Kodak Koncerns

Many of you who follow my posts on DentalTown will recall that I expressed a lot of concern when Kodak purchased PracticeWorks back in 2003. While support was terrible at first, anecdotal reports I got seemed to indicate that things were improving. Well, a recent thread on DentalTown seems to present a less encouraging picture. Now, I know that people who post there don't always present the straight facts, so some information must be taken with a grain of salt. When there are multiple posts that support the first, though, you need to realize that some problems may exist.

According to the thread, there are two areas of concern:

1. Kodak seems to have zero stock of sensors and cannot provide sensors to new purchasers until October. If this was just an issue for people buying the new sensors, it wouldn't be an issue. The problem is that these same new sensors are due to folks who have sensor failures under warranty, meaning they have to wait over two months for a new replacement. Now that is a problem. It seems that Kodak will offer a refurbished sensor if pushed (and pushed hard), but if the warranty calls for new sensor replacement, then this should not be acceptable to their customers.

2. The service and support problems seem to be ongoing. There are posts about people being turned over to collections for balances they do not have, software updates that are not sent out unless multiple requests are made, and follow up phone calls that are never received.

I've said this many, many times before, and it bears repeating: Just because a product is owned by a large, financially solvent company does not mean this is a good thing for the end-user. I've seen how all the companies, including Kodak, Patterson, and Schein, are trying to lock dentists into their product lines, and frankly, it is rarely in the dentist's best interests. The whole concept of "integration" is a major marketing force, but that's really all it is. If you are planning to keep your high-tech products in one company, make sure you understand all of the ramifications, including the costs of support and warranties, and the limitations you'll have to add components from other companies down the road. I would never talk someone out of this "one stop shop" concept if they feel it's best for them, as long as they understand the long-term implications.

You Say Goodbye, and I Say Hello

Well, after a frustrating month with my Treo, I finally decided to make a switch to the new Samsung i730. All I can say is, WOW. What a difference. The Treo isn't a bad unit and mine worked fine, but it didn't work with Wi-Fi (a big negative for me), didn't do a great job with Office documents, and wouldn't allow to use our web-based support software which required IE. The Samsung is a huge improvement, with built-in Wi-Fi and IE. There's no camera, which I never needed anyway. The only annoyance is that when you go to Wi-Fi, it disables the phone, which then must be manually turned back on. Other than that, it's a great unit and highly recommended. I was also fortunate to find a buyer on eBay who used the Buy-it-Now to purchase my Treo in less than 2 hours.

Put it in Writing

If you want to document your network and settings (which we do for all of our installations), there are some great resources to make the process easier. One of the best is the Network Documentation Workbook by Karl Palachuk. This book is based on the working papers and forms used by a real small business technology consultant. The book comes in two flavors—the standard edition with printed forms (39.95 USD) and the consultant's edition which also contains a CD with editable electronic forms (89.95 USD). Here's a link to a sample form and table of contents.

We Are Not Alone

I am always on the lookout for interesting blogs on technology. One of the most impressive ones I've seen to date is John Jolly's blog. Highly technical but highly informative. Only a few articles so far, but I've been told there are more to come. How do I know? Well, John happens to be one of Dental Technology Consultant's technicians, so I'm obviously quite proud of his accomplishments.

Mirror, Mirror, On the Wall

A very cool technology that should become more popular in the next few months is the Mirroscope. This is basically a fusion of different systems: think mirror, loupes, microscope, and intraoral camera all rolled into one, and that's the Mirroscope. It should be a lot easier to use than intraoral cameras. I've not seen one in action so I cannot comment on the image quality, but the concept is very interesting.

Skype-ity Do Dah

I've been really impressed with the Skype service. For those who haven't tried it, it's a combination instant messaging service and VoIP service, where you can speak to other Skype users by just using a headset connected to your computer. The cost? $0...worth a download at the very least.

Podcasting 101

One of the newest forms of distributing media online is known as Podcasting. While some of the first ones were geared towards the iPod, most can be used with any MP3 player or your desktop media software (like Windows Media Player). Podcasting, in simple terms, is a feed of audio that can be downloaded into your software. It's very similar to RSS feeds for news, except it typically is used for audio. Wikipedia has a great definition and history of podcasting that you can read about here.

