Here is a five minute demo for meeting planners looking for a high tech dental speaker.
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Tag: dental technology
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WannaCry Update
From Strategy Page:
The incident began with the activation of ransomware malware called WannaCry. What made WannaCry so dangerous was that it made use of several capabilities including a hidden (but findable) backdoor program that tried to spread WannaCry to Microsoft Windows computers that had a known vulnerability but were not updated to remove the vulnerability. This automatic spread of malware is called a worm…
Source: Information Warfare: An Endless Mystery Called WannaCry
Very interesting including speculation that the attack came from North Korea, but then again maybe not. Plus a useful glossary of computer terms.
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Guide to Digital Radiography
What is your excuse?
Digital Radiography is no longer new; it has been on the market for close to thirty years. If you are not using it you probably have a convincing personal excuse. On the other hand you could compare film x-ray users to a dentist still using a belt driven handpiece in 1995, thirty years after the air turbine was invented.
There is no longer any excuse. Make 2016 the year you lower your patient’s exposure to radiation, improve diagnostic efficiency and reduce the cost of taking radiographs. If you are still wondering what to get and are concerned about costs check out my comprehensive technology guide, “Digital Radiography”
The “Digital Radiography” guide exposes nine myths about digital radiography and it will answer the basic question…Why bother? It then provides step by step help choosing and then setting up digital x-rays.
You will learn about; the five part imaging chain, the sensor wars, image enhancement and much more. And what will come as a complete shock to most dentists… there is even a budget and financial analysis that shows how digital radiography is actually cheaper than film.
“Digital Radiography” will answer all your questions, provide a plan and show you how to save money… all delivered in a fun and easy to understand style.
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Patients Like E-mail
Did you know?
58% of consumers start their online day by reading their emails.
76% of dental patients said email is the best way for companies to communicate with them.
This is based on a 2008 Sesame Communications research paper. Most likely today even more of your patients prefer e-mail.
So the question is…are you using it? Or even better are you gathering patient e-mail addresses in order to use it?
Here is an example of how e-mail communication can be used effectively with e-services.
First you have to collect and sore the e-mail address. Most Practice Management Systems like Dentrix have e-mail address as a field in the patient information field. Be sure you get it filled in. It has to be on your intake form, if you are still using the forms you had in 1995 you need to update.
As all those existing patients who started with you last century and didn’t have an e-mail address need to provide it now. Make it part of your health history update. Ask for it and give the patient a good reason to provide it.
For example advise them that you will send e-appointment reminders rather than bother them with a phone call and most (76%) of patients will give it to you…but you have to ask. Another idea is to offer an incentive. For example: Dr. Digital has written a list of the five ways to save money on dental care. If you give us your e-mail we will send you a free copy.
Now that you have e-mail addresses how do you use them. The best way is with e-services. Again Dentrix provides a good example of these services.
Appointment reminders are an obvious use for e-mail. However you can also use e-mail to direct patients to your web site to fill out forms. NOTE: Online forms are not just for new patients, this is a great way to make sure all existing patients have up to date personal and medical information on file. And better yet it is on file in a digital format so you can eliminate those pesky paper charts.
I was interviewed by Pam Johnson for the linked article in IDT Magazine. We discuss online lab communication and interoperability, or more accurately the absence of interoperability in dentistry.
In our personal and business lives, we have come to expect fast, reliable connectivity that seamlessly allows us to bank online; remotely control our smart homes or smart cars; buy anything from books to furniture to airline tickets; take accredited university courses remotely; hold virtual business meetings; socialize with friends; and even monitor our heart rate via a smart watch, regardless of location…
Unfortunately, the same open transfer of data that is experienced when a digital picture is taken and then shared via text, social media, or email does not yet exist in dentistry. “We still have barriers to that process,” says Emmott. “Proprietary software from various vendors won’t allow communicating with the software from other vendors. So unless the dentist and laboratory have compatible software programs, we can’t communicate on that seamless level.”
Source: Connected – – dentalAEGIS.com
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MagnaVu Procedure Scope
I always thought this was a great product that should have more industry acceptance.
The company now has an updated website which includes many more computer and magnifications products. A nice resource.
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Fuzzy no More
One of the best things about a digital x-rays is that they are…wait for it…they are…digital! That means we can use diagnostic software to examine and possibly enhance the image and improve our diagnostic efficiency. Most dentists believe that digital radiography is all about the sensor, but when it comes to diagnosis it is all about the software.
