I'd like a second opinion..

Quite the busy end of year rush. And all because of those few simple words. I've seen a significant increase in business over the past two months (which has kept me from posting) because Dentists are beginning to question their current computer technical support. And for good reason. Overcharging and under-delivering seems to be norm lately. And so, as the Dentists searched for a second opinion, I was called upon to deliver.

I'm also writing this because I'm attempting to convince a Practice that they should do just this, ask for a second opinion. They're in the midst of changing practice management software, and they've been quoted an exorbitant amount of money to upgrade/replace their computers in order to support the new software. Unfortunately, it seems many Dentists are used to one person (their Rep) providing the vast majority of their supplies, software, etc. And when it comes to their systems, they're used to relying on one opinion so they accept whatever quote as the cost of business.

Most unfortunate is that the technical support companies that cater to Dentists seem to know this, and in my experience they have been taking advantage it. So I'm trying to spread the word that Dentists should at least consider "I'd like a second opinion" when evaluating system upgrades. They might be pleasantly surprised.

Introducing the Technically Dental Event..

In an effort to get in front of Doctors with the very topics I discuss here, I came upon the concept of a hosted event in a setting in which they are very much at ease. Co-hosted by a wonderful oral surgeon (that happens to be a client of mine) and catered by an award-winning service, I held my Technically Dental event recently with the attendance of eight offices. Absolute success.

My goal was not so much to get in front of Doctors and preach about technology but to have a group discussion (or study) regarding the technical issues they face today. It took a bit of coaxing, but I was able to get everyone involved. And with each office's involvement came a different revelation or misconception of how they could/should be handling the office technology. Experiences were shared, tips and recommendations were imparted, and everyone seemed to take a little something from the event. Including some delicious food.

The decision has already been made to do this again, perhaps before the end of the year. And with the number of offices I come across on a regular basis still struggling to get their arms around the technology side, I imagine these events will continue for the foreseeable future. I may even have to look into the ability to supply CE credits.

2,147,483,648 is the Magic Number..

But all you need to remember is 2 gigabytes (or GB). Purchasing a new desktop or laptop for your Practice? Accept no less than 2GB of RAM (or Random Access Memory). Need to replace an aging server? The absolute minimum amount of RAM should be 2GB. See? 2GB is pretty easy to remember.

It's easy for me to throw out an arbitrary number like 2,147,483,648 when recommending how much memory your computers should have, so I'm sure you're wondering why. To put it simply, everything you do on your computer is competing for the use of RAM. Every application uses it, as does the operating system (i.e. Windows, OS X, Ubuntu, etc.) And for the sake of the performance of your computer, it's best they don't share. While a good virture to teach children, sharing (of memory specifically) is not something you want to force upon the installed software.

So now you're wondering why I didn't post this earlier to save you the hassle of upgrading your brand new system? Sorry. It just came to me that I hadn't mentioned it after receiving a client request to do the same. So now you know. And when you're ready, head over to Crucial for the very best in RAM. It's the only place I buy my (and my clients') memory upgrades.

Disaster recovery done right..

What happens when the computer used to process all digital x-rays via phosphor plate encounters a hardware failure, bringing all x-ray production to a standstill? Pick up the phone in a panic and hope that technical support can resurrect the system? Fortunately, in this case it was a regular client.

One hour later, everything is up and running as if nothing ever happened. Coincidence? No. The Doctor has listened to my incessant calls to protect the data collected from patients in all digital form to ensure no single point of failure threatens the Practice. In this case, the system that processes the digital x-rays does not contain any sensitive data. It is a means to an end. All of the data is securely stored on the server awaiting the replacement worker bee to send more images.

And so the Doctor left for lunch unable to process x-rays only to return as if nothing was wrong. I only hope more Practices are secure in their computer support. Something leads me to believe the answer is unfortunately no.

Same as it ever was..

There haven't been any new developments to speak of recently, technically speaking, so it's been a bit quiet around here. Much of the same as families go on vacation after school has let out. The emergencies have subsided, and we've settled into a more routine maintenance mode. And so, I've taken the time to evaluate where my regular clients' technology stands in relation to the coming upgrades in software.

