Not all x-rays are created equal..

Can you spare a JPEG? And no, I don't mean DICOM files exported from your digital imaging software renamed with a .jpg extension. I'm referring to your garden-variety JPEG format image that every dental imaging software is capable of exporting. Why do I ask, you say? Well, as digital imaging becomes more common, so do my calls from clients complaining that they cannot view the x-rays that office "B" just sent them via email.

Now why would that be? Well, it seems there's a crucial training topic missing from the usual syllabus for digital imaging software classes. You see, when a patient visits the specialist (oral surgeon, periodontist, etc.) and the specialist's office calls asking for x-rays (preferably digital), what does your staff do? Export and email. But in what format?

My usual response to the calls mentioned above has been "Please call/reply to office 'B' and ask them to export the images as JPEG, not (insert proprietary format here)." It's true that the majority of dental imaging software understands the DICOM format, however, that is not their default image type. In fact, nearly every product uses its own propriety format for storing images. But they're just images, right? I wish it were that simple, but there is a simple solution (hint: it's my usual response).

More data jacks, please..

Not sure what I'm referring to? Well, what has kept me busy as of late (and why I haven't posted up until now) has been the build out of new dental offices. Outfitting new dental offices with new and existing equipment is one of the more enjoyable parts of this job. Everything goes in looking and working properly from the beginning. However, the planning and implementation takes a significant amount of time. And each project has revealed the same issue overlooked from the beginning, not enough data jacks for networked equipment.

I'm talking about the outlets in the wall that look like oversized phone jacks. These are used to allow networked equipment to talk to each other. The typical means of determining the necessary amount and location of data jacks have been to outline where computers will go and count them. What is missing in this equation are networked printers, cameras, scanners, and now digital x-ray sensors. When building a new office, all of this should be taken into consideration to provide enough data jacks to accommodate all of this equipment.

So how do you know the proper amount of data jacks needed? Plan on more than you think. In busy areas (e.g. reception and consultation), add a few extra beyond what has already been outlined on the blueprints. In operatories, consider if you will be making equipment upgrades in the next three years that may necessitate network connections (e.g. those new digital x-ray sensors). It's easy to say no to save a few dollars now. It's more expensive to learn you need additional data jacks after the office has been completed.

When smaller is better..

For years I've been recommending the Gyration keyboard and mouse primarily due to the small form factor of the keyboard. Space on the countertops of operatory cabinets is always at a premium. Installing a full-size keyboard, even wireless, creates competition with dental instruments and supplies on a daily basis. This is where the Gyration keyboard excelled; a smaller footprint leaving room for what is truly necessary.

And now there's an alternative, the Microsoft Arc keyboard. The small form factor maintains the small footprint of the Gyration keyboard, and adds a very nice look and feel to the product. Not only functional, but the Arc keyboard leaves a nice impression without even using it. I've paired these with the new Microsoft Wireless Mobile Mouse 3500 for a clean look and responsive use. The new mouse even uses BlueTrack™, providing smooth tracking on just about any surface without the need for a mousepad. In the dental operatories, you'll know this is important to ensure cleanliness.

Having worked with and installed these keyboards and mice (and seen the very positive reactions firsthand), I can't recommend them enough for your office. The cost is very reasonable for a wireless product, and even better.. it just works. And while this may be the last thing I mention, it is the first thing I look for when reviewing any product for a potential recommendation to clients.

What Implant is that?

Not that I would know (I'm not a Doctor, I support their technology), but the thought of an online resource to identify implants based on radiographs is very interesting. I'm a technology person. I find resources like what implant is that? to be fascinating. So when I came across the free online reference of implants, I found myself spending quite a bit of time just researching implants.

From the technical standpoint, the site is very well put together. The ease of use is nicely done as well. I was able to quickly review different implants based on their charateristics. Again, not being a Doctor, I'm fairly certain I'm not the target audience. But I found the site very effective in its stated goal.

And so, if you find yourself looking at an x-ray of an implant and wondering "What implant is that?", you have an excellent online resource to answer just that question. If you're just curious, give it try anyway. You might find yourself digging into all of the various implants just for fun.

Secure, remote access.. please!?!

I suppose having used remote access to systems, servers, and network equipment for many years, it's a bit of a novel concept. But I still find the question coming from Doctors to be a bit entertaining. More and more often, I'm asked how to securely access patient data without having to drive to the office. For me, the answer's simple: LogMeIn.

I've used LogMeIn Free, Pro, and Central versions for quite some time. I've worked with several other products in the past, but I've found LogMeIn to consistently be easy to use and problem-free. And so, I've stuck with their product consolidating the various systems for which I'm responsible into a single account. An additional perk? I can setup access to the individual accounts of other users (read Doctors) in order to help out when called upon.

As I mentioned, it's a bit entertaining when the Doctor has that "wow" moment, realizing how simple it is to review the patient information on the office computers while sitting at home. And the "Thank you!" is appreciated after they've reviewed x-rays over the weekend without the drive. But what're really great are the expressions when I walk through the use of LogMeIn Ignition for the iPhone allowing remote access from just about anywhere, literally.

Something Old, Something New..

The more offices I'm called upon to fix, upgrade, or build from scratch, the more unique circumstances I come across in regards to dental technology. Replacing computer systems is relatively inexpensive when considering the cost of dental-specific software, intraoral cameras, digital x-ray sensors, and the like. Inevitably, the desire to get as much use as possible out of the dental hardware while taking advantage of the capabilities of upgraded software on new computer systems becomes a pervasive theme.

And so, my task becomes how to combine pre-existing intraoral cameras and digital x-ray sensors with new computers. This would all be simple if everything used USB for connectivity. Unfortunately, that's not the case for the majority of older dental hardware. Coupled with the fact that many new computer systems are removing older connectivity ports (e.g. COM), I've found myself searching for solutions. Some products are able to communicate through USB to <insert your favorite connection type here> adapters. Others require the addition of capture cards, which have proven altogether frustrating. The pairing of older cameras (read drivers) with new PCIe adapters has not been particularly successful.

Some have asked why not just explain to the Doctor the necessity of replacing the dental hardware. My experience has told me this is easier said than done. Especially when the cost of a single intraoral camera can be just as much as all of the computer systems throughout the office. It's a difficult justification to make to avoid searching for a solution. And the chance to solve the puzzle is nearly always a little satisfying. Gradually, though, this will all become moot as the older dental hardware is eventually replaced leaving USB as the defacto standard. Happily, USB doesn't appear to be going anywhere anytime soon.