Back in Town

Sorry for the missed time, all. I'll get caught up this weekend.

Practiceworks Problem?

There was a warning on DentalTown today about a problem with the latest version, 6.0.1. Apparently, Practiceworks no longer permits users to zoom in or magnify scanned documents. I haven't had a chance to test this out yet, but if it proves to be true, it would certainly rank as one of the dumber moves I've seen from a PMS company. I cannot think of any reason why a company would make a product more unusable than a previous version. Then again, I've long maintained that it makes no sense for Kodak to have two competing software products (Practiceworks and Softdent) and that it would make sense for them to eliminate one of these programs. Hmmmm......

They Say that Backing Up is Hard to Do...

Keep hearing that Neil Sedaka tune in my head...

This is the most common question that I get and there's no definitive solution on the "best" backup. It will depend a lot on which PMS and Image software is running, whether SQL is running, and a host of other factors. However, there are certain basic concepts that we adhere to for every backup:

1. I highly recommend the backup is removed from the office on a daily basis.

2. We typically prefer an external hard drive, such as the Maxtor One Touch.

3. We use a minimum of two drives that are rotated daily out of the office. So, there's always one backup on-site and one off-site.

4. We create separate folders for each day of the week. If you're using two drives, this means you'll have 10 days of backups...enough to restore to an earlier time if the data becomes corrupted.

5. We recommend backing up to at least one workstation that can, in a pinch, act as a temporary server.

6. For SQL databases, it might be easier to have a server with hot swappable RAID drives so that one of those drives can be used in an "emergency" server should the main server fail.

7. The backup should be handled automatically by software...the less input from the office, the better.

You can't backup too often and I usually try to find out where each dentist's comfort level lies when designing a backup protocol.

Aloha

Sorry for the lack of updates, all...I've been on vacation in Maui since Saturday and I'm running a few days behind. Just did an amazing 38-mile bike ride down a volcano today; very fun. I'll get caught up shortly.

Lorne

Treo is Tee-Riffic

Just got my Treo 650 today, and I have to tell you, I'm really liking it. I was a Palm fan way back in the day until the Pocket PC devices came out. I found the integration between the Pocket PC and my computer to be tighter than it was with Palm, but because of limited functionality, the PDA didn't do much for me.

The Treo seems to have it all. Not only is it a phone but also a PDA. The coolest feature for me, by far, is the Wireless Sync I have with Verizon. Basically, any changes to my Inbox, Calendar, Tasks, or Contacts get "pushed" to my Treo automatically. So, I can get my email and reply while I'm on the road (which is a lot as many of you know) and I can leave Tasks for my Business Administrator as well. I can do that already with my laptop...assuming there's a Wi-Fi hotspot around and that I don't mind paying $9.95 for the connection (and believe me, I do mind). The Treo isn't as zippy as Wi-Fi, but it seems fast enough for email and basic web surfing to check flight departures, weather, and a host of other things. Very cool so far...I'll let you know how I fee when I get back from my vacation next week if it was put to good use.

A Match Made in Heaven?

While this news is not brand new, it's still pretty significant: starting in 2006, Apple will be shifting their systems away from the current PowerPC processor to an Intel platform, with the goal of being totally Intel-based by the end of 2007. This is an interesting strategy, since a company with very small market share takes a huge risk by shifting platforms. They will lose customers that they cannot afford to lose. The other big question is whether it will be possible to use Mac OS X on any run-of-the-mill PC, which Apple has never allowed to happen in the past. Should be very interesting to see what happens in the next 2 years.

The Big Easy

It looks like Easy Dental is releasing an image management module for their PMS suite. The web site doesn't tell us much. This is a curious strategy for Schein. Easy Dental is still one of the top systems in use based on the number of users. However, Schein has always marketed Easy Dental as "Dentrix Lite": Easy Dental for the office that requires only the most basic of features, and Dentrix for offices that need imaging and other components. With Easy Dental being priced at a fraction of Dentrix, I'm interested to see how this will affect the bottom line. I also would like to find out which digital sensors work with Easy Image. If I was a betting man, I'd bet the list is identical to Dentrix Image/Vipersoft.

Why Not Both?

