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The University Magazine

Medicinal purpose

RIT grads are using technology to help build careers in the medical field

Physician takes the paperwork out of his practice

Robert Smith
Robert Smith '96

With the vast volume of patient records, insurance forms and regulatory documentation, the medical establishment is seemingly awash in paperwork.

Dr. Robert L. Smith ’96 (M.S., clinical chemistry) has found a way of staying afloat. He’s pioneering the concept of the “paperless” medical office at the family medicine practice he launched in 2006 in Canandaigua, N.Y.

“It’s a very logical, very practical system,” Smith says. “Staff and patients love this because it’s so much more efficient than paper charts.”

Smith grew up in Rochester and received a bachelor’s degree in health and sports science/biology from Wake Forest University in 1991. He worked as a PGA golf professional from 1991-1993 before attending RIT. Smith received his M.D. degree at SUNY Upstate Medical University in 2000, completed a residency in family medicine at St. Joseph’s Hospital in Syracuse in 2003, then joined the medical staff at F.F. Thompson Hospital in Canandaigua before opening Finger Lakes Family Care.

He began consulting in the field of healthcare informatics during his residency, founding Medsmith Solutions. He now serves as chief medical officer for Apractis Solutions LLC, a company founded by physicians dedicated to online collaboration and secure communication using a variety of digital media ( www.apractissolutions.com).

In his “paperless” system, incoming voice mails, e-mails, and faxes are received in a software program called UpDox, (www.updox.com). This desktop application routes incoming and outgoing communications to other medical offices or directly into the patient’s electronic record after it is given an electronic signature. Messages are routed from the doctor’s online, automated answering service directly to Smith and his clinical staff. Smith can check for messages online while at home, in the office, or at the hospital during rounds, instead of relying on a traditional answering service. Paper charts are replaced by electronic files that are easily accessible by multiple office staff simultaneously as well as when Smith is out of the office. Patients can make appointments, fill out required forms, request refills of medications, check for the results of tests or make inquiries through a secure Web site.

“Having more and more transactions and communications coming from patients’ online instead of via the telephone has enabled my staff to actually focus more of their time on our patients who are in the office requiring care, rather than answering the phones all day,” states Smith.

Recently, F.F. Thompson Hospital has begun securely e-mailing lab reports instead of faxing them to Smith’s office. “It is completely backwards to continue relying on faxing confidential medical information in this day and age,” says Smith. “Faxes are not a secure form of communication, yet it sadly remains the method of choice between offices and hospitals. My mission is to stop faxing altogether.

“The field of medicine has been slow to incorporate technology into the patient-physician relationship,” he says. “As a new physician, it just made so much sense to start out with a system that takes advantage of the latest e-health innovations. My goal is to change the perception of patients by encouraging them to e-mail our office for all of their medical concerns, including urgent medical requests requiring a same-day visit.”

In his work with Apractis Solutions, Smith assists with the development and implementation of applications such as UpDox to assist physician-physician and patient-physician communications.

“My office is the laboratory for the communication systems we’re building,” he says. “It’s exciting to be a part of this new era in medical practice redesign, for the benefit of physicians as well as patients.”

For more information, go to www.fingerlakesfamilycare.com.

Orthodontist builds on engineering background

Brandon Comella
Brandon Comella ’97 uses 3-D computer modeling to help determine a course of treatment for patients.

After graduating from high school, Brandon Comella ’97 (B.S., M.S. mechanical engineering) joined the Air Force, “because I wanted to fly airplanes.”

He ultimately did receive a pilot’s license, but he discovered another passion while working as a dental technician for the USAF. By 1993, he knew he wanted to become an orthodontist. Perhaps surprisingly, his next step was engineering school.

“ Mechanical engineering is a great segue to orthodontics,” he explains. While at RIT, Comella worked as a technician for Roy Epstein Dental Lab in Webster.

He went on to study dentistry and work on his Ph.D. in engineering at the State University of New York in Buffalo. In 2001, he graduated from the dental program and started his career in orthodontics. After several years working at a dental practice in Buffalo, Comella opened his own office in Penfield, N.Y., in 2005.
He ’s putting his RIT education to good use.

“ One of the things that separates this practice is the high-tech engineering process I use to diagnose and determine treatment, ” he says.

The first step, making an impression of the patient’s teeth, is nothing new. Comella then sends the cast to a company in New Jersey that makes a digital, 3-D computer model of the teeth. Using the computer model, Comella can virtually place the brackets, wires and rubber bands and project how the teeth will respond over the course of treatment.

“ The computer program gives a demonstration of how the process starts and finishes,” he says. “If I’m not satisfied with the projected result, I can make adjustments before putting any hardware in the patient ’s mouth.”

In cases requiring surgery to correct severe problems affecting the jaw or bones of the face, he can determine precisely what needs to be done to achieve the desired result.

The computer technology improves the overall outcome and it also reduces the total amount of time the patient spends in the dentist’s chair, he says, adding that most people appreciate that.

Comella says this system has been in existence for several years, and is becoming more widely used. Besides the computer technology, advances in adhesives and in materials used in constructing the brackets and wires have revolutionized orthodontics. In addition, in setting up his office from scratch, he opted for digital radiography and an expanded Web site where patients can track their treatment.

At least part of his enthusiasm for the system comes from personal experience. While in dental school, he diagnosed his own treatment. Besides improving the appearance of his teeth, he was able to correct a problem with his nasal passages to improve breathing.

“I did the setup on the computer and had friends assist in the work,” he says. “It took about 1½ years, but I’m very pleased with how it turned out.”

For more information about Comella’s practice, visit www.comellaortho.com.

Kathy Lindsley