Emmott On Technology

When you switch from one computer system to another there is no need to trash the old system once the new one is in place. Keep it up and running. That does not mean you do dual entry and try and use both systems simultaneously, that’s a sure recipe for disaster. Set a day to “go live” with the new system and just do it. Keep the old system available for looking up old information, like last year’s treatment or what the insurance paid six months ago. That’s why you don’t need to transfer every piece of old data, you can always access it from the old system. You will find the need to look up information in the old system will quickly pass and you will rarely access it after a few months. None the less it is there as an archive.

You will probably use the old system for continuing care recall for the first six to twelve months as people and information are added to the new system.

I am not convinced that Winows 7 is a must have for the dental office. However if you are an early adaptor and want a bargain; here it is.

First generation attempts to create digital referral slips simply recreate the paper form in an electronic format. The dentist still needs to fill in the information (patient name, practice information, tooth #, diagnosis etc.) by hand with a mouse and keyboard.

Second generation digital referral slips are smart and interactive.

The system will upload all the appropriate patient data from the paperless record. This would include the minimum information we now scribble on the paper slip; patient name the tooth and the treatment.

But that’s not all. With a smart interactive referral you are not limited to minimums. The online digital referral system will upload all the patient information; like address, employment, contact numbers and the other things we need to create a new patient record. The system will upload the patient’s insurance information; plan, group numbers, contacts and benefits. The system will upload the patient’s health history with areas of concern noted.

In other words all the information a patient usually needs to spend time writing onto a form on an old brown clip board is sent automatically before the patient even arrives for the first appointment. Rather than spending time typing and clicking the information from the hand filled form to the computer chart the data automatically fills in the computer chart.

Digital communication is very fast (virtually instantaneous) and very inexpensive. However there is an even greater benefit that is so obvious it is often not appreciated and that is that digital communications allows us to transmit digital data. And it is now possible to turn virtually everything we do (photos, radiographs, pocket probings, and even impressions) into digital data.

Using a smart interactive referral system you will upload diagnostics like photos, x-rays and probings. These will be available to the specialist before the patient arrives, they are the same quality as the originals (unlike a conventional copy of a model or a radiograph) and they can be enhanced with diagnostic software.

As the referring dentist you will then be prompted to fill in details using a decision tree. A decision tree is an interactive system that guides the user through various selections with each new decision based on the previous answer. For example the system could ask, “Is the patient experiencing pain?”  If the answer is yes then a new and different set of questions is launched. “Is the pain constant?” “Is the pain mild, moderate or severe?” and so on.

If the answer to the first question is no, then the system jumps to a completely different symptom, “Is there any swelling?”

Once you have made it through the decision tree you will have a blank page on which to type all the detailed notes you wish.

Focus: To be effective in dentistry a digital camera must meet several criteria. First it must be able to take a good picture in focus with out distortion of both a full face and a close up of the smile. Inexpensive cameras can’t do this.  Most standard point and shoot cameras are designed to take a photo from six feet or more away.  In the dental office we need to be much closer with “macro” focus capability. Cameras without good lenses and zoom capacity can’t get a close up smile in focus and they often “fish eye” the full face. This results in a distortion of the middle portion of the picture making the nose seem enormous.

Resolution: The next factor is image quality or resolution. Quality requirements will vary significantly depending on how the photos will be used. Dentists taking clinical photos for lecture presentations will need high quality with high resolution to show fine detail in a projected image. On the other hand insurance documentation photos can usually be low resolution. Cosmetic imaging photos may be some where in between. As a general rule any camera with four or more mega pixel capacity will do well in the dental office.

Flash: Next the camera needs a remote or diffused flash. Standard point flash systems on most cameras will often wash out close up smile photos. All the detail and color are lost. Or the flash will create deep shadows on one side and bright highlights on the other obscuring detail and making cosmetic imaging difficult. To be effective the camera needs a remote flash, which can be attached to a ring flash, or a flash diffuser to evenly distribute the light.

Accessories: To effectively use digital photography in the dental office the dentist will not only need the proper camera but he/she will need lens adaptors, a remote ring flash or diffuser, memory media, a media reader, batteries, possibly a battery charger and most importantly instructions. Finding the right camera and putting all the accessories together can be an expensive time consuming process. Most dentists should consider a kit from Photo-Med, Norman Camera or Lester Dyne.

File this under dubious and possibly misleading statistics. Lightspeed Research conducted a “multi-nation” study about cell phone use and reached some odd conclusions. Take the data point that 13% of cell phone users don’t use them to make calls. I have heard of safety phones stowed away in the car, but more than 10 percent of users?

Details here:

Is it possible to absolutely prevent anyone from ever, ever hacking into your computer? The answer is no. On the other hand ask your self this question, Is it possible to prevent someone from ever, ever breaking into your home or office, stealing your car or for that matter robbing the bank where you have deposited your valuables?  Again the answer is no. What is possible is to use basic security measures that make it more difficult for a thief to break in and lower your risk.

Good charting software has many features. One of the most important is that is eliminates all paper. That means the software must accommodate all the bits of paper data that accumulate in a chart and it must have a method of importing virtually anything either with a scanner or file import function. If some bit of paper possibly a lab slip or patient letter must be stored in a folder then you have lost one of the primary benefits of an electronic chart.