One of the questions I'm often asked is about which digital radiography system is "best", sensors or phosphor plates? As most people who read my DentalTown posts are aware, I don't believe there is a right or wrong or best; I just try to find what is best for each office. When it comes to digital radiography, we are seeing more and more office eliminate this decision by getting both. The phosphor plate system provides an easy transition from film, takes good images, and is easy on the patient. For those times when an immediate image is desired, the hard wired sensor can be used, such as for implants and endo. Sure, this combination isn't cheap...it will run $16,000 to $27,000, depending on which sensors you get and whether you want or need pan/ceph capabilities from the system. And, of course, you'll need to plan out the image software decision since not all sensors and phosphor plate systems work together (and having separate programs would be a nightmare). However, this is an excellent option for any office to consider.

New Dells

Dell has recently announced two new additions to the Optiplex line, the GX 520 and GX 260, which you can read about here. While I am always a fan of new technology, I'm not at a point where I can recommend these systems...yet. The area of concern is the video options. On Dell's site, they say that the GX 520 handles dual monitors...yet, when you try to configure it online, there are no options to change the video, which is built into the motherboard. The GX 620 does offer dual display...but only one VGA and the other is TV-out. You'll need an optional DVI cards (and DVI-VGA adapter, most likely) if you want to do two monitors in the ops. These systems, as they stand, appear to be better suited for the front desk than ops at the present time.

Share and Share Alike

There is no doubt that there are certain products that dominate the market. As an example, Microsoft Office has a lock on the office-suite software market. While I use it daily and don't see how I could function without it, I also realize that many folks are not fans of Office and have found other comparable programs. Some are using Office, but version that are 5 years or older. However, since I want them to be able to read new Office documents I send, what do I do?

The solution is to get either a viewer or a converter. These programs will allow someone who doesn't own the software to still be able to read the documents. If a document comes to me in a format that I normally could not read, such as Wordperfect, I can still convert the document into MS Office format.

The best collection of these viewers and converters can be found right here on Microsoft's site.

Image is Everything

So, you've managed to create a perfectly humming, stable system. How do you ensure that you can return to this scenario? While most backups are designed to backup your crucial data, they won't help you to restore a system state. For that, you'll need to image your drive.

Imaging involves using software to create an exact image of your entire computer system, so that you can return to this state should the system become unstable. One of my favorites is Acronis True Image, which costs $50 for a home computer. You can get their server version for $700, but Windows 2003 Server already has a free built-in program called NTBACKUP which works fine. The other well known product in this category is Norton Ghost, which runs $70.

Searching High and Low

Almost everyone who is online is familiar with the better known search engines: Google, Yahoo, MSN...the list is endless. But what if your search is closer to home, like your own computer?

There are a number of products that do just that and it's the latest rage in search technology. Often called "desktop search", these are basically indexing software. The program will search all of the content on your hard drive and then index the results: emails, MP3s, photos, MS Office documents, basically every file on the computer. With the index constantly updating, you can search for a document, for example, by entering any word or phrase in that document and the results will be displayed in under a second.

My personal favorite, and the one I use every day, is called X1. I can instantly find any email or proposal I have sent out. The downside? Well, two come to mind. First, it cannot search through Outlook Tasks or the Calendar, which is something I would really like it to do. Secondly, it costs $75 for the program.

If you want the ability to search Outlook Tasks and Calendar, the only desktop search that I know of that can do this is MSN Windows Desktop Search. This program is free. Other search programs that are good include Google and Copernic, which are also both free.

Claris Revisited

Just got back from an installation in Maryville, Missouri, where we installed a couple of Claris cameras. I have to admit that these installations are about the easiest I've ever done. Plug the camera in, attach the RCA cable, attach the capture cable, and boom. Great images to boot. I find them to be on par with fiber optic cameras and definitely better than most other USB LED cameras. This is now the number one system we recommend and we have about 10 more to install in the next couple of weeks. Kudos to Sota Optics.

For those who are interested, the retail cost for the USB version of the Claris i310 is $3990. Of course, Dental Technology Consultants can get these systems for a minimum 10% discount.

Mac Mayhem

In a previous post, I raved about two new Mac products for dental offices that I saw at the CDA, idental and MacPracticeDDS. Based on how these companies have been behaving on DentalTown, I would have trouble recommending either of them. The story reads like a soap opera: bashing each other's products, misrepresentations of the number of users, people with obvious financial connections to the companies pretending to be users of the software, espionage at the CDA meeting...the list goes on. Both of these companies should realize that they look foolish airing their dirty laundry and should spend more time making sure they have usable products and happy customers, which, based on the responses on Dentaltown, are both in short supply.