Dentrix is rumored to be out with their next version (G5 maybe?) before the end of the year. Imaging 4.5 will soon be replaced with a version more akin to Dexis, the proud (somewhat-)new owner of that package. Eaglesoft is currently at version 15 and has been since October 2008, so an upgrade is likely in the near future as well. Kodak (or is it Carestream Health?) has some advances slowly rolling out, per my recent trip to the CDA Presents. And Schick CDR has recently released version 4.5. And wouldn't you know it, each new version has been accompanied by an increase in recommended hardware requirements.

So, as I was saying, I've been evaluating the technology status of regular clients. End of year/holiday sales by manufacturers are always a good time to take advantage of discounts. And as of right now, commitments are already beginning to fill my calendar. Good for me? Well, yes. But it also ensures my clients will be able to take full advantage of the latest advances in Practice Management and Digital Imaging software without the performance penalty.

And speaking of Digital Imaging, apparently Cone Beam 3-D systems are becoming more prevalent. Care to guess the hardware requirements for these new systems and software?

Extending extended warranties?

That was a new one to me, so I was temporarily at a loss for words. Should you pay to extend the extended warranties on computer systems? The rule of thumb for business systems is they generally last three to five years. Beyond that, the system either suffers a hardware failure or fails to live up to the abilities of the current software. That means there's a performance problem, and there's no magic blue pill for this one. So, to answer a question with a question, why would you fix a computer that's no longer capable of keeping up with the software you're using to run your business?

There is a context to everything, so to be fair I suppose it depends on the situation. Servers in general should have a five year warranty. Workstations, laptops, and printers should stick to three years. If it continues to function beyond the warranty, be happy you've gotten your money's worth and plan for its eventual replacement. Which comes back to a topic I've mentioned in the past, preventive maintenance.

Dentists stress the importance of preventive maintenance all the time. Brush, floss, regular cleanings. In terms of computer systems, preventive maintenance includes the replacement of old systems before they fail. Why not just run it into the ground? I suppose you could. I would prepare, however, for a fair amount of frustration and vocal dissatisfaction with how poorly the systems are running throughout the office. Particularly from your staff. Then there's the downtime while you wait for the failed computer to be replaced. Inefficiencies everywhere.

Looking at the Invoice to add a few more warrantied years to your office systems? Save the money and schedule an end of year replacement.

The CDA Presents..

With my focus largely on the dental industry, I had informed my clients that I was heading to the CDA Presents in Anaheim to see what was up and coming in technology. As several of them were not attending, I received requests to look into a few things. One of those requests was for intraoral cameras.

Visiting the numerous vendors provided quite a bit of insight on the products currently on the market as well as the products coming in the next few months. Knowing what kind of questions to ask from a technical stance proved enlightening and also gave a few of the presenters pause. Perhaps they're not accustomed to justifying their product technically. In any case, an intraoral camera that impressed me was the coming Polaris USB by Air Techniques. The specifications are very much in line with all other intraoral cameras. What sets it apart is the swivel head for capturing images from bottom to top without the need to rotate the camera in your hand. Additionally, the inexpensive USB connectivity cord that can be left in each operatory transporting only the handheld just makes sense.

As I mentioned, this product is coming to market so only time will tell if it proves to live up to the whitepapers and demonstrations. Integration with the major imaging software vendors will be key. One can only hope the introduction is quick and smooth.

It's 3pm, do you know where your Technical Support is?

He's busy managing a bar that he owns on the side. No really, that's the answer a new client of mine was given when asking for help from their previous IT Support person. Note the term "previous". Sadly, once again I find the offices of a very successful Practice in very poor condition. Computers down in operatories for upwards of six weeks, frequent issues with printing, corrupt backups going back to 2007, and a Personal-Use ONLY antivirus product installed on 20+ systems. I can see this is going to be a very busy year for me.

It's truly unfortunate that situations like this give the Technical Support/IT industry a black eye. And the horror stories continue because it is so difficult to distinguish the good from the not so good until the damage is done. So I'm working on getting the word out on my services and availability. Meanwhile, I have a few offices to resuscitate.

I wonder which bar he was managing. Perhaps I should go buy him a beer.

New, now, next!

There's been quite a bit of buzz lately about the next operating system to come out of Microsoft, namely Windows 7. Seems the recent reviews are proclaiming Windows 7 to be Microsoft's best release yet. That's great news. Glad the pundits approve of Microsoft's work. But before we all go running out to purchase the latest and greatest, perhaps we should consider a few things. Care to think this through?