With digital radiography we tend to forget we can enhance the image; we are used to analyzing a similar non digital film image with our eyes so we don’t easily appreciate the software analysis. Most dentists in fact just analyze and diagnose from the raw digital radiograph with their eyes. Just as they did film in the past; it just seems like a different version of the same old diagnostic.
Here is an example of how software can enhance diagnostics. These images are from the XDR Radiography system.
Above is a raw image straight from the sensor. Can you detect interproximal decay? Most dentists can see the lesions but we feel the image is “fuzzy” not as clear as we are used to with film.
Now look at the same image after a “sharpening” tool has been applied.
The sharpened image is more like film and most dentists find it better diagnostically. Interestingly the sharpening tool extracts data to make grayscale changes more abrupt. Here is what Dr. Doug Yoon a dentist and the brains behind XDR Radiography says about sharpening.
“I think sharpening can serve as a visualization aid by making the fuzzy borders of lesions look more distinct (even though we all know lesions really do have fuzzy borders).”
The point to remember is that a primary advantage of a dgital image is that it can be enhanced with software. Don’t judge digital radiography by the image alone it is both a high quality image and good diagnostic software that makes digital better than film.
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Get Paged on Your Wrist
Doctor Meow – Receive pages directly on your wrist
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Add privacy to your messages
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Do not waste time checking boards and post-it notes
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Remove the noise from your intercom system
via DoctorMeow.
Doctor Meow is a new service that pushes office pages directly to a Pebble watch on your wrist. No sticky notes, no running down the hall and waiting, no expensive and out of date light system.
The system is simple. The doctor is called to a room with a simple message and a sound alert. Text messages can be added. Once the doctor arrives he/she can check in.
The system times how long the doctor takes to respond to the call and how long he/she spends in the room.
At last hygienists will have a way to really know how long it takes for the doctor to come in for the exam. Is it two minutes like the dentist believes or more like the twenty minutes hygienists complain about.
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3D Printing for Surgery
From NYT:
Before he operated on Violet, Dr. Meara wanted a more precise understanding of her bone structure than he could get from an image on a screen. So he asked his colleague Dr. Peter Weinstock to print him a three-dimensional model of Violet’s skull, based on magnetic resonance imaging pictures.
This story is a dramatic example of the kinds of things we are doing in dentistry and the potential for even more amazing options in the future.
We are already sending CBCT scans off to labs for the fabrication of surgical guides. Imagine being able to create the guide in the office using a 3D printer while the patient waits.
Another device could mill a custom titanium implant and a custom abutment to be placed. There are even 3D printers that use cells to create actual tissue printed for a specific area.
The future is coming…you know the rest.
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Reputational Management
If you find that you have some negative malicious reviews online what can you do? Actually it is easier to tell you what not to do.
Don’t Sue: As reported in the ADA News Dr. Yvonne Wong decided to file suit when she received a negative review on Yelp which she thought was false and unfair. The result Dr. Wong lost the suit, she has no legal recourse and to make it worse, much worse, she was ordered to pay over $80,000 in defendant’s legal fees.
Don’t Preempt: There are services that sell dentists and physicians contracts and patient forms that supposedly will prevent patients from posting negative online comments. These are of dubious legality and for at least one dentist who tried to use them it was an unmitigated disaster.Stacey Makhnevich a NY dentist has been sued by a patient for trying to enforce an agreement preventing patients from posting negative online comments. This set off a firestorm of online news and universal condemnation from the general public. None of it is good news for Dr. Makhenvich who it seems has been forced out of the profession by the bad publicity and legal complications.
Don’t Panic: As professionals our reputation is precious and we never want to see anything negative said about us. The conventional thinking is that negative comments need to be removed at all costs. On the other hand recent research indicates that a negative online review is not always bad. In the right situation it demonstrates that the reviews are legit, not just reviews from staff and family. Some negative seems to have a “blemishing effect” that actually makes the positive reviews more persuasive.
The only thing you can actually do is to overwhelm negative reviews with positive ones. However even with this tactic dentists face obstacles. For example if you appeal to your happy patients to write good reviews and several of them do some review sites choose to consider a flurry of new reviews to be somehow illegitimate and they will “filter” them out.
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At the ADA
I heard at the ADA meeting that Planmeca was showing a new impression scanner built into the dental unit. The Planmeca system now called PlanScan was the old E4D system. I went looking for it eager to find out more and predisposed to really like it. What a disappointment.