Difoti Going Bye-Bye?

I had heard a lot about the Difoti system, a very high tech transillumination system for detecting caries, fractures, etc. I finally got to see the system in action at an office in Santa Monica. While I was impressed with the technology, I was less-than-pleased to see that the system uses an extremely proprietary capture card, making it impossible to integrate the images with image management software and other systems. I wanted to speak with them at the CDA, so I went over to their booth...which was empty. They didn't show up. Now, I hear through the grapevine that they are focusing their efforts on their other product called Melafind, a similar product used to detect melanomas. My sources tell me that the company is shopping Difoti around to potential buyers, and I wouldn't be surprised to see a Kodak or Patterson buy it out. That's too bad...I always enjoy working with small innovative companies as they have great products and excellent support. At the present time, it would be tough to give a "Buy" recommendation on Difoti.

Disappearing Discs?

It used to happen to us frequently: Client would call and had done something to a system and needed to re-install a program, drivers, etc. Easy, just go get the disc and re-install the software. Now, where is that disc that they haven't seen in over a year...? You can see how this became a difficult challenge.

For the past year or so, we've made a copy of every disc we use in our installations and place that in separate folders on the server. That way, whenever we need to reload software or drivers, we just point to the folder on the server, rather than spend hours hunting for the discs that are tucked away gathering dust somewhere. I highly recommend this for any office with enough free space on their server. It will be a real timesaver at some point.

Head North, Young Man

While most of the products we purchase are for our US customers, there are many dentists in Canada who can take advantage of the different systems available. Being a Canadian myself, I know that the dentists there are just as technologically advanced as their counterparts below the 49th parallel.

For imaging, my favorite product is CaptureLink. Easy to use, good pricing, works with PSP and sensor-based systems. Other good systems include Adstra and Tracker.

The Dell Dilemma

We often recommend Dell systems to our clients (as in, 99.9% of the time). One frustrating thing for us is that when we quote a system that comes in around $1100, some people complain that they just got a flyer from Dell advertising a similar system for $500 or so. It's important to understand exactly what you get with these "specials" from Dell:

1. The processor is either the almost-obsolete Pentium 4 2.8 or even worse, a Celeron processor.

2. The Operating System is Windows XP Home, rather than the far superior XP Pro.

3. There is usually only 128-256 MB of RAM, well below the 512 MB minimum we recommend.

4. Warranty is either non-existent or 90 days, rather than the 3 years of Gold support we suggest.

5. Optical drive is CD-ROM. Many offices want to be able to play DVDs, so a DVD player is the better option.

6. Graphics chip is built into the motherboard. There is no option to upgrade the graphics or add dual display for operatories.

As you can see from the above, we rarely recommend systems like these as they are underpowered, have poor components, and inadequate warranty and support. Is it really worth the risk to save a few hundred bucks on something that is so critical to the smooth running of your practice?

Krazy Konfabulator

For those who have fallen in love with Mac OS widgets, there is now a PC version called Konfabulator 2. For lack of a better description, these are small "Post-It" style notes that you can position on your desktop. However, unlike Post-It's, these are dynamic notes, such as weather, traffic, baseball scores...you get the idea. Very cool and fund; there are around 600 different ones to try right now.

Windows 98 is Not Fun

Well, just got back from two days of hell in Virginia. Went in thinking this would be one of the easiest installs I've ever done: convert a Vipersoft database into Apteryx, configure the intraoral cameras with Apteryx, set up the backup...sounds pretty tame. Until I got there and realized that the office was using the first version of 98, not SE. Vipersoft was version 2.0...too old to be converted by me locally (I had to ship it off to Apteryx). The 98 machines with the Viper PCI capture cards couldn't handle capturing in Apteryx, and installing Hauppauge cards was an exercise in frustration. Sigh. Guess I learned my lesson the hard way.

Email Ecstasy

Looking for an inexpensive, easy way to send out marketing to your patients? We've been recommending Constant Contact for years. For about $15-$50/month, you can send out very professional-looking HTML e-mails that will really grab people's attention. Here's an example. They also make it easy to opt-out, to track who clicks through to your web site, etc. Highly recommended and they offer a free 2 month trial.

