dental software Tag Archive

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Charts in the Cloud, who owns the data?

saved by the cloud... or not

When we buy a paper book or a DVD video what we are really doing is assuring access to that “content” whenever we want. If we want to read it or view it we just go to the shelf and get it. But if we can just go to the Internet and get it streamed to our e-reader we have the same benefit of ownership we just don’t actually have a physical book. But do you really own that e-book?

So how about a patient chart? We have charts stacked on shelves because we need assured access to that info whenever we need it. However if we could get the same chart info from the cloud anywhere any time wouldn’t that be just as good. In fact better as you could get the data at home or while traveling you don’t have to actually be at your office.

From a purely intellectual point of view cloud storage of digital content makes perfect sense it just seems strange and risky to us. Just as we are becoming comfortable with storing important information in the cloud another huge data breach is announced on the news. Then there is the other question. Who owns data in the cloud?

The vast majority of reported data breaches in healthcare (62%) are the result of lost or stolen computers. Not malicious hackers. That means that cloud based record storage is actually safer than storing the data on a computer in your closet. If the data is in the cloud there is no need to have the data stored on a local computer. If a burglar steals a computer out of the office that has no patient data on it there is no breach.

Data storage is just one aspect of cloud computing. What is even better but also even harder to accept is that the actual computing takes place in the cloud. We don’t have any software applications installed on our local computer we just exchange data with a big server in the sky and the actual processing of the data takes place in the cloud.

This idea was originally called ASP (Application Service Provider) and has been a wonderful but elusive geek dream for almost twenty years. Several dental management systems have been launched based on the ASP or cloud model and the early ones all failed. As have most of the general cloud based business applications. They failed for a variety of reasons including people’s distrust of the Internet and worries about the system failing.

With the new attitude, faster Internet access and just overall better systems cloud based dental systems are back. They are Curve Dental, Dentrix Ascend and PlanetDDS.

Originally published on Emmott on Technology.

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ShadeWave

shadewave

ShadeWave from digital dental camera expert Dennis Braunston is a cloud based software that determines tooth shades using a digital camera and a special shade tab.

A digital camera image is made of the patient’s tooth or the one that has been manufactured on the bench. In the image, next to the tooth is our scientifically formulated ShadeTarget placed near the tooth. The reference target has known mathematical formulas as do all of the shade tabs. These are called our Standards. The image is then uploaded into the ShadeWave program.

The user selects their image and clicks on Auto Correct. This unleashes an automatic process that locates and determines, through the use of advanced algorithms, the formula of the reference target colors. The target formula is then compared and mathematically equalized to the Standard. This color corrects the entire image revealing all of the unknown shades, translucency and value.

via Features.

The number on reason for crown re-makes is color. Holding a tab up to the tooth to choose a shade is little better than using a paint chip to match your drapes. If you really want to match the color you take the drapes to Home Depot and they match the color with a high tech device. We can and should do the same in dentistry.

The ShadeWave system can be used by both dentists and labs. It is cloud based so it is accessible from anywhere anytime as long as you have an Internet connection and a digital camera.

Emmott on Technology

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Saved by the Cloud… or not

saved by the cloud... or not

When you visit a medical or dental office in the future you won’t be handed a clip board and paper forms, all your personal and medical data will be stored on the cloud. The medical / dental office will merely request a download and all the data will be available instantly. No forms, no guessing about medications, no forgetting your last visit, no confusion about insurance.

Isn’t that great all your highly personal medical data will be available to anyone with access through the cloud!

That will be really great because we wouldn’t want out personal stuff available to any old hacker so we will have the same level of protection that people had for their nude photos or that Target had for purchases or …well maybe it won’t be so great.

As much as I love technology and see the incredible potential of cloud based data and want it to be safe and secure, clearly it is not.

As digital technology and electronic health records stored in the cloud continue to develop they generate legal, moral and philosophical questions our existing ethical framework is simply not equipped to handle.

Most of these ethical questions can be summed up as:

Who owns the data?

Patients? If you ask patients the immediate and unequivocal answer is that they do. That seems right, each patient should have control of their medical information. That is what the HIPAA privacy rules are supposed to address. Yet that is not how the system works.

Doctors? If you ask a dental practice management software company (PMS) who owns the data the immediate and unequivocal answer is that you do the doctor owns the data.
Yet again this is not how the system works.

If as a dentist I own the data, I should be able to exercise the basic rights of ownership including using or transferring the data. However current systems do not allow me to transfer the data to another dentist or to use it as I wish for analysis. Plus as a dental professional I am obligated ethically and legally to protect the data as confidential.

