By Paul Feuerstein
In this issue, where practice-management systems are in the spotlight, we should once again evaluate how we ensure data security. In November 2001, I reviewed the validity of backups. (Please re-read "Backup Your Backup" on dentaleconomics.com.) The main point was — and still is — that many offices have backup systems that are faulty and perhaps unreliable.
Too many offices do not manage their backups properly. Most of the offices I have visited have systems in place, yet seem to blindly follow the routine that was set up at the initial installation. I have also surprisingly found many offices that do daily backups, yet leave the media in the office. Even if you keep this important data in fire-protected safes or similar boxes, it is essential to have some of the backups taken out of the office. Stuff happens, and while it's unlikely that a tornado will hit downtown Boston, numerous other disasters can occur. I recently interviewed Ray Range of Professional Software Solutions in Walden, NY (www.pssne.com). Range has been involved in hundreds of dental installations and disasters. His rather understated tenet is that "The only purpose for backup is restorability." The biggest problem Range encounters is trying to restore systems from disasters such as hardware failures, virus destruction, water damage, theft, and vandalism using unreadable backup media. Offices that use tape (still one of the most common systems) are still using the same tapes they started with. You know from experience with audio cassettes that the tapes stretch, crimp, and often become garbled due to tape problems or perhaps heads out of alignment. More importantly, due to technology changes, there may not be any old-model tape machines available if the current one is unusable. A good analogy is the 8-track tape — where could you find a player now if you wanted to listen to one? After restoring 1500 systems, Range found that only 16 percent went smoothly with no errors. Those that were readable had data corruption or errors, and some even had viruses.
Range suggests that you periodically send a copy of your backup to your installer for verification. Of course, you could do this yourself by reinstalling the data on another system in the office or at home, but can you be sure that all of the data is there? There has to be a comparison — bit by bit — to the actual database. While you are at it, an archival copy should periodically be made and stored. This could be an invaluable legal document in situations with patients or even former employees.
Many new backup systems are available. Removable hard drives that connect via USB2 or firewire are fast enough and large enough to do full-system backups. Writable DVDs also could be helpful, although they are slow and may not be large enough for full backups. Small backups can now be done on memory cards (those used in cameras) as well as USB "flashdrives," which are reasonably priced little memory sticks that now go over 1GB (floppies of the future?) Some of the newer tape systems can handle over 100 GB and act as a (slow) drive; Sony just announced 1.3 TB tapes. If you have high-speed Internet access, data can be streamed overnight to offsite services. Of course, this has to be carefully checked for security in light of HIPAA.
Companies that provide this service are cropping up everywhere. I discovered nightbackup.com, an inexpensive service that stores your data, at a recent dental meeting. Another company, ndcc.com, not only stores but also will rebuild your corrupted system. A wonderful program called Karen's Replicator (karenware.com) has been touted on several internet dental forums and is highly recommended by consultant Lorne Lavine. This program allows you to set up automated backups between different computers in the network, allowing instant recovery from a hard-drive failure. It does not replace a RAID system, but the download is free. If you do choose to use this program, Karen will accept donations, noted on her site. Other safeguards can be found using Duplidisk, a system allowing you to have removable hard drives (arcoide.com), as well as SnapServer (snapappliance.com), which can be used as a network backup and/or data server.
As you update your hardware and software, continue to treat it the same way to treat your patients. Preventive maintenance is not just for patients!
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.computersindentistry.com) and can be reached by email at firstname.lastname@example.org.