Future Tech Hardware Management

Enterprise software, devices to drive 2021 IT spending to $4.1T

From  VentureBeat:

The source of funding changes “from an overhead expense that is maintained, monitored and sometimes cut, to the thing that drives revenue,” Lovelock said in the press release.

Source: Enterprise software, devices to drive 2021 IT spending to $4.1T | VentureBeat

The linked article is more for investors than tech buyers. Nevertheless it makes a point I have been pushing for years. Technology used properly should not be an expense it should be a revenue driver. It should reduce overhead.

Many dentists do not see this. Instead technology becomes an ever increasing and expensive burden. The key to making technology pay is to use it. Stop doing things the way you did before technology and adopt a digital, paperless workflow.


  • Use paper charts
  • Call to confirm
  • Mail paper statements
  • Hand out a clipboard
  • Send impressions to a lab

Use the digital technology you already have and employ the e-services you are most likely already paying for.

Corona Pandemic Future Tech Internet Management

Is the 9-to-5 office routine dead? Here’s what workers want

From Fortune:

Taken together, these survey questions help paint a picture of how workers have evolved—and how the workplace must evolve, too.Here’s what we found. The numbers to know 63%… of knowledge workers prefer a hybrid model. Another 20% prefer fully remote, and 17% want to always work from the office.

Source: Is the 9-to-5 office routine dead? Here’s what workers want | Fortune

These findings apply to dentistry.

Do NOT be in a big hurry to get back to normal; defined as the way we did things prior to February 2020.

The pandemic and shutdown showed us we can do many of the management tasks in a dental office remotely using technology. There are three different systems that we can use.

Do tasks that used to be done in the office using the office website. For example take payments and collect forms.

Use an e-service to do tasks that people had to do. For example send reminders and statements.

Work from home. For example run and evaluate month end reports.

Some tasks can simply be eliminated. For example you do not need to pull and replace paper chats if all charts are electronic.

Artificial Intelligence Theraputics

AI system to evaluate dental restoration

The patent “Enhanced Techniques for Determination of Dental Margins in Intraoral Scans” covers a machine learning process applied in Smart Margin and Prep Assess

Source: Pearl gets patent for AI system used in dental restoration

Great, as if dentists aren’t critical enough of each other we will soon have an artificial intelligence telling us how bad our restorations are.

The developers claim that 80% of dental restorations are “sub optimal” and this algorithm will help find out why.

Despite my snark, I like the concept and will be interested to see if it actually works.

Future Tech General Security

Harvard curator examines the worth of a digital work of art

From Harvard Gazette:

A digital collage of 5,000 images by the artist known as Beeple fetched an eye-popping $69 million at auction last week as a non-fungible token, or NFT, a type of digital file that uses computer networks to prove a digital item’s authenticity, paid for in cryptocurrency. It was a striking sum for something that can so easily be copied and co-opted by anyone with an internet connection, according to many experts,

Source: Harvard curator examines the worth of a digital work of art – Harvard Gazette

Interesting. The curator is very reluctant to accept this as art and justify the absurd selling price. She sees it possibly as a cryptocurrency investment rather than an art investment. Maybe.

Can it be copied? If so is the original as designated by the block chain still worth more. Is it worth 69 million even if it has been copied. Will the owner or anyone for that matter be able to view it in twenty years when the technology has advanced? I cannot access data I stored on a floppy disk twenty years ago.

It relates to an issue I have been discussing for years. In a digital world who owns the data? Do you own a Kindle book that you buy from Amazon? Or do you just own the right to read it on your device? Do you own your digital impression device? What if that device can be rendered useless by a vendor who simply turns off the software connection. “Bricks” it.  It has happened.

Corona Pandemic Management Telemedicine

Planning a Return to the Office

Do you have a plan for office work of the future?

Policies about the mix of remote and in-office work have ramifications beyond short term cost and efficiency. Because of what we’ve gone through over the past year, we are about to enter a new era in the evolution of organizations. Decisions that CEOs make over the next few months will set the tone for how work will be done in the future, impacting the relationships employees have formed and their emotional connection with the company. They should be made carefully.

Source: A CEO’s Guide to Planning a Return to the Office

The pandemic has shown us that a great many of the tasks we used to do in the office can be done as well or better remotely. That is either as work from home or outsourced to an online e-service.

Don’t be in a big hurry to get things back to the way they were in February of 2020. Now is a perfect opportunity to redesign the workflow of the office to outsource some work, transfer some tasks to your web page and reassign some tasks to remote work from home options.

For example:

Online bill pay instead of a person answering the phone to take a credit card number or opening an envelope and depositing a check.

Month end billing, reports, and accounting can be done by an administrator working from home.

No paper charts to pull and refile at the end of the day if you use fully digital charts.

Billing, and insurance claims can be done from home or outsourced to an e-service.

No paper re-call cards with postage but use text or e-mail to send reminders electronically. This can be set up and monitored remotely as work from home.

There is more, be creative.


Pediatric dentists using teledentistry the most

From Becker’s:

The percentage of respondents by dental specialty who said they were using any kind of virtual service, ordered from greatest to least:

  • Pediatric dentist: 75.2 percent
  • Orthodontist: 62 percent
  • Prosthodontist: 42.3 percent
  • Dental surgical specialist: 38.5 percent
  • General practice: 33.1 percent
  • Periodontist: 32.3 percent

Source: Pediatric dentists using teledentistry the most: 7 stats per ADA

Corona Pandemic Health Care Politics Telemedicine

Telehealth used in 30.1% of visits during COVID-19 pandemic

Telehealth visits accounted for approximately 30% of total outpatient visits early in the COVID-19 pandemic, with uptake varying among specialties and by patient characteristics…

…Among specialties, telehealth was used at least once by 67.7% of endocrinologists, 57% of gastroenterologists and 56.3% of neurologists. However, the use of telehealth was considerably lower among some specialties, with just 3.3% of optometrists, 6.6% of physical therapists, 9.3% of ophthalmologists and 20.7% of orthopedic surgeons using teleh

Source: Telehealth used in 30.1% of visits during COVID-19 pandemic

From the ADA via Becker’s

The percentage of respondents by dental specialty who said they were using any kind of virtual service:

  • Pediatric dentist: 75.2 percent
  • Orthodontist: 62 percent
  • Prosthodontist: 42.3 percent
  • Dental surgical specialist: 38.5 percent
  • General practice: 33.1 percent
  • Periodontist: 32.3 percent
Corona Pandemic Health Care Politics Telemedicine

Congress Gets Another Shot at Easing Telehealth Licensure Restrictions

From mHealth Intelligence:

The TREAT Act, which has the support of dozens of health systems and connected health organizations, would allow providers to bypass licensing rules and use telehealth to treat patients in any state during the coronavirus pandemic.

Source: Congress Gets Another Shot at Easing Telehealth Licensure Restrictions

I have often made the point that the primary barrier to increased acceptance of telemedicine is not the technology but the politics. This act is a good step but it is very limited. Hopefully it will lead to more permanent rules.

I am usually a big fan of local control in politics however the Internet has expanded the meaning of local. I cannot determine how it is in the best interests of our patients to not allow them to seek the best most timely care online simply because it is offered by a dentist in a different state. Or why insurance companies will not pay for a telemedicine appointment if the outcomes are good and the cost is lower.

Future Tech Hardware Mobile Telemedicine

CES sees rise in telehealth tech in response to pandemic

From Las Vegas Review-Journal:

“This year, with all of the digital health products, we’ve seen rapid acceleration of these technologies given the global pandemic,” said Lesley Rohrbaugh, director of market research for the Consumer Technology Association, which owns and presents CES. “It’s definitely a category that has been rising over the past few years. It’s been a big category during CES. It will be again for CES 2021.”

Source: CES sees rise in telehealth tech in response to pandemic | Las Vegas Review-Journal

Follow the link for a rundown of some of the amazing devices now available for at home telemedicine, including:

— Toothpic, a teledentistry program that partnered with Philips. For $10, users can get help with a specific dental issue within six hours just by taking a photo of the problem area. An in-depth oral health report using six photos is available in less than 24 hours for $35.

Future Tech Internet Management

Lynk raises $24 million to bring knowledge-as-a-service platform to more industries

From VentureBeat:

Lynk, a “knowledge-as-a-service” platform that connects domain-specific experts with businesses, has raised $24 million to fuel expansion in the U.S.While there are myriad platforms and tools that unlock insights from vast swathes of data, Lynk offers an AI-powered engine that indexes “knowledge domains” and vetted experts to find answers to questions businesses are asking.

Source: Lynk raises $24 million to bring knowledge-as-a-service platform to more industries | VentureBeat

This is a very interesting concept. I can see many dental applications. Dentists can ask business and or clinical questions. Such as what is the average overhead expense in a US dental office. Or what precautions should be taken with a patient taking the drug XYZ?

Patients may also wish to ask dental questions. In this case the dentist  could be signed up as the expert.

Corona Pandemic Health Care Politics Telemedicine

U.S. lawmakers reintroduce House bill safeguarding access to telehealth

I am a huge fan of the concept of telemedicine and teledentistry. I believe it has the potential to reduce costs and improve care to a remarkable degree. This is critical to solving the “Healthcare Crisis”.

From  Healthcare IT News:


The bill, which was first introduced in July 2020, would help safeguard access to virtual care after COVID-19 via four main provisions. According to a press statement from Thompson’s office, it would:

  • Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site.
  • Authorize the Centers for Medicare and Medicaid Service to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency.
  • Make permanent the disaster waiver authority, enabling Health and Human Service to expand telehealth in Medicare during all future emergencies and disasters.
  • Require a study on the use of telehealth during COVID, including its costs, uptake rates, measurable health outcomes, and racial and geographic disparities.

The bill avoids some of the thornier issues around telehealth, such as coverage parity or interstate licensing issues, while making permanent broadly popular policies such as eliminating geographic and originating site restrictions.

Source: U.S. lawmakers reintroduce House bill safeguarding access to telehealth | Healthcare IT News

The primary barriers to the acceptance of telemedicine are not technological but political. Government, especially regulatory agencies, professional associations (including the ADA) hospitals, insurance companies and others all have a vested interest in the status quo and an incentive to block the acceptance of robust telemedicine.

One of the few good things to come from the Covid 19 pandemic is the use and acceptance of telemedicine.

This is why IMHO telehealth has such tremendous potential.

Corona Pandemic Management Telemedicine

Why the five-day workweek is outdated for working from home

From Fast Company:

It’s time to get realistic about how people work in the 21st century. To the degree that we can acknowledge what is actually happening—and what is actually effective—we can begin to experiment with work hours in ways that simultaneously increase productivity and well-being.

Source: Why the five-day workweek is outdated for working from home

Technology allows us asynchronous work from home options. Doctor do you care if your office manager submits the days insurance claims, sends out statements and records payments from the computer on the right side or the left side of the office? Of course not. Then why can’t she/he do it from a computer in a different building? Why not from home?

The 9-5, five day a week office work week was needed when everyone needed to be in the same place and have access to the supplies and data to do their job. Now all they need is a computer with an Internet connection and they can do the work from anywhere. Not just anywhere but any time.

Future Tech General

Less than 5%

According to Eric Topol huge amounts of medical data pour in constantly from medical records, continuous output wearable sensors, whole-genome sequencing, hi-res images and more. Processing and understanding this data has the potential to dramatically improve the human condition. By most estimates we have processed only a tiny fraction of it, 5% or less.

Artificial Intelligence Diagnostics Future Tech Health Care Politics

Deep Medicine; What I am reading right now

Diagnostics Future Tech Radiography


Is it as good as film? Wrong question.

Is it diagnostic?

What makes a digital radiograph diagnostic? It is a combination of image and software. Dentists tend to focus on the sensor and the final image but it is the software that matters more – or at least as much – as the sensor when it comes to delivering a diagnostic image.

In this regard I have long been a fan of XDR Radiography.

Doug Yoon, the founder of XDR is a dentist, a scientist and one of the smartest people I know in dentistry. Doug recently reminded me of the XDR motto “Imaging Through Science”. What that means in practice is that the team at XDR is constantly looking to refine the digital x-ray process through scientific investigation based on diagnostic efficacy. Sadly some vendors concentrate on what looks good and what will sell rather than on what is the best diagnostic result.  Instead of a lot of cool looking but useless enhancements XDR actually uses advanced image enhancement to improve diagnostics…what a concept.

Don’t get me wrong, XDR has one of the best sensors on the market as well as great software.

Are you up for some in the weeds, future focused, nerdy stuff? If so keep reading.

The opening question about film refers to our early attempts to diagnose dental disease from a digital image by looking at it, just we used to do with film. But do we really need to look at an image to diagnose? Do we even need an image? No, we do not.

When we diagnose an x-ray image, we are using our eyes combined with knowledge, training and experience to detect changes in tissue density. These density changes are indicated by how opaque the image is. We have learned that lack of opacity indicates loss of density which indicates pathology. We can see changes in the image because the pixels are displaying different shades of gray. Here is the part we tend to ignore. The computer knows the difference in each pixel even if it does not display it as an image.

Imaging software can be trained to distinguish patterns and changes in grayscale that are too subtle for the human eye to detect. Once the software has been trained to know what pathology looks like whether it is interproximal caries, periapical pathology or crestal bone loss the software can render a diagnosis without rendering an image. That is what machine learning and artificial intelligence is all about.

We are a ways away from total digital diagnosis and will certainly pass through a significant hybrid step where the software does a preliminary diagnosis and also renders an image for the human to look at. However, once you get past the film-based paradigm from the early days of Roentgen you can see that we do not need a picture we just need a data steam that can be used to detect tissue changes that indicate pathology.

Until we get there we will still need to use our eyes, knowledge, training and experience looking at the best image we can get to diagnose dental disease. XDR will help you do that.


Four Types of Teledentistry

From Teledent:

Four Types of Teledentistry

Live Video (Synchronous)
Best described as a two-way interaction between patient and dentist, using audiovisual technology.

Store and Forward (Asynchronous)
Recorded health information, such as radiographs, photos, video, digital impressions or
photomicrographs that is transmitted through a secure electronic communications system. The
practitioner then uses the information to evaluate the patient’s condition or render a service
outside of a real-time or live interaction.

Remote Patient Monitoring
Personal health and medical information is collected from an individual in one location then
transmitted electronically to a provider in a different location for use in care. This could be
used in a nursing home setting or in an educational program.

Mobile Health
Health care and public health practice and education supported by mobile communication devices,
such as cell phones, tablet computers or personal digital assistants. Patients can access
teledentistry by a smartphone app, and could include apps that monitor patient brushing or other
home care.

Health Care Politics Telemedicine


It should have been titled the ANTI Dental Telehealth Bill.

From NY State Dental Association:

The amendment protects dental patients by requiring that dental telehealth providers identify themselves to patients and provide their New York State license number. It also stipulates that patients undergo proper examinations, necessary X-rays, and reviews of medical and health history before treatments can begin by a licensed dental practitioner.



Teledentistry in action

So, Ruiz did what many people do when they have a question—she turned to the internet. That’s where she found a teledentistry app called Toothpic.

Toothpic allows people like Ruiz who need a check-up or have a specific dental concern to snap a few photos of their teeth and submit them along with a short write-up of their issue. A licensed dentist then reviews the submission and sends back a personalized report with recommended treatment options and estimated costs, in as little as six hours.

Source: A reason to smile | Coverage

Corona Pandemic Future Tech Management Telemedicine

The shift to virtual and home care: An interview with Annie Lamont

Interesting, from McKinsey:

“There is no doubt that the patient–provider experience during the past several months has accelerated virtual models of care by five to ten years.

…Hospital systems have been the drivers of our healthcare system. Our nurses and doctors in those hospitals have been heroes throughout the COVID-19 outbreak. But the reality is that if we want to lower costs, if we want to provide the best care, the future of healthcare has to be driven from outside of the four walls of a hospital system.

Source: The shift to virtual and home care: An interview with Annie Lamont | McKinsey

The “Health Care Crisis” is not a crisis of care it is a crisis of affordability. New techniques and new uses if digital technology will lower costs and improve quality. The linked article focuses on medicine but applies equally to dentistry. In dentistry we will eventually have to actually touch the patient but there are many diagnostic tasks and business tasks that can be done virtually.

3D Printing Digital Impressions Scanners

Carestream Dental Validates SprintRay Pro Printer, Makes it Easier for Practices to Offer Clear Aligners

Now, more doctors can confidently add in-house clear aligners as a treatment option for their patients with the validation of the SprintRay Pro printer for use with Carestream Dental’s newest update to its modeling software, CS Model+ v5.

Source: PRESS RELEASE: Carestream Dental Validates SprintRay Pro Printer, Makes it Easier for Practices to Offer Clear Aligners

I like this for two reasons. Carestream is moving toward interoperability by adding more 3D printer options that will work with their scanners and software. Plus I believe 3D printing will be the future of dental fabrication and this is another nice step in that direction.