"Help me if you can …"

July 1, 2002
Attention techies and manufacturers: I need your help! I am often asked about image management in the dental practice.

By Paul Feuerstein, DMD

Attention techies and manufacturers: I need your help! I am often asked about image management in the dental practice. Many offices have purchased intraoral cameras, digital cameras, scanners, and other input devices and have images galore. The problem is cataloging all of these and retrieving them easily. Let me be a little more specific.

Intraoral and digital cameras are wonderful tools for diagnosis, patient education, and documentation. Many offices that adopted this technology early purchased expensive, cart-mounted units. These essentially were video cameras with TV monitors and a printer. Some offices used a VCR to tape the entire exam.

When computers came on the scene, it was apparent that these images could not be easily stored digitally for future retrieval, nor could they be printed on the simpler, less expensive color inkjets. Due to the clumsiness of these units and subsequent mechanical failures, many now sit forgotten in a back room somewhere. Those offices that still wanted to use this thechnology bought newer, more compact units with better storage capabilities. The cart could be abandoned in favor of units that were portable, docking stations, or wireless technology.

Still, without putting computers in treatment rooms, there was no easy way to save these images in a digital form. Some offices have installed elaborate wiring schemes that allow offices to share images between treatment rooms, and they even send them to a central computer. If a computer is installed in the treatment room or on the network, a special video card must also be installed. The most popular is ATI's All In Wonder series. Of course, some companies have required proprietary capture cards, which adds to the difficulty. Newer computers have other input ports such as USB and fire wire; however, they require an adapter to utilize them.

Now, let's add the digital camera. We love to take photos of our patients, for smile design, and, in many cases, spectacular intraoral images. Again, how do we store these quickly and can it all be done without a computer in the treatment area? Can the digital images be shown on the existing TV monitors? And, can an ordinary dentist do all of this without being a Windows expert?

The ultimate problem is cataloging these for easy retrieval. Practice-management software companies all have a system to save an image in the patient file. That's great - assuming the computer is in the treatment area and the doctor/assistant/hygienist is well versed in this process. If you cannot put the pictures in the software, they must all be catalogued. Popular programs such as Thumbs Plus make this possible; however, this program has its own database. Your staff will have to type in some sort of patient name or identifier for each image or group of images.

The easy out is to tell dentists who are interested in this technology to put computers in all of the treatment rooms, update their practice-management software, and get some new cameras. I know Dental Economics readers follow the advice of my fellow writers and are having amazing financial success, so all of these purchases should not be a problem!

However, some of you may prefer to set up in stages. Also, there are companies that can refurbish those old cart cameras and make them useful again.

Some companies specialize in integration and can put everything together by wiring the office with cabling, allowing for future network expansion. Some of them advertise in these pages, so certainly see what they have to offer. Since I'm a do-it-yourselfer, I haven't used these products and can't report on their quality. I invite all readers of this column (both users and providers) to send me possible solutions and reports of success or failure. This will make a nice feature for a future edition. So, "won't you please, pleeeeaaase heeeeelllp me."

Dr. Paul Feuerstein installed one of dentistry's first computers when he placed a system in his office in 1978, and he has been fascinated by technology ever since. For more than 20 years, he has taught courses on technology throughout the country. He is a mainstay at technology sessions in New England, including annual appearances at the Yankee Dental Congress, and has been a part of the ADA's Technology Day since its inception. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site (www.computersinden tistry.com) and can be reached by email at [email protected].

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