The PlanScan instrument uses a USB plug in, that’s good but they insist you only plug it into their special laptop. The sales woman even tried the old line that it was in my best interest to use their closed system. The unit can only communicate using their closed network and then they stick a mini tablet on the unit taking up very valuable chairside real estate that can only be used with their system. I can’t run Dentrix or anything else on it I can only view what they let me. All for my own good…please…really?
Just let me plug it into my chairside computer, let me use a standard monitor and let me store the scans on my server and transmit them to the lab of my choice using the Internet. Don’t make me buy yet another laptop and don’t insult my intelligence by insisting it benefits me for you to keep me captive in your private garden.
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Sensors for Dummies
A corded sensor has three basic elements. First is a scintillator. When x-rays impact the scintillator it fluoresces, creating a very precise pattern of light.
Many, but not all, sensors have an optical fibre. It transmits the light from the scintillator screen to the chip and protects the chip from x-rays.
A solid state computer chip receives the light and converts it into a digital electronic signal. This is the same basic chip technology that a digital camera uses to convert light into a digital photo. There are two different types of chip in use; they are CCD (Charged Couple Device) and CMOS (Complimentary Metal Oxide Semiconductor).
These two chip types function differently but both produce good images of diagnostic quality.
More information about digital radiography in the dental office.
Most everyone is aware that a major advantage of digital x-rays is the speed of acquisition. Once the sensor is exposed the image is produced within seconds. This of course saves the time of going to the processor, opening the film packs waiting for the chemical processing then labeling and mounting the films. However there is another advantage to fast image acquisition which is rarely appreciated. The operator does not need to remove the sensor in order to see the image.
This creates a tremendous clinical advantage. For example if the doctor takes an x-ray and inadvertently misses the apex, he or she will see the error within seconds. The tube head or sensor (which has not moved) can be re-arranged as needed and another image taken immediately. In this way the operator can insure that hard to see structures can be captured for proper diagnosis.
With a film pack or a phosphor storage system the film or plate must leave the mouth and be processed. The operator will not see the image for several minutes. If there is an error the operator will need to re-position the tube and film with no physical reference point to return to to improve the image.
In case you missed it: Dentalcompare from May 2013.
In 1820 it took a man wielding a scythe three days to harvest one acre of grain. In 1860 that same man using a mechanical thresher could harvest twelve acres in a single day.
We easily understand that kind of mechanical automation and how it helps us do more with less. Now we are learning to use information automation, and even though the savings in time and money can be just as dramatic as we saw with the industrial revolution, people resist the change.
People resist change for the usual reasons; they think it will devalue their work, they think it will be too hard and expensive, but mostly they resist because they just don’t know what is possible. With online digital e-services it is possible to transfer much of the information work that a passel of paid staff members used to do in the office to software in the cloud.
We gather digital information about our patients simply as a byproduct of doing business. For example our computer knows the patient’s name, phone number, insurance coverage, birthday, employer and next scheduled appointment, plus a whole lot more. Once the data is in a digital form, a computer can be programmed to use it in a specific manner.
For example, the computer can see when a patient is scheduled for care and simply send a text message to the patient’s cell phone a day in advance. No additional data entry, no human writing messages or dialing phones is necessary. It is all done automatically with no humans involved.
via Emmott On Technology: Dental E-Services Do the Work Without the Workers | Dentalcompare.com.
One of the best set of e-services called eCentral is offered by Dentrix. It includes patient reminders, online patient to web site services such as forms and insurance verification. Many Dentrix users are already paying for eCentral and not using it.
In case you missed it: Part two of my HIPAA series in Dentalcompare.
Protecting your patient’s privacy is important. Dentists have an obligation to honor patient confidentiality, and the digital age has made that obligation harder to fulfill. In addition you are expected to comply with the HIPAA privacy rules which have only a vague connection with actual privacy.
Last week in we made the distinction between PMP (Protect My Patient) documentation and CYA (Comply Yet Again) documentation. PMP might actually improve patient data protection and CYA protects the dentist from investigators. (As was stated last week the usual disclaimers apply: I am not a lawyer and you would be a fool to take my advice as legal counsel.)
PMP
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Risk Assessment
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Team Training
via Emmott on Technology: Untangling the Latest HIPAA Requirements – Part II | Dentalcompare.com.
I believe that one of the first and most important things you can do to comply, not only with the law but with the professional obligation we all have to protect patient privacy, is to make team members aware of the issue. Foster a culture of respect for patients and awareness of the importance of confidentiality.
What happens in the office stays in the office. Do NOT talk about anything related to patients at home or with friends.
