Emmott On Technology

Which is more likely to kill you?

A: a deer

B: a shark

Surprise; you are 300 hundred times more likely to be killed by a deer than a shark. Each year deer kill close to 200 people by jumping in front of a moving car. On the other hand only eight fatal shark attacks were reported along the Pacific Coast of the United States in the 20th century. Eight deaths in a hundred years. (HT Dr. Nancy Haller.)

Which is more likely to kill your computer?

A: a virus

B: a fire

The answer, according to Craig Wright the President of Continu Data Services is a fire.

However malware attacks (such as computer virus) are exciting and like shark attacks they are hyped and sensationalized by the media.

The lesson: It is OK to go swimming and it is OK to use the Internet…just be sure to make a back up.

I saw this list of six steps to health care reform. (As opposed to complete change and government takeover) Personally I like the first four. But IMHO numbers 5 and 6 make good political reteric but would be hard to implement and will likely have little real effect on the cost of health care.

1. allowing small businesses to pool their resources to purchase health-care plans,
2. reducing junk lawsuits against doctors,
3. allowing the purchase of insurance across state lines,
4.  expanding health savings accounts,
5.  promoting wellness and prevention,
6.  taking steps to reduce waste, fraud, and abuse.

The following is excerpted from an article I wrote for Dental Economics:

The most important element a dentist needs to understand about new digital impression technology is not whether or not it can make a crown like we used to or how the technology works but simply that it is digital. That changes everything – that is the Aha. To understand the advantages of digital impressions let’s compare it to another digital system you have probably already used and understand; a digital photograph.

Infrastructure: Back in the olden days, you know, last century, BC (before computer) we took photographs with a film camera. This required a complex infrastructure that was purpose built and exclusive to photography. That is the film, the camera the chemicals the processing equipment and the printing materials were all exclusive to photography. In other words you could not use the photography system to send a post card or take an impression.

Conventional impressions also need single purpose systems from trays to impression materials and various stones, vibrators, mixers and vacuum pumps to create a model. You cannot use the impression system infrastructure to send a postcard or take a photograph.

Since the infrastructure is single purpose, complex and expensive most people do not try and do it themselves. They instead send the film to a special lab to be processed and printed.

Of course the same is true of impressions. Most are sent to a special lab to be processed and the restoration created.

Process: In addition to the infrastructure there was the process. You would take a photo but you would need to put it through a long and complex process of developing and printing before you could use it, usually hours or even days later. If there was an error, like poor focus or over exposure, you would not know about it until the photo was developed printed and returned to you. Then of course it was too late to fix it. If the photo was unneeded or just ugly (Aunt Tilly blinked) too late you already spent the time and money to create it.

The conventional impression process is similar. You take the impression but do not get to see or use the model for hours or days later. If there is an error, a bad margin a void or distortion it is too late to fix it.

Storage: Once you finally get the film photo print or slide that you want you then have to store it. At home that means throwing the snapshot in a shoebox randomly with all the rest or taking the time to put it neatly in a photo album. At the office it means labeling and dating the image and putting it in a patient chart.

Impressions are even harder to store. They need to be labeled, dated, boxed and stored on shelves in a manner where they can be found later. Because this is so tedious most models end up stored with the random shoe box technique or just thrown away.

Distribution: If you want to send a film photo to a friend or a clinical film photo to a colleague then it would need to be copied back at the lab, put in an envelope and mailed. The process would be expensive, the quality of the image would be degraded and it would take days to accomplish.

Sending a copy of an impression would be similar but even more complex time consuming and expensive.

Digital: With digital photography everything changes. The infrastructure is a computer network. This digital infrastructure can be used to capture, process, display, store and transmit the photograph. However it can also be used to send a post card; that is an e-mail. It can be used for impressions, records, diagnostics and a whole lot more.

With the digital photo process the user can see the image immediately. If there is an error it can be corrected right now. There is no need to pay the processing costs simply hit the delete button. The same is true of a digital impression. The user sees the image immediately and can make corrections if they are needed and discard the mistakes.

Digital photos don’t fill up shoe boxes or bulge out of files but are stored as part of the patient record on a hard drive. Digital impressions can also be stored on a hard drive. The storage process usually requires three or four mouse clicks and the hard drive is smaller than a shoe box and costs less than a file cabinet.

Sending a digital photo to a friend or colleague can be done online with just a few mouse clicks. It costs nothing, it happens instantly and the image is exactly the same quality as the original. The same is true of a digital impression.

Applications: CAD-CAM stands for Computer Aided Design and Computer Aided Manufacture. These systems take a digital impression of a prepared tooth and then the computer designs a restoration and mills it out in a special chamber. The result is a one step lab type restoration with no impression, no temporary and no second appointment.

There are two dental CAD-CAM devices available. The first is Cerec from Sirona which was introduced over 25 years ago. The second is the E4D from D4D Technologies.

Another application of this type of technology is a digital impression. A digital impression is simply the first step of CAD CAM; that is the capture of a 3D digital version of a tooth. There are two digital impression devices available. The first is iTero from Cadent. The second is the Lava COS from 3M.

Both iTero and Lava COS are designed with single tooth restorations in mind. However it is possible with Lava COS to take a full arch impression.

Full arch images leads to the final use of virtual 3D models and that is Invisalign. Any dentist who has seen the virtual models created by the Invisalign ClinCheck process has to have been impressed. Imagine having that type of system available in the office to create routine virtual study models. Currently Invisalign still requires an impression which is then scanned to create the virtual model.

Once it is digital everything changes…”Aha”, the future is coming and it will be amazing!

The following comes from an e-mail newsletter from Cactus Sky Communications

Dental Case Study

Location: Baltimore MD
Practice: General Dentistry
Time Frame: 9/1/09 to 10/1/09

Google Search Results during Time Frame:
Denture = 368,000 searches
Dentures = 301,000 searches
Extractions = 235,000 searches

Prior to the campaign, the Dentist was averaging 10 inquires per week for dentures and less than 5 per week for tooth extractions.

RESULTS: Campaign yielded enough NEW business that the Dentist had to hire another Dentist to keep up with the increased demand.

Very interesting look at tablets and the history of the idea. The dental connection? Tablets have long seemed like such a cool idea, a natural for the dental office…but the fact is they have never caught on. Will the iPad lead the next revolution?

…mankind seems to have some deep-seated, almost genetic, desire for tablets to work and play on. What I didn’t say is that we need such a tablet. And there’s the rub.

via Edgelings.com » Tablet Dreams.

More interesting ideas from Seth Godin

…the resistance. The resistance is the voice in the back of our head telling us to back off, be careful, go slow, compromise. …

The resistance grows in strength as we get closer to shipping, as we get closer to an insight, as we get closer to the truth of what we really want. That’s because the lizard hates change and achievement and risk.

via Seth’s Blog.

The most obvious addition to a basic digital radiography system is a digital panoramic x-ray machine. A panoramic radiograph provides diagnostic information that is simply not possible with periapicals (PA). With a panoramic image you will provide better treatment for your patients; that’s what is most important. However as an added bonus the machine will quickly pay for itself and provide exceptional ROI

As a general rule you will be taking a pano on all new patients and once every five years on existing patients. Here is the math:

Total active patients 2000 – 1/5 will need a pano each year – 1/5 of 2000 = 400

Six new patients a month for 12 months = 72

Average digital pano fee = $85

472 x $85 = $49,120

Panoramic x-ray machines provide such great diagnostics and financial return every dentist should have one. In fact they are such a good choice dentists who may be uncertain about “going digital” should consider getting a digital panoramic immediately, even before going with sensors.

The above is from the EOT Guide to Digital Radiography

I am a huge fan of soft tissue diode lasers. I have not tried this one from AMD but it is endorsed by Ross Nash who I respect a great deal. This seems to have all the basics covered and is only $2500. Ten years ago I paid $15,000 for my first diode.

…an unprecedented level of affordability, the new multi-functional soft tissue diode laser offers comprehensive clinical results in surgical, periodontal therapy, endodontic procedures, and bleaching,

via AMD LASERS, Picasso Soft Tissue Dental Laser.

Just got an e-mail about this product. I have not used it but the concept looks great.

Small business owners are concerned about whether their network is secure, their data is backed up, and their computers are healthy. But many small businesses operate with limited or no IT support. Small business owners are often not aware of a security hole or a lurking problem. The result is not calling their IT support provider for assistance until it is too late

Intel IT Director Download.

I will be presenting a free course  at the Yankee Meeting, Saturday morning January 30, thanks to the generous sponsorship of Henry Schein. Here is the link;

After years of rumors, speculation, and leaks, Apple today announced its long-awaited tablet, the iPad.

via Apple Launches iPad Tablet, iBooks Bookstore – Reviews by PC Magazine.

The link below is to a course I presented on using technology that is available online from the ADA.

ADA CE Course Overview.

This Stuff vs. Solutions issue has been one I have mentioned several times here and here.

Following is some advice via the Pride Institute that was written for my EOT Technology Guides. The idea of course is that the machine or technology itself has little value unless you have a plan to implement it in a way that adds value to the practice.

Management Tips for the Paperless Office

At Pride Institute we teach that there are four parts of every system. In order to achieve full integration, you must fully implement each part.

1. Purpose / Vision (the big picture)
2. Mechanics (how we will do this)
3. Verbals (how we will communicate with one another and our patients)
4. Follow up/through (the consistent daily actions and agreements that hold us accountable and let us know when we’ve succeeded.)

1. Developing a Purpose or Vision

The purpose for making any change should be persuasive and powerful. It has to be bigger than simply saying that being paperless “will make us more efficient.”  You need to appeal to the hearts and minds of the people who will implement and experience the change.

2. Mechanics

The second part of a system is mechanics. The vision provides the why; mechanics puts the spotlight on strategy.  Mechanics include the decisions and actions that must be addressed for successful implementation.

3. Verbals

The third component of a system focuses on the communication skills that will support the change.  Before you go paperless, you need to consider how the new technology will change the way you communicate with the team, how the team communicates with one another and how the team communicates with patients.

4. Follow–up / Follow-through

The final part of the system is the one that most dental practices pay the least attention to with the result that many a great idea dies a death of slow attrition.  If you are going to invest considerable time and money in installing technology and training your team, then you need to invest an equal amount of energy making sure that you and your team are utilizing the technology correctly and to its fullest extent. One of the most effective ways to insure that the new systems are operating correctly without glitches is by holding daily and weekly meetings.

The only way to assure that your dental office will appear on page one of a Google search is to buy it. It is easy to do and you only pay if a searcher clicks your listing. That is you pay per click or PPC.

How much?

To be in the top few listings in a megalopolis like Los Angeles it will cost from $10.00 to $12.00 per click.

To be at the top in a search in Boise a thriving city of 200,000 people you will pay from $1.00 to $2.00.

To get at the top of a search for a small town of 20,000 people anywhere USA will cost you pennies.

It is not enough to have the newest technology, the people in the office, including of course, the dentist must understand the benefits and want to make positive changes. But change involves risk. What if this doesn’t work out the way the sales person says it will?

People will only take active steps toward the unknown if they genuinely believe – and perhaps more importantly, feel – that the risks of standing still are greater than those of moving forward in a new direction.

The most common password by far…123456. Other popular options: 12345, 123abc and the long time favorite…password.

This means that the users, if allowed to, will choose very weak passwords even for sites that hold their most private data.”

via RockYou Hack Reveals the Worst 20 Passwords – Reviews by PC Magazine.

If you are afraid or just plain not sure of using Twitter this is supossed to be the world’s simplest Twitter client.

Microsoft and Seesmic on Thursday unveiled a shiny new Twitter client called Seesmic Look that wants to bring Twitter to the masses.

via Microsoft, Seesmic Aim to Make Twitter Simple – Reviews by PC Magazine.

The link below is to an interesting take on the new Internet culture and social media. If you have a Facebook “friend” is that person really …you know…a friend? The article points out how, as humans, we can only process a limited number of friends.

What is doesn’t discuss is the next level of relationships. What about clients or patients? Most dentists have thousands of patients in our practices and we have an ongoing relationship with them. The doctor-patient relationship is not exactly that of friends but it is a lot more than a casual acquaintance.

I am still working to find how to use social media in an effective way to nuture those people who are business friends and use it in a different manner to interact with more intimate friends and family.

Ever heard of Dunbar’s Number? According to British anthropologist Robin Dunbar, it’s the cognitive limit to the number of people you can be friends with. The number is 150, meaning your brain can only handle that many friends, and — shockingly enough — it also applies to Facebook.

via Your Brain Can’t Handle Your Facebook Friends.

I am always bugging dentists and their team members to get more basic business software training. That is training on programs like Word, Excel and Outlook. If you are located out west follow the link to find a training center. Then sign up what are you waiting for????

Our experienced instructors will help you to learn new skills and refine your existing knowledge of desktop applications, graphics software, databases, and technical systems. We also feature business skills and professional development workshops to make sure that you and your organization have the skills needed to keep your business running smoothly

via ExecuTrain West – Training, Room Rentals, & Consulting.