Healthcare Software

What’s Wrong with Using Excel to Manage a Medical Clinic?

Microsoft Excel is used routinely in medical clinics as a way of managing patient data. Is there anything so terrible about this or is it a good way of running things?

On the surface, there is not much wrong with using it. Excel can do it all: data fields, graphs/charts, calculated values, spreadsheet references, etc. It is cheap, present on nearly every computer and everyone knows how to use it in some capacity.

Digging a little deeper, however, many problems exist:

• No data input feed. Data must be re-entered even though it was probably already entered into another system. This wastes time and provides another opportunity for data entry errors.
• No data output feed. The data remains in place and provides no benefit to other systems. If anyone wants the data, they have to access the spreadsheet directly.
• Promotes data silos. Usually management is organized per clinic or department. If the data is collected and managed at one point, then it will remain as such and require much more effort when the initiative comes to integrate the data with data from other systems.
• Data inconsistency. When the same data exists in two or more different sources (or spreadsheets), effort is spent to keep all sources consistent. If data in one location changes, it needs to be updated in all other locations. Databases offer a much more flexible environment where design practices reduce data duplication and therefore facilitate data updates.
• Low security. Spreadsheets can be weakly protected with a secret password, but this is easily bypassed with programs to remove the password. Better security is offered by databases.

A database on the other hand can help alleviate these problems, but it does require a greater level of infrastructure. It mandates the need for people who know how to use and manage it. Front-ends are needed to manage the data and servers to host the database instances. It is for this reason that in many small clinics, where these things are not present, Excel is the tool of choice.

The only case where it truly wrong to use Excel is in an environment where the necessary infrastructure exists, but for whatever reason, clinic managers choose not to use it. It is in this type of context where the most amount of time is wasted given the limitations of Excel. The clinic could be managed at a much more serious level if the full functionality of the deployed databases was leveraged.