I have developed a full course on HIPAA compliance that follows the series of articles in Dentalcompare. The compliance process is not easy. The ADA has created a guide to help but even with the guide the process is daunting. Most dentist will need to consult with their IT provider to do the assessment and create the paperwork needed to comply. If you need some help contact Pact-One.
In case you missed it: Dentalcompare article from August.
If you have ever bought an airline ticket online or purchased a book from Amazon you have a good idea of what dental lab communications of the future will be like. It won’t be printed forms, scribbled notes and plastic baggies; it will be an Internet connection..
At the point in the procedure when in the past you reached for the printed lab slip, you will instead log on to the dental lab website. As you log on the system will recognize you and automatically know all the basic details about your practice such as address, account number and phone number. In addition, it will know your preferences as to materials, design and technicians.
via Emmott On Technology: The Digital Future of Dental Lab Communications | Dentalcompare.com.
The rapid development of digital impression systems will make digital lab communications even faster and better. It will be like snail mail compared to e-mail.
One of the biggest obstacles to universal digital lab communications will be proprietary systems. When you take a traditional PVS impression you can send it to any lab in the world using whatever delivery system you choose.
With certain digital systems like CEREC you can only use their network and their designated labs. Closed systems that keep dentists prisoner are great for the vendors but not so great for the dentist. When you are shopping for a digital impression system be sure to let the salesperson or better yet the product manager know that open interoperability is an important element that will affect your buying decision. Until we as a profession demand open systems vendors will keep us locked in their private walled garden.
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At the ADA: LocalMed
One of the few things I saw at the ADA meeting in New Orleans that was truly new and unique was LocalMed an online service that allows patients to actually book an appointment in your office.
I believe we are ready to take that step. Of course you do not allow patients to take control of the appointment book but you can make limited appointment times available. For example you could allow new patients to schedule an exam or existing patients to schedule or change a routine prophy.
LocalMed is still quite new, it does not yet integrate with all the major practice management systems and is expanding both as a service to dentists and to patients seeking a dentist.
I really like the concept and properly set up and managed I believe it would be a great asset for any practice. I predict two things will hold it back in the beginning. Dental practice management systems that do not allow outside parties to work within the software and dental office administrators who see it as a threat.
In case you missed it.
Many dentists spend countless hours and tens of thousands on marketing efforts chasing the elusive new patient while sitting quietly on a fortune.
The ADA estimates the average dental practice generates between $700,000 and $1 million worth of incomplete diagnosed treatment per year. From 20 to 30 percent of your current patients are non-responsive, yet most of them probably still consider you their dentist. Your existing patients are a rich vein of gold just waiting to be mined.
via Emmott On Technology: The Reactivation Equation | Dentalcompare.com.
This Dentalcompare article from a few months ago explores the use of e-services to re-activate patients. Using an e-service does the job for you quickly and with no staff time or software purchase. This is one of the amazing benefits of digital data. Once the computer knows the patient’s name, when they were in last and what treatment they need it is simple for the machine to generate a letter and track who responds.
E-services are greatly underutilized by most dentists and yet they have a tremendous ROI.
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Ontario Dental Association May 2-4
I will be presenting two sessions at the Ontario Dental Association Annual Spring Meeting May 2-4 in Toronto.
ASM.
I am originally from Canada,I was born in Ontario so I am looking forward to “going home”.
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Intraoral Camera and Interoperability
Interoperability is the ability of different technologies from different manufacturers to work together.
UVC is a tech industry standard for use with streaming video devices like web cams, camcorders and most important for us intraoral video cameras. If a camera is UVC compliant it will plug and play with any standard computer both Windows and Mac. This is the essence of interoperability, using industry standards to allow systems from different vendors to work together.
In dentistry there is very little interoperability. Many vendors purposely prevent systems from working together in order to keep you in their closed garden. If a software vendor requires you to use their camera or will only save images by default to a proprietary file format (not a standard like .jpg) then they are attempting to keep you captive.
I believe we should reward vendors who use open systems with our business and complain to those who want to keep us captive. Vendors will not change unless the market compels them to.
With that in mind take a look at two UVC compatible cameras from Imagin Systems the Imagemaster and the more advanced Imagemaster HD
…the first intraoral camera to incorporate the UVC interface video specification (USB Video Class), which makes this intraoral camera the first camera that is totally “Plug & Play”. This camera requires no drivers, just plug it in and it works!
via Imagin Systems Catalog, Intraoral Cameras: Call Us! 650-596-1001 | IMAGEMASTER USB.