Where “We” Are – Part 2

When I use the pronoun “We” I do not mean the collective we, but the “We” of CaringQuest and those who share our vision of iS/iT from this point forward. You might say that we are taking a contrarian view.

con·trar·i·an [kuhn-trair-ee-uhn] noun

a person who takes an opposing view, especially one who rejects the majority opinion.

The majority opinion 20 years ago in dental information systems were character-based DOS systems. Seeing the promise of a more straightforward graphical interface (GUI), we jumped on the MS Windows® bandwagon, the sole option at that point was Dentrix®. Today the vast majority of practices use one of the Windows® based systems. Whether it is one of the significant players Dentrix®, Easy Dental®, Eaglesoft, Open Dental or some other software, the Windows® platform (Win10) is the foundation OS.

The Windows® platform began to show it’s shortcomings as we have moved into the comprehensive digital record and the “Point of Care” paradigm.

We identified 3 of the critical elements for practice management systems are Simple, Reliable, and High Performance. The best systems available did a relatively good job of implementing these elements. Some more naturally than others, most reliable and a few higher performance. As long as the system handled the financial component, scheduling, and a basic chart, things worked pretty well.

To incorporate an authentic “Point of Care” model not only are Simple, Reliable, and High Performance critical, but we identified 3 additional essential elements.

Remember, in the “Point of Care” model, we are going to manage up to 90% of the information needs for the patient at chair-side. The first two additional elements are seamless and transparent. Seamless means the flow of information follows a smooth integration process for collecting and recalling clinical, financial, and appointing information. Transparent means that you have the right information in the right place at the right time. Transparent is another crucial layer of simplicity as we create a comprehensive dental record in the system.

In the next section, we add the most powerful element and the major shortcoming of the Windows® OS.

As practice management systems (PMS) progressed from financial centric to time centric (with the appointment book), the interface moved from character-based to a graphic approach. Most systems then added a decent visual chart with some incorporating 3D tooth graphics. Over the past years, the more advanced systems have integrated x-ray and photographic images into the chart. Some of the systems utilize a low-level integration bridge tool.

In our simplified approach, we have broken the “Cycle of Care,” into two phases,  “Getting it To Do” and Getting it Done.”

Getting it To Do.

We foresee the next arena of development is the area the delivery of care and the digital dental record. Whether you refer to this electronic health record as an EHR or electronic dental record (EDR), it will be the core of the next phase of digitizing the dental office.

Digital technologies have affected the entire cycle of service in the clinical area. It all begins in the diagnostic arena. We have now moved beyond digital x-ray sensors, digital SLR’s and intra-oral cameras.

The leading developers integrate additional sophisticated digital diagnostic devices (e.g., CBCT, TMJ and Neuromuscular devices, perio-systemic tools, cancer screening, and more.) The data from these devices should all be integrated into an advanced comprehensive EDR. This requires data from these specialized and sophisticated devices to be in a universally readable format.

One of our clients who uses multiple advanced diagnostic devices has to gather data from 4 or 5 software programs that work on various versions of the Windows operating system. Very few share data or integrate into the PMS. As a result, to utilize all of this valuable data and create a CarePlan, it takes 2 to 3 times longer than it should. The information is not in a patient-friendly format to co-generate a plan at the review of findings visit. To state the obvious, this is an area that must be addressed to create a comprehensive record that is not only Simple, Reliable, and High Performance, but also Seamless and Transparent.

All this comprehensive diagnostic data requires a sophisticated operating system and hardware configuration to handle high bandwidth multimedia with ease. Our experience has proven that the Apple platform handles it with ease. Currently, many of the specialized diagnostic tools are integrated on the Windows platform in proprietary software, we expect that the integration of many of these devices will migrate to the Apple platform in the coming years. In the meantime, virtual machines (VMware Fusion or Parallels) can be a practical bridge.

With this platform, you also get the seamless integration of a form factor platform. From the iPod Touch, iPhone, iPad, MacBook Air or Pro, an iMac or Apple TV, you can transparently move from one form factor to another. The result is that you have “The right information in the right form at the right time to make the right decision.”

We will delve into this area in more detail in future posts, but next, we look at “Getting it Done.”

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