Florida Probe Voice

At the Chicago Midwinter:

Another new product I saw in Chicago was a new voice activated system from Florida Probe.

Florida Probe has long been a favorite product of mine for many reasons. With the new voice system they have added a third way to input periodontal charting data to a digital patient record.

Voice activated perio has been around for some time and has had limited acceptance. However voice recognition technology is improving all the time and the new Florida Probe wireless headset is easy to use and easy to train. See the demo below:

The three entry systems are direct input using the digital probe, a remote number pad called go-probe and now voice. In fact there is a fourth option using the probe and voice together in a “hybrid” option.


Dentrix Ascend

Dentalcompare e-Services Internet Paperless Security

Sending Dental Patients to a Specialist Without Sending Paper

Dentalcompare article:

The final step in the truly paperless office will not be some device in the office. It will be more creative use of the Internet.

via Emmott On Technology: Sending Dental Patients to a Specialist Without Sending Paper |

Management Security

How to Make Your Data Last Forever

This has been an issue ever since the library at Alexandria was burned in 48 BC.

Because there’s no single, perfect digital archiving solution, the key to making our data last forever is good habits. We need to be vigilant, continually moving our data forward to new formats and keeping it on multiple devices—before whatever we have becomes obsolete or simply fails. The best protection we have against data loss is redundancy—and lots of it. (Emphasis mine LE)

via How to Make Your Data Last Forever – Popular Mechanics.

There are two different but related issues here. One is protecting our data from a sudden catastrophic loss. This could be a fire, a flood or some other natural disaster plus the more ominous computer age disasters, a hard drive crash or malware attack.

The second issue is preservation of our data over time. Even a great digital copy of our data has no value if the device or the application needed to retrieve the data is no longer available. Think eight-track.

In dentistry we are far more concerned with the first issue than the second but both are important. We do not really need to worry about preserving our data forever but we do need to worry about preserving it until the dental / legal statute of limitations has passed.

The danger here would be data stored on an old system that has been replaced. Consider this unpleasant scenario. A patient you treated for a short time six years ago decides that you mistreated her and files a malpractice suit. You upgraded to a new computer system, both software and hardware, four years ago. Following best practices you made and verified a complete back up of all your data at the time of the upgrade. Now you need those old records.

Here is the likely problem. The backup media cannot be read by your existing hardware and the old machine that could read it is nowhere to be found. But even if you could dredge up an old reader you do not have a copy of the software to access the data. If you can find the software it is not the right version.

What can you do? The linked article makes this suggestion:

Because there’s no single, perfect digital archiving solution, the key to making our data last forever is good habits. We need to be vigilant, continually moving our data forward to new formats and keeping it on multiple devices—before whatever we have becomes obsolete or simply fails.

That is sound advice yet it is extremely hard to follow and I know of no one that is doing anything like that.

On the other hand there are well established methods to protect against a sudden catastrophic loss. Backup, backup, backup.

  • Backup one is a redundant server hard drive, some sort of RAID.
  • Backup two is a full local copy to a removable drive that is taken off site every day.
  • Backup three is an automatic incremental backup to the cloud at regular intervals several times a day.

PS, In theory full cloud based applications like Curve Dental will solve both these problems.

Health Care Politics Paperless

Diagnostic Coding Kerfuffle

From Dr. Bicuspid:

With the proliferation of electronic health records (EHRs) and a growing emphasis upon accountability in healthcare, diagnostic coding will become increasingly important

via Dental Practice Management.

I read this in Dr. Bicuspid, found it interesting but frankly did not care much for the attitude of the guy they quoted from UCSF. However I am for anything that will advance the effective use of technology in dentistry. Then I found the following from Titus Schleyer. Quite frankly Dr. Schleyer knows a whole lot more about this than I do.

Does dentistry really need more than one diagnostic vocabulary?

In case you had to guess, the answer is “no.”…

So, what should we make of all of this? I fear that neither effort at developing a dental diagnostic vocabulary will produce a very satisfying result in the long term, unless some radical changes are made. Even worse, the tug-of-war and duplicate work consumes precious resources that dentistry, as a profession, can ill afford to waste.

Read the whole thing here: The comments are interesting as well.

Dr. Schleyer makes a number of well-informed remarks; however in my opinion the most interesting is that the whole concept of a vocabulary is out of date. Vocabularies are being replaced by computer ontologies which are far more powerful and sophisticated tools.


It Could be Millions

We have the same issues in our dental offices. The cost of the paper we produce is hidden in the cost of doing business and we have no idea how much it actually costs. In the dental office it isn’t millions but it is tens of thousands. The EOT Tech guide on going paperless has a section on costs and budgeting that shows a $40,000 per year cost.

Paperless records…when done properly…will save money.

Dental Speaker Paperless

Stop Making Paper

My latest article in the Sacramento District Dental Journal, Nugget.

It is a truth universally acknowledged that in order for a dental office to go paperless you must stop making paper.

August/September 2012 Nugget.

Dental Speaker

Webinar Tomorrow July 26: Workflow is Data Flow

Much of the work of a dental office revolves around creating, adding to, storing, retrieving and moving around dental records. The records, including chart notes, diagnostics, financial and schedules are the critical data of a dental office. When the data is on paper it can only be in one place at a time so we assign work to a specific place (like a front desk) and a specific person to that place.

With paperless (digital) records, work flow changes radically, it can now be described in terms of tasks not places. This has been called Front Desklessness.

via Event Registration (EVENT: 494828).

Management Security Software

Ease of Use = Ease of Abuse

The Dr. Bicuspid article linked below makes a point I have often written about (here  and here) The unfortunate truth is that the qualities of digital technology, speed and ease of use, that make it so powerful when creating dental records are the same qualities that make it easy for thieves and hackers to exploit.

When compared to paper records, EHRs make it easier to input, duplicate, store, retrieve, manipulate, transmit, and archive patient data, the authors noted. However, the evolution from paper to electronic charts has also prompted concern for the safety and privacy of patient information.

via Dental Practice Management.

The article is centered on academics and the concern that electronic records could be manipulated by students. Of course there is the same concern in the real world, that unscrupulous persons could manipulate and abuse your medical dental record. On the other hand the article points out that the people who are developing medical and dental electronic records take this issue very seriously. There are substantial safeguards already in place to protect personal medical data.



Phishing is an attempt to obtain information  such as usernames, passwords, credit card details (and sometimes money) by impersonating a trustworthy source (like your bank) in an e-mail or other electronic communication.

If a staff member falls for one of these scams it could put the security of your system at risk. You could face losses from credit card fraud or even fines for failing to protect patient data.

The following PC Magazine article discusses a system that trains employees how to recognize and deal with Phishing.

Malicious emails with booby-trapped attachments or links to suspicious websites flood user inboxes daily. While businesses are investing in spam filters and advanced scanning tools to prevent these messages from showing up in the inbox in the first place, it’s also important that regular users be alert and recognize the malicious few that still make it through. After all, just one user opening a loaded Word document can compromise the entire company.

via PhishGuru Review & Rating |

Hardware Paperless

Minimum Requirements to “Go Paperless”



Having a single computer or carrying a laptop from room to room will not work. In order to be paperless the office needs a server – workstation network.

“Cloud” based systems are an interesting alternative to this classic model. With a cloud system you would just replace the switch with an Internet router and the server would not be in a closet in the office but would be located off site somewhere (anywhere) in a big “server farm”.

Never the less as cool, hip and happenin’ as the cloud may be most dentist will still be using a locally installed network as described here.


This is the central computer where all the data is stored. Most offices should have a dedicated server running specialized server software.

Front Desk Workstations

These are the computers at the front desk. It is not a good idea to have one of these as the server.

Treatment Room Workstations

It seems obvious however some dentists still resist this. If you wish to enter chart information and review it the office must have computers in the treatment rooms. All of them.

Doctors Office Workstation

Another area of resistance. As a busy dentist you may not spend much time in a private office, however when you are there it is almost always to do something that requires access to chart data. For example, writing notes, reviewing x-rays, creating treatment plans, and talking on the phone with a specialist or referring doctor.

Besides you need a computer to fool around on the Internet.


Remember you have a paperless record not really a paperless office. You will print statements, estimates, letters, photos and more.


A flatbed desktop scanner with a transparency adaptor is ideal. If you do not wish to scan x-rays the transparency adaptor is not needed.

Digital Radiography

This is the only Diagnostic that is required to get started. Either a sensor system or a PSP “wireless” system will work, however I much prefer the sensor systems. Other digital diagnostics such as cameras are desirable but not essential.

Need More Help? The article above is an excerpt from The Emmott on Technology Tech Guide;  Going Paperless in the Dental Office.

Dental Speaker Internet Security

Who Owns the Data?

Follow this link to my most recent Inscriptions article on a very important subject we will need to pay more attention to in the future;

Who Owns the Data?


If you ask patients the immediate and unequivocal answer is that they, the patients, own the data. That seems right, each patient should have control of their medical information. In fact however that is not how the system works.

Internet Security

Stanford Hospital Patients’ Private Data Was Posted Online

Another frightening story from the NYT of patient data exposed online.

A medical privacy breach led to the public posting on a commercial Web site of data for 20,000 emergency room patients…

Two items struck me about this story.

  1. The cause of the breach seems to be unknown, probably foolish and inadvertent and simply the result of human error.
  2. Even though the error is unerving and scary sounding, absolutley no one was damaged by it.

via Stanford Hospital Patients’ Private Data Was Posted Online –

Dental Speaker

Wilmington Delaware March 11

I will be presenting an all day meeting for the Delaware State Dental Society on March 11 in Wilmington. The primary topic will be going paperless with lots of Internet and digital communications as well. For more information: Delaware Meeting

Health Care Politics Management Paperless

Paperless Dental Records by 2014

Have you heard that there is a new government regulation that requires dentists to have electronic records by the year 2014? I have heard or read a number of variations on this theme in the last month along with various rants and dire warnings regarding the alleged new rules.

Let’s get the really important information out there right now; at this time there is no federal requirement for dentists to be using paperless or electronic records by 2014 or any other date. What there is is a lot of confusion, speculation and scare tactics the same as we saw when OSHA and then HIPAA first plagued the dental profession.

However, as a dental practice consultant, setting up an electronic dental record (EDR) or what is commonly called “paperless” dental records makes sense for many reasons even if the law does not yet require it. Paperless records are: faster, more accurate and less expensive than traditional paper records.

EDR are in essence part of the complete electronic medical record or EMR. This is good as dental health is of course part of overall health and many general medical conditions are important to dentistry and dental conditions affect general health. On the other hand, it is bad as dentistry has become lost in the much larger battle over creation of an EMR which has many more players and much more money involved than we have in dentistry.

In 2004, President Bush set a ten year goal for most Americans to be using an EMR by 2014. The current administration through the dept of Health and Humans Services (HHS) has made stimulus money available to health care providers to help them get paperless by 2014. I assume dentists could get in on this federal stimulus give-away although it is obviously designed for hospitals and physicians.

All of this is made more complicated by the political circus that has become healthcare “reform”. Bureaucrats are meeting to come up with the actual rules and the speculation is that some deadline will be imposed. When that will be and what the rules will be is anyone’s guess. In the meantime don’t wait around for some bureaucrat to tell you what to do, develop EDR for your office just because it is the right thing to do.