Another important feature is full integration. That means that each item is entered one time and then transfers to where ever else it is needed electronically. For example a procedure will progress from diagnosis to charting to treatment planning to scheduling to treatment to insurance to payment. This is called single entry. If the user has to re-enter information such as procedure codes, tooth numbers or fees at any stage then the software is not fully integrated.

Good charting software must accommodate all the information we used to record on paper. That includes existing restorations, conditions, diagnostic findings, treatment plans, periodontal probings and tissue conditions, tooth surfaces, materials and procedure notes.

Charting software must be easy to use. Every mouse click or keystroke slows down the process and makes the program harder to use, which means it doesn’t get used. The more the user can customize the chart the easier it is to use. That means the user can create shortcuts, eliminate features they don’t use and designate functions for each button.

Data entry needs to be fast and easy. The standard is still mouse clicks and keystrokes however faster more intuitive entry methods are available. Like voice; we’d all like to talk to our computer just like Star Trek. Some charting programs allow users to speak in clinical findings like pocket depths, tooth conditions and restorations. Another alternative entry is touch, instead of clicking a mouse the user touches the screen. The latest is ”Ink” a special function that allows users to write or draw on the chart just as if it was a piece of paper.

There are some things computers do well and there are some things they don’t do well at all. One thing computers do very well is they do the same thing over and over again. They do it very accurately, very quickly and they never get bored with it. That means that with a good computer system the dentist only has to enter “tooth number three crown” one time. The computer will then transfer that information to all the other places it is needed. It will attach the other information such as fees and insurance codes automatically. It will do it instantly and accurately. This feature is called single entry.

The single entry feature of a computer system has a profound effect on the human systems of a dental office. Single entry frees the staff to do other things, such as care directly for the patient. It speeds up the communication process, saves time and reduces errors. It reduces stress and makes dental staff jobs more meaningful and human directed. The single entry concept is very important because it answers the fundamental question, “What the heck does a dentist need a computer for anyway?” and it leads to most of the advanced features and uses of computer systems in dentistry.

So it’s a no-brainer, right? Well, maybe. There are a number of important issues to consider before making the jump to Windows 7 on an existing Windows XP machine.

Read the rest here:

Great minds discuss ideas;
Average minds discuss events;
Small minds discuss people.

“Microsoft pulled the plug on Windows XP a year ago today, no longer selling new copies in most venues. Yet according to a report from InfoWorld, various downgrade paths to XP are keeping the operating system very much alive, particularly among businesses.

Follow this link for the whole story here:

My experience and advice follows the article. If possible dentists should “downgrade” any computer used in the Office to XP Pro. The reviews of Windows 7 are good so far but I am skeptical for now. Windows 7 is scheduled for October release. Maybe it will be OK for the dental office by March of 2010.

It’s inevitable now, with any high-profile news event that there will be spam and malware campaigns to take advantage of them. Thus it has been with the death of Michael Jackson.

Details Here

Of course the real reason I included this post was to get a Michael Jackson entry just to pump up the site on the search engines.

Cubex is one of my favorite new pieces of technology. The following video explains it very well. For more information look here:

a thorough overview on how to protect your privacy on Facebook.

Eliminating jobs is not the only way to cut costs. In the large medical practice where I work, EMR is allowing us to free up enormous amounts of time for clinical staff who are snowed under by paperwork, while reducing errors and speeding patient service. Overall, EMR leads to a shift away from paper-shuffling jobs and towards more technical jobs. If hiring an IT worker cuts down the amount of time a group of doctors spend dealing with paper records, that’s a significant cost reduction through a new hire. If those 212,000 new workers improve efficiency and eliminate waste, that can be money saved, not to mention improved patient care and the benefit to the economy of putting people back to work.

More Here:

High-quality scans for prints and film. LED light source eliminates warm-up time.

A good inexpensive ($150) scanner for film x-rays. It has a transparency adaptor and can do a full set of bitewings in a single scan. May not be adequate for a panoramic film. PC Magazine Review here:http://www.pcmag.com/article2/0,2817,2213394,00.asp

Do you know your patients’ preferences? Henry Schein Practice Solutions is conducting a nationwide survey to better understand dental patients’ preferences.  If you would like to participate, you will receive a unique URL link to a survey that you can link to from your practice website and/or email to your patients so they can complete the online survey. The survey will run for 30 days and at the conclusion we will send you a PDF report with the results of your survey.

To request to participate, email your Name, Practice Name, Phone Number, Email Address and email Subject: Patient Survey to research@dentrix.com by July 24th. You will then be given the unique URLs to participate. To see an example of the survey go to Sample Survey.

This offer is open to the first 100 dental practices that request participation, so act now to request the survey.

…betting, for example, that PC users will increasingly control their computers by touching their screens….Windows 7’s support for multi-touch technologies — the ability to use multiple fingers on a screen, as a supplement or replacement for a traditional keyboard and mouse.

Will more natural interfaces work in a dental office? In dentistry asepsis is always an issue. Touch could be an answer. If you follow the link read the comments, very interesting.More Here.