For those of us with a server in our Practice, did you know Microsoft released Windows 2008 Server back in, yes, 2008? Are you also aware that the vast majority of Practice Management software, including the cutting-edge Dentrix G4, is still not certified for Windows 2008 Server? What does "certified" mean, you ask? Well, it means if you call technical support with a problem and tell them you're running their product on Windows 2008 Server, they'll likely end the conversation right there. It means they have no obligation to support you.

But surely workstation operating systems are "certified" much quicker than server's, right? Well... considering the fact that it's fairly easy to run into limitations of digital imaging products when using Windows Vista, I'd give that a lukewarm maybe. Also considering that Windows 7 builds upon Vista, that splash of water I just threw on your parade is getting a little colder. And finally, the chances that technical support will help you install their product on your new Windows 7 system? (That last one was actually a joke.)

So the moral of the story? New technology is great. Advances are made every day that promise to better our lives in and out of the office. But please, please, don't go rushing out to buy the latest gadget, gizmo, or operating system (in this case) without first considering your current environment. And if you're not sure, just ask.

Amazingly bad advice.. But hey, it's cheap!

"The assistant's brother takes care of the computers, and when he's not available we call another computer guy." Meanwhile, I'm looking at a rather successful dental practice. Are they feeling the sting of the current economy? I'm sure. As is everyone. But that's no excuse for past decisions, made long ago, because they were easy, and yes, cheap.

This particular experience likely wouldn't result in a drawn-out lesson if it weren't for the awful state of their systems. Perhaps the Doctor realized how poorly the environment was put together, because what brought me through the door was a dire request to setup offsite backups through our online service. No trust in the stability of your systems? I can certainly see why. When I walked in, one of the three front office systems wouldn't even start. And "support" would be getting back to them at some point. Not quite sure when.

My question: Why would anyone entrust their business, one that relies heavily on technology to function, to someone that happens to know a thing or two about computers and is cheap? I understand some people have a problem spending money on infrastructure and supporting said systems. But when you lean on the infrastructure in order to provide your services, why accept the cheapest possible option? There's a reason a common phrase even exists, "you get what you pay for."

I honestly just feel bad for the Doctor. The environment is teetering on collapse. And when it does, the practice will need to take a vacation in order to recover. Perhaps then I will receive a phone call. Hopefully. Not for me, but to help the practice move forward appropriately. But then, it seems I'm always fighting fires.

Just when I thought I was out.. they pull me back in.

In a previous life, I put together quite a few point of sale systems. I have since put that behind me to focus on the dental trade, of which there is plenty to learn. But when a door opens, do you walk through it or go about your business? Well, I chose to try and not let it hit me on may way through.

Having made recent friends with an owner of a local establishment, I was asked for help in getting setup with a new point of sale system. And so I've been busy recently. Technically dental? Well, yes. Let me explain.

With the recent proliferation of HSAs and Flex Accounts, credit/debit cards are becoming a more common form of payment for dental services. Dental offices typically have a handheld credit card processing machine off to the side to handle these transactions. Slow, runs off of a phone line, and a bit painful to use. But is there an easier way. As if the clouds parted and the sun shined down in a moment of inspiration.. YES!

Retail establishments have known the benefits of processing credit card sales via software for some time. Authorization over the internet, 2-3 second transaction times, automatic batch settlement and reporting features. Run the card through a standard issue magnetic stripe reader, and the software does all of the heavy lifting. If you want the ubiquitous credit card receipt paper, thermal printers are aplenty. Bartenders, sales clerks, and wait staff rejoice at the very sight of such a system.

Possible for a dental office? Absolutely. Will it make a difference? You mileage may vary. I personally know of an office that despises their credit card processing machine for the reasons I stated above. Now, perhaps in my moment of enlightenment I might offer an alternative.

A Recommendation.. and a Reason.

As I noted in my previous post, I recommend NOD32 Antivirus software by Eset to protect every system in your office and/or home. And while I explained why you should protect every system, I reserved why NOD32 for another day. I suppose today is as good as any.

So let's go positive before we go negative. I've been using NOD32 on my own systems since 2004 and began recommending it to clients shortly afterward. The software has proven to do exactly what it's supposed to do, namely prevent malware from infesting a computer. This is evidenced by the numerous awards NOD32 has received, specifically the consecutive string of VB100 awards. A brief background, Virus Bulletin runs independent tests of nearly every antivirus software available using a variety of environments. Only if you pass all of the tests (e.g. identify and prevent all malware) do you achieve a VB100 award.

So yes, it's very good at its stated purpose. And as an added bonus, NOD32 is easy on your system resources. Definitely good to have with the ever-increasing system requirements of the recent Practice Management upgrades. I should note here, if you're installing any antivirus software on the computers that run your business, there are settings that should be configured so as not to interfere with your existing applications (i.e. Dentrix, Eaglesoft, et al.).

So, what's wrong with free alternatives? Well, for one, nearly all free alternatives are for Personal Use Only. No, your Dental Practice doesn't qualify. If you'd like to install it on your home computer, have at it. But the licensing is quite clear here, AVG Free Edition and the like are not permitted in a business environment. And while it might seem like a victimless crime to simply use the free edition anyway, I'm fairly certain you expect to be paid for the products or services that you offer as a part of your business.

There's also the matter of open-source software, such as ClamWin. Free? Yes, even for businesses. But you might want to read one very important line on their website:

"Please note that ClamWin Free Antivirus does not include an on-access real-time scanner. You need to manually scan a file in order to detect a virus or spyware."

Essentially, you can still download, install, and infect your entire network with some very bad malware. But don't worry, ClamWin will try to clean up the mess the next time you decide to run a full scan of your systems. Not exactly proactive. Wait, prevention, isn't that the term Dentists use?

And finally, please don't be lulled into thinking you're fine just because you have a 5 year old copy of Norton running on your server that hasn't seen an update since the Chicago White Sox won the World Series. New viruses, and variations of existing ones, are detected daily. You might as well not be running anything at all.

No Antivirus Needed..

Do you really need to brush your front teeth? Don't your back teeth do all of the chewing?

Sounds a bit comical, doesn't it. By the same token, this is the reasoning Doctors are given by their technology support providers when asked why they don't need antivirus software on their operatory computers. "You won't be browsing the internet, so you don't need antivirus software." Sounds a bit comical to me too.

Sadly, this little bit of "advice" seems to be more common that I had hoped. Briefly, YES, you NEED antivirus software on all systems. The only exception to this is if the computer will not be connected to any network, router, or wireless access point (e.g. a portable CEREC system). However, if it plugs into the network even just to access digital x-rays, please protect the system, and by extension your entire network, with antivirus software.

Why, you ask? The vast majority of viruses, trojan horses, and boot sector infections are made to spread themselves to any system they can discover. If one computer on the network becomes infected (say.. the Consult Room system that doubles as the Staffs' internet kiosk), the malware will broadcast over the network looking other machines that are vulnerable. Any system without antivirus software that it can contact is gravy.

So what do you do now? Purchase the necessary number of licenses of NOD32 Antivirus, Business Edition by Eset to cover all of your systems (especially that internet kiosk in the Consult Room).

Coming soon.. Why NOD32 instead of say.. AVG Free Edition. I'm shaking my head already.

Why, why, why?!?

Seems everyone has an agenda. Me too. If you happen to have a Practice in San Diego and are in need of technical assistance, please feel free to give me a call. Not in the San Diego area, you say? Then I suppose you'll get the benefit of my writings, reviews, and recommendations (like the alliteration?) all for the cost of your internet access. Sorry, nothing's free.

I see Doctors that are technology buffs, a few defunct writings of technology companies that cater to Dentists, but no real resource for matter-of-the-fact questions and answers. As if our profession were some sort of mystery. Don't look behind the curtain! So here I will attempt to answer the questions posed to me day in and day out, provide an independent opinion of hardware and software (no, I am not a reseller of anything other than my time), and add a little flavor to the otherwise bland topic of "computers".

And don't be shocked if you read about a horror story I've encountered in a Dental office that happens to be set up in the same fashion as your office. I have seen the results of more than a few, shall we say, misguided "computer guys". And not just in the Dental industry, so please don't feel you're being picked on.

That said, if you have a question that's really been bugging you but you haven't had anyone to ask, send it along. I'll see what I can do. And I might even post it as a lesson for all other Doctors (without the obvious identifying traits, of course).