In the dental realm, the one that I am most familiar with is the Dentalcast Podcast, which was developed by David Dodell, the person who started the Internet Dental Forum. Look for yours truly to be on their next podcast.

Apples to Apples

One of the most challenging tasks for dentists who are evaluating high-tech products is to find an easy way to compare the different products in an easy-to-understand format. Enter DentalCompare. This excellent site makes it easy to see the stats of literally thousands of dental products, plus giving you the ability to contact the manufacturers directly. There are a number of good articles (I think they could benefit from a few from yours truly) and the site is well designed. Highly recommended.

Online Backup

As many of you know, I feel that backup of your data is the most critical component of a digital office. While I normally prefer external hard drives that are removed nightly from the office, I realize that even this simple chore is a challenge for some busy offices. In those cases, online backup makes a lot of sense. While there are a number of services that provide this, my favorite is DataSavior, which is run by my friend Brad Callis, who I'll be meeting on Monday in San Antonio. Brad is one of the brightest people I know and posts frequently on IDF and DentalTown. His system uses proprietary software to speed up the process to ensure your data gets to their servers where it is constantly available and monitored. I definitely recommend this service for people who want an alternative to physical backups or as an addition to their current backup protocol.

Help is on the Way

Got this from my friend, Pat Williams, Head of Technical Support at Apteryx. We had noticed a few offices could not open the Apteryx help file recently so here was what he found:

Lately we have noticed a growing number of offices experiencing Windows inability to view CHM HELP files.

This is a fix for the problem.

ftp://64.32.240.32/WindowsHelpFix/

This is a registry editing script that adds the necessary keys for windows XP to view CHM help files.

Here are some facts about the problem:

When you open a CHM file from a UNC path or from a network drive even if the network drive is mapped to a drive letter, the HTML Help viewer opens and instead of displaying the topic, it displays an error message "Action cancelled" in the topic pane.

The Microsoft Security Update 896358 restricts execution of HTML Help files to the local machine zone. In fact it disables half of the CHM files in the world (the other half is installed on the C: drive).

Batten Down the Hatches

Ever wonder if your network is as secure as you think it is? (Hint: If you answered yes, you're probably wrong). There are some excellent an inexpensive tools to find out.

Microsoft has a free one called the Microsoft Baseline Security Analyzer, which will check for the latest patches and security updates on your system. For a complete look at any vulnerabilities, then you'll really want to use a program that includes a port scanner, which will scan your internal network as well as your firewall for known vulnerabilities. An excellent one is NeWT Security Scanner, which can also be downloaded for free. Other ones include AppDetective, and Internet Scanner.

Bursting the Balloon

If you're like me, you probably hate the balloon pop-ups that you get with Windows. Here's how to eliminate them:

Go to Start, Run, type Regedit. Once the Registry Editor opens up, go to HKEY_CURRENT_USER > SOFTWARE > MICROSOFT > WINDOWS > CURRENT VERSION > EXPLORER > ADVANCED. Right click anywhere in the right column, select NEW, DWORD VALUE, and call it EnableBalloonTips. Double-click this new entry, then give it a Hexidecimal value of 0. Close and restart your computer.

*Note: I highly recommend you backup your registry before you do this...registry changes can be very difficult to correct.

Wireless Wonder

One product I'm constantly asked about are wireless headphones. Many offices want to allow patients to watch DVDs or patient education or listen to music. The problem we've had with most wireless headphones is that due to the amount of circuitry in the earpiece and battery pack, they are large and bulky, which affects the patient's ability to turn their head side-to-side. The best wireless headphone I've seen is the Motorola Bluetooth Stereo Headset HT820, which is combined with their PC850 Bluetooth USB adapter. The only place that was selling it for US customers was Skymall, that magazine you find on most airplanes. It appears that Motorola is redesigning the headset and should be releasing it in September, although you probably can buy it if from an online merchant that specializes in imports.

