman searched for commercially available solutions, but when he couldn' t find an exact match for his needs, and when he found prices steep for a small private practice, he decided to create his own – using Access. He also called upon a friend with a Master' s Degree in electrical engineering to help on the coding, which was done using the Microsoft Visual Basic® built into Access.

Increased efficiency with Access

" Access has been incredibly friendly for our development efforts," Schwieterman said. " And it has allowed us to create an application that is easy to maintain. Whenever we need to update our prescription library, reference information, or any other component, all we need to do is update the corresponding reference table. We also use Windows encryption and logon security features to help us meet HIPAA (Health Insurance Portability and Accountability Act) requirements for security."

Chartscribe, which runs on the Tablet PC, provides complete data on medications including interactions, and automatically transmits prescriptions to the patient' s designated pharmacist. The system also prints out the patient' s bill, hard copy prescriptions, drug information, sample instruction labels, referral slips, and patient educational material and tracks what was done during a patient visit.

" We chose Office as our platform so I can write or import all of my patient education materials in Word and add them into my database in Access," Schwieterman said. " I' ve also incorporated an electronic textbook that provides diagnostic information. I can export my patient demographic information from my billing software into Excel. By integrating Microsoft Office into Chartscribe, at the end of an appointment I can check out my patients in about 30 seconds – transmitting or printing my prescriptions, printing out my patient education material, and any physician referrals I made. At the same time copies of all of this print out on a special form with adhesive labels so I can place the information into the patient record. I just stick the label into the patient chart and go to the next examining room to see the next patient. It' s very efficient."

The system was so efficient that Schwieterman saw an effect on his bottom line. " My efficiency increased by 15 percent because I could see three or four more patients a day. My income increased by 20 percent, which is important because we pay close to $60,000 a year for malpractice insurance even though our clinic has never been sued since it was founded 107 years ago."

Schwieterman has also benefited from Office integration with the Tablet PC. " The Tablet PC answers a huge number of needs," Schwieterman said. " The Tablet PC and Microsoft Office provide a powerful combination. I use the handwriting recognition and dictation, and having wireless networking built in is a tremendous benefit. This is a case where technological development perfectly matched my needs."