If I have the data but can’t access parts of it or more commonly can’t transfer parts of it do I really own it?

Public? One of the most significant benefits of large online data bases of medical information is the aggregation of data for medical research purposes. Already there have been important findings resulting in improved patient care based in data base analysis. It seems axiomatic that more data from a wide range of sources will ultimately lead to better results. That is a good thing, but.
Is it OK to use personal medical data in a study without the patient’s permission? What if the personal identifiers are removed?

Then there is the issue of privacy. The primary issue driving HIPAA privacy rules is that a patient’s information must be protected. HIPAA is not about speaking a patients name aloud in the waiting room, it is about electronic medical data and making it available to others is wrong. Wrong morally and legally. That seems to be obviously true on the surface. Our personal data should be held in confidence. But what if we choose to make it public by participating in a study? Do we still own that data? Who does; the researchers, the web aggregator or the public, as in the public good?

In an ideal world all our medical data could be accumulated in a huge national (or for that matter global) data bank. This mass of data would be used by benevolent researchers to delve into disease patterns and treatment outcomes to provide a vastly improved understanding of the human condition.

But of course in the real world we have fear, politics, hackers, bureaucrats, proprietary data bases, the nightly news and less than benevolent people.

Check out more articles on Dr. Emmott’s Blog >

 

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“Good” Charting Software

Good charting software has many features. One of the most important is that it eliminates all paper. That means the software must accommodate all the bits of paper data that accumulate in a chart and it must have a method of importing virtually anything either with a scanner or file import function. If some bit of paper possibly a lab slip or patient letter must be stored in a folder then you have lost one of the primary benefits of an electronic chart.

Another important feature is full integration. That means that each item is entered one time and then transfers to where ever else it is needed electronically. For example a procedure will progress from diagnosis to charting to treatment planning to scheduling to treatment to insurance to payment. This is called single entry. If the user has to re-enter information such as procedure codes, tooth numbers or fees at any stage then the software is not fully integrated.

Good charting software must accommodate all the information we used to record on paper. That includes existing restorations, conditions, diagnostic findings, treatment plans, periodontal probings and tissue conditions, tooth surfaces, materials and procedure notes.

Charting software must be easy to use. Every mouse click or keystroke slows down the process and makes the program harder to use, which means it doesn’t get used. The more the user can customize the chart the easier it is to use. That means the user can create shortcuts, eliminate features they don’t use and designate functions for each button.

Data entry needs to be fast and easy. The standard is still mouse clicks and keystrokes however faster more intuitive entry methods are available. Like voice; we’d all like to talk to our computer just like Star Trek. Some charting programs allow users to speak in clinical findings like pocket depths, tooth conditions and restorations. Another alternative entry is touch, instead of clicking a mouse the user touches the screen. The latest is ”Ink” a special function that allows users to write or draw on the chart just as if it was a piece of paper.

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Prioritize Vendor Training for ROI

software ROI
Training from your software vendor is a crucial step to successful use and ROI on software investments. In my experience, many practices, especially small ones, think that they can read the manual and self-train and get the benefits of their software. However, many times dissatisfaction with software is actually a lack of training. Many practices don’t use all the relevant features, or use them wrongly, and therefore spend much more time and effort on tasks than needed.

When selecting software, asking around is a common method to figure out if software will work for you. Talking to other users, checking references and finding out about the user experience is valuable.  However, dentists need to recognize that few dental practices prioritize vendor training and make the most of it. Further, at any particular software vendor, there may be several trainers and there may have been changes/upgrades in software. Furthermore, practices that use a software may have purchased the wrong software or not allowed enough time for their own training.

In addition, training from a vendor is the first step in a two-way relationship. Establishing the importance of the software in daily work is necessary both internally to the practice and to create a channel of communication with the vendor. Ideally, a practice has selected the best software for their needs, and will use that software for years to come. To build a strong, ongoing relationship, practices need to treat vendor training as a mechanism for setting up communication channels, providing feedback and important information. The trainer often becomes the go-to person, the key link in the communication chain for practices to understand upgrades, communicate unique needs and problems, and receive important information from the vendor.

Using your software fully demands deep knowledge, and trainers can provide personalized information about the nuances and features. Communicate with the vendor and trainer; don’t suffer in silence, and don’t expect the vendor to read your mind.

In small and large practices, the organization must value the training and be committed—even if that is hard to do. Treat training as an obligation and an opportunity that you have paid for.

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