Dumb and Dumber

About a month ago, I commented on the fact that while I was excited about the two new dental software programs for the Mac, MacPracticeDDS and iDental, the companies seemed to be shooting themselves in the feet by bashing each other on DentalTown. Well, it appears they haven't learned any lessons. On a recent post on DentalTown, I responded to a post and said that when we start to see more posts from folks without a financial investment in the company, I would take more notice. In response, one of their "investors" launched a personal attack, accusing me of being biased and twisting my words around. Smart...try to win converts by bashing the forum Moderator.

The same day, I received the following (slightly edited) e-mail from one of our clients:

"Lorne. FYI. We where about to dump our PC-based PMS program. We missed the Mac. MacPractice shot themselves in the foot trash talking Heathware. So Healthware offered us a deal. They would give us the software for one year of support. This was for about $1500 + or -. They said they had all the software except the scheduler. 3 weeks later no software and our credit card was charged $3000. We found out they did not have the software ready and said we misunderstood the offer. I don't think so. It took about 4 weeks to get the refund. The good news is we are now ready to accept our PC-based PMS program."

I've alluded to this before, but allow me to spell it out: Neither of these products are on my recommended list. One appears to be nowhere near a finished product, and one spends more time on DentalTown bashing anyone who questions their product than any other marketing I can see. I will be re-evaluating these products in early January, 2006, but until then, caveat emptor.

Accent is Blue (Literally and Figuratively)

A while back, I mentioned that my friends at Air Techniques were coming out with a CCD hard sensor, to supplement their popular Scan-X system. While I was worried about the rationale of the move, since we often recommend both a sensor and PSP solution to many offices, I think the hard sensor is a smart move on their part.

They recently released the specs and prices for their new Accent sensor. The first thing you'll notice is that the sensor is a nice shade of blue. Cygnus, which was bought out by Progeny a few years ago, was the last company to have a colored sensor. The specs are pretty typical for a hard sensor: two million pixels for the #2 sensor, one and a quarter million for the #1. The sensor, at 5.7 mm width, is a tad on the thick side, although I've never found sensor thickness to have much affect on comfort. The big news, though, is that Accent uses Bluetooth technology. There will still be a cord from sensor to controller box, but there's a bluetooth option to connect the box to the computer, which will open up many possibilities for where the sensor is mounted in relation to the x-ray head. Cabling becomes a lot easier.

Pricing will vary depending on whether you get it with a Scan-X or not, but it's in the $7500 to $8500 range if purchased standalone. And no, Dental Technology Consultants will not be able to sell these...they will only be sold by Air Techniques distributors.

Brawny Backup

We are constantly evaluating new and more secure ways to handle backups. As offices become more and more digitized, the importance of the daily backup rises. One product that I've very excited about is the OfficeStor. Basically, it's designed to be set up with one unit in the office and one at the home. Each unit is an enterprise-level RAID 5 "server" that is pretty bulletproof and stable. Through use of a program called Rsync and SSH (you can read about it here, but trust me, you do not want to try this on your own), it will sync up with the home unit. So, instead of needing to take a drive home with you, your current backup will already be at home by the time you get there. I'll be evaluating the system over the next few weeks, but so far, I'm very impressed with the concept. I first heard about OfficeStor through Tom Block on DentalTown and I'm sure he can answer more specific questions.

DTC Makeover

Well, our new and improved website is finally online. It's still a work in progress as I add content and try to move my blog over to the site (I will need to add each old post manually, one at a time...ug!). But feel free to visit us at The Digital Dentist and let me know your thoughts.

Dexis Marries Dentrix?

Well, I can't say I saw this one coming, but here it is: Dexis has entered into an agreement with Henry Schein, the owner of Dentrix practice management software and ImageRayi digital sensors, to distribute the Dexis line of sensors and software. You can read about this here. All I can say is, "Huh?"

This one makes no sense unless there's something else going on that I don't know about. You've got two sets of sales reps who have literally spent years bashing each other. While both are very good products, there is no love lost between the reps who are constantly battling for a relatively small market share. Now the Schein reps have to offer Dexis to their clients? I just don't see how it's going to work. I'm sure we'll be hearing the expected corporate spin about how great this is for both companies in the upcoming days, but I will be very curious to see how this plays out. Although I have absolutely no evidence of this, I would not be surprised at all if the Dentrix product line as we know it isn't radically changed in the next 12-18 months.

Dell Dropout

As of today, the Optiplex GX280, long a staple of the Dell line, has officially been put out to pasture. We can still get them for a few weeks but they are no longer available on the Dell website. In their place are the GX 520 and 620 lines. For dental operatories, the 620 is the only system we can recommend, as the 620 has dual-display video options that the 520 does not. A quick configuration shows the systems coming in around $1050-$1150 with 3 year Gold support, CDRW, XP Pro, 512 RAM, 40 GB Hard drive, and P4 3.2....so about the same as the GX 280's.

Gameport Goodness

I wish that manufacturer's of intraoral cameras would develop true USB drivers for the capture function. We've been struggling for a few days with a client that has had difficulty with a Claris camera and XDR software. Both are great systems and they should work together. The problem is that almost all intraoral camera companies still have the capture tied into the joystick button. This would be fine if computers still came with gameports...except they haven't for years. You can use a gameport to USB adapter that you find at Radio Shack but it doesn't work with all systems. You can add a sound card, many which still have gameports...except that most of the computers we sell are small form factor and cannot fit a full sized sound card. Since hardly anyone uses gameports any more, this technology needs to be changed. Intraoral camera companies, are you listening?

Patient Reminders and Recalls

I've always felt that in the digital era, we should be communicating with our patients through email on a more regular basis. Unfortunately, most of the practice management software programs, which should handle these chores, have limited to no functionality when it comes to tracking referrals, reactivation, and recalls. There are currently three program that I know of that can handle these duties. They are DemandForce, UAppoint and Smile Reminder. It's beyond the scope of this blog to get into all the differences between them. Suffice it to say, each has their respective merits and all are excellent in my opinion. I just saw a demo of DemandForce's product and was very impressed, and UAppoint just released a new recall and reactivation module which I haven't seen yet but you can read it about it here.

All of them are priced between $199 and $299/month, depending on features, size of the practice, etc.

The Big Cover Up

One of the more challenging issues to deal with is infection control in the operatories. Even though we recommend the Gyration wireless keyboards and mice, which can easily be moved around, infection control is still an issue. In the past, we're suggested Saran-Wrap as the best solution. Well, thanks to my friend Mark Kiefer, he's found a nifty keyboard cover for the Gyrations. The website is Police Computer Supplies and it appears they specialize in covers for police situations. According to Mark, the covers wrap easily over the keyboard and are a nice solution for offices looking to protect their keyboards. It appears that they cost around $12 each.

Fire in the Hole

One of the more frequent questions I get is whether dental offices should have a firewall. I definitely think that in this day and age, a firewall is just as necessary as anti-virus and anti-spam. The question is what form should this firewall take.

Most of the routers in use today, such as the Linksys WRT54G which we recommend for many offices, use a combination of NAT (Network Address Translation) and have a Stateful Packet Inspection firewall built into them. In addition, Windows XP SP2 came with a new firewall turned on by default. This firewall is ok, but doesn't protect against outgoing attacks. We've also had many issues with the SP2 firewall and practice management software, so we often disable it.

Is a router and SP2 enough? For most offices, the answer is yes. We don't feel that dental offices are the target of many attacks and find that basic firewall security is adequate. However, for offices that want more protection, there are plenty of choices. Most offices will elect to use a software Firewall, such as Zone Alarm. While you can get the Pro version, there is a free version you can find here. If you want the ultimate in protection, then look at a hardware firewall. Ones that we've used before that are a good mix of features and cost are the SonicWall TZ150, which costs under $300, and the Watchguard Firebox X15, which is a bit pricier at $450 or so.

Windows on the World

I know a lot of people who read this blog are computer savvy and want to learn some things on their own. It seems like dealing with servers is one of the most daunting tasks for anyone without a lot of experience. My guide in my learning process of Windows 2003 Small Business Server was Harry Brelsford and his two excellent books on Small Business Server 2003. These are written in plain language and gave a great overview on how to properly install, maintain, and learn the features of this software. Highly recommended.

Why Wi-Fi?

As many of you know, Wi-Fi has become the de facto standard for connecting your laptop to the Internet. The problem is that you need to find a hot spot in order to connect. Starbucks, airports, bookstores...these are all good places to connect. But there are competing providers, such as T-Mobile and Boingo. Also, service costs about $7-$10 per use or a monthly unlimited plan of around $30-40. Because of these limitations, there are two up-and-coming standards that may replace Wi-Fi hotspots as we know them:

1. Wi-Max. Also known as 802.16, this is a very promising technology. Right now, the theoretical maximum distance for Wi-Fi to work is about 150-200 feet. Imagine a system where the maximum distance is 30 miles, and you have Wi-Max. While I don't expect the standard to really start appearing until 2006/2007, this has tremendous potential.

2. EV-DO. (Evolution Data Optimized). This is a standard that is used by cell providers, the so-called 3G network. Since many cell phones are capable of web access, a system is being developed to allow for broadband-like connection speeds. The most developed system in the USA right now is Verizon, which provides this service in 32 cities. While you can get cell phones with this technology, a lot of folks are getting the PC Card adapter to be used on a laptop. The advantage over Wi-Fi is that you don't need to be near a hotspot: if you can get cell reception, then you can connect. Verizon's monthly data-only plans range from $30-$50.

What Not to Wear

In many of my written articles, such as the one I wrote on the 4 C's of Digital Radiography, I've discussed the features that are important in choosing a digital radiography system. Since we are constantly bombarded by sales reps, I thought I would review the three items that I feel are least important in choosing a system:

1. Line pairs/millimeter (lp/mm). Probably the most meaningless statistic in digital radiography. According to my friend Dr. Dale Miles, considered the leading authority on digital radiography, the unaided human eye can differentiate about 8 lp/mm. So, if you view three images on the same 17" screen at real sizes, one with 10 lp/mm, one 15, and one 25, will you a difference? The answer is no. If you zoom in to a large degree of magnification, then the higher lp/mm image will keep its image longer.

2. CCD vs. CMOS. The only people who care about this are sales reps who are trying to put down the competition. CMOS are less expensive to produce so they will probably replace CCD in the next 5-10 years, but both are equal in image quality and durability.

3. Sensor comfort. Although I do believe that comfort can be an issue, I don't know of a single office that has returned their sensors due to comfort issues. In most cases, the positioning system, such as RINN, Wingers, and Snap-A-Ray will have just as much, if not more, affect on the comfort. It's often just a matter of learning to position the sensor properly.

Save a Tree

If you're like me and travel a lot, it's always nice to catch up on your favorite magazines. However, those periodicals can start to add a lot of weight to your carry-on. Enter Zinio. Zinio is basically a digital format for your favorite magazines. You load a small software program onto your laptop computer and then subscribe to the magazines you want. It acts like a real magazine, allowing you to flip through the pages, bookmark pages, make annotations, etc.

I subscribe to PC Magazine and Computer Shopper through Zinio, but many other major magazines, such as Business Week, Sporting News, and US News and World Report are also available. Check it out!

Cable Conundrum

There was a post about this on DentalTown so I thought I would make mention of this here. One of the issues that often comes up when designing an operatory is dealing with the cables. There are typically 4 sets of cables that must be taken into account:

1. Ethernet, or network. We recommend a minimum of cat 5e and many offices are going with cat 6 for the gigabit speed. Keep in mind that to get the faster (1000 MB/s) speed, all of the network cards, the switch, and the cabling must be rated for that speed.

2. Power cables. This is often more of an issue for ceiling mounted monitors or pole mounts, as you need an electrical outlet. Some monitors use a power cord with a "brick" in the middle. We don't recommend this as that brick cannot be hidden within the arm assembly.

3. Video cables. I personally don't find any difference between DVI and VGA. You will need to know which connector is used by your video card and your monitor. While some folks use boosters for longer distances, we don't find this to be necessary. We use shielded cables from Cables To Go , which come in lengths up to 100' (most offices will find 25' adequate, a few will need 50'). We don't suggest linking cables together as this can cause ghosting of the images.

4. Audio cable. These are very thin and will run in tandem with the video cable.

With proper planning, you can avoid a cable nightmare and have a clean, aesthetic look to the operatories.