Making Money from your Website

Did you know that your can make money by allowing Google to place relevant ads on your site? If you look in the right-hand blue bar in this blog, you'll see that there are 5 ads for companies whose products and services are similar to the things I talk about in my blog. This is part of a program called Adsense. You get paid every time someone clicks on one of the links (so please click mine!), and have complete control over not having certain sites be included. For example, I try to filter out any medial imaging companies and have just dental companies shown. As it turns out, many of the ads are for companies that we already recommend to our clients, so it's a good fit for us. They give you the code so that you can easily insert, or have your web designer insert, the code into your site. Took me about 5 minutes to set it up. Not a huge money-maker (I made about $40 last month), but hey, why not? $40 is a free month of online access through my ISP.

Taming the Tiger

I had a chance to get a full demo of the Pro version of Tigerview. I have to tell you, I was very impressed with this software. I've never had much experience with the older versions, but the Pro was really slick. Scan-X images looked good, full customizable, works with some hard sensor systems, etc. Definitely on my list of software products to recommend for folks who are interested in adding digital radiography. I still like both Apteryx and XDR, and all three systems have their strengths and weaknesses.

Networks 101

I know many of the offices we work with also have home networks as well. While setting up an office network can be a challenge, it doesn't have to be this way at the house. Enter Network Magic, a nifty little program. For $50, you can use the program to network up to 5 computers at home. You can use it to help with some of the more difficult and annoying tasks, such as sharing printers, sharing files and folders, setting up your router, etc. I've played around with the demo and find it really easy to use and configure. They offer a 14-day trial online.

HIPAA Hype

As a consultant who travels to offices all across the country, I'm surprised at the number of offices who seem to be caught in the HIPAA hype. For me, this is the same hype we saw with OSHA back in the early 90's, and I expect the end result to be the same.

Basically, HIPAA mandates a certain level of measures that must be undertaken by health care facilities to protect the confidentiality of patient records. There appear to be a lot of companies out there selling HIPAA compliance kits, and most of the sales pitches and information I've seen appear to be dead wrong. For example, I've seen some of these kits that determine that encrypted e-mail is mandatory. Nothing could be further from the truth.

The key area of the specification is found on page 8336 of the HIPAA Final Rule, which you can read here. The key point is that certain parts of the specification are required and certain parts are addressable. Addressable means that the facility has flexibility in how they implement the specification. The law actually states that it's up to each practice to determine what's reasonable, which I think is great. Basically, you need to institute their recommendations. If you feel that they are unreasonable and that an alternative exists that meets the standard, then you institute that. And, if you think that no alternative exists, you document how you are meeting the goal of the standard. So, it really is up to you to decide how you want to protect that data. They will certainly give you recommendations (like encryption), but nothing in the law says you must follow that recommendation.

HIPAA, like OSHA before it, has different applications for hospitals and dental offices, so I would recommend offices read the actual document rather than pay large amounts of money for kits that often are incorrect.

Browser Wars are Back

While Internet Explorer is still the dominant web browser, their market share continues to shrink. The browser that one dominated at over 95% market share has slipped to around 83-87%, depending on which survey you read. There are a number of alternative browsers that are getting a lot of press:

1. Firefox. Great browser with many features and plug-ins. On the downside, it doesn't work with certain website that require IE (DentalTown's Rich Text feature doesn't work), and the first reports of security holes and virus attacks are starting to surface.

2. Opera. Also a nice program that is more advanced and stable than Firefox.

3. Slimbowser. This is the one I actually use every day. I like the tabbed browsing, but also the ability to use the Google Toolbar (many browsers don't work with the new toolbar) and RoboForm, which allows you to easily fill-in web pages that ask for your personal information, passwords, etc.

4. Avant Browser. Also very promising although it doesn't work with Google Toolbar.

Almost all browsers are free so give them a try. You'll be amazed at how much better some of these are to Internet Explorer. Then again, Internet Explorer version 7 should be out this summer with many of the features that these other browsers now have. It should be interesting.

Scanning the Horizon

As more and more offices start to use digital radiography, there becomes an increasing need to be able to scan film images into the image management software. Many offices have no film processor and thus, cannot duplicate films.

The industry standard for many years has been the Epson 1680 Professional. The Professional model is the only one with the Transparency Adapter, which is necessary for scanning x-rays. Some offices have been getting the newer Epson 4990 lately. The concern with this scanner is that it only scans 8" X 10" transparencies, which is often too short for some pans and many FMX series in their mounts. The 1680 can scan up to 11.7" (their web site incorrectly says 10"). Other models that should work for dentistry include the Microtek 9800 XL and a few of the UMAX models.