Double Vision

Feb. 1, 2006
At recent dental meetings, I have noticed a proliferation of computer monitors and display televisions at booths with a couple of these being Jumbotron size.

At recent dental meetings, I have noticed a proliferation of computer monitors and display televisions at booths with a couple of these being Jumbotron size. I also see more large-screen televisions appearing in dental offices, particularly in the waiting area. Some show programs, such as CNN or current sporting events.Many display patient-education programs while a few use these costly units (one recently noted in a large supply house magazine) to show virtual aquariums! These large-screen televisions often accompany spa-type amenities in more spacious waiting areas. It seems a shame to waste these venues on a Sunday afternoon during an important football game.Perhaps, though, you can generate some rental income!!

The treatment rooms have single or dual monitors. There is usually one that is at least 17 inches in size for patients to view. Smaller (older) monitors often grace the area behind the patient for office use. The advantage of this setup is to allow practice-management information to be used by the doctor or staff member without displaying it in front of the patient. Privacy rules frown on the appointment book being shown to the patient. Some of the PM systems have a cryptic “HIPAA scheduler view” so names are not displayed in cases where there is one monitor in the patient’s view. To do this wizardry, most installers recommend a computer with a “dual monitor” video card, and the use of Windows XP extended desktop. There are variations on this theme, some of which have been written about in this column and others in this magazine.

This prompts a discussion of monitors, specifications, and requirements. Since many offices have existing computers, what should be done with the old CRT monitors? They are still functional and, in fact, better than many of the new, low-cost flat screens. There are areas of the office - the lab, staff room, even a kiosk in the waiting room - to which these less fragile monitors can be relegated. The kiosk can be used for patient Internet access, online patient registration, or even for patient-education programs or video games. In theory, these CRT monitors can be used as the back unit in the treatment room. But the size and heat from one of these monitors does not retrofit well in the cabinetry.

Here are some specifications to look for in the newer monitors. The size of an LCD screen is a true diagonal measurement. A 15-inch LCD is equivalent to a 17-inch CRT, a 17-inch LCD to a 19-inch CRT, and so on. This can be confused with a specification called the “aspect ratio.” The standard width-to-height ratio of a screen is 4:3; however, in the wide-screen format it is 16:9. The diagonal measurement is still accurate, so you might get a smaller screen than you realized if you didn’t see it before you received it. Bring a tape measure to an appliance store to familiarize yourself with this specification. The wider format is better-suited for movies (so you don’t have to deal with the “letterbox” black lines), HDTV, and some current dental applications. Programs, such as PowerPoint, can take advantage of the wide screen. But keep in mind that the projector has to be compatible, too.

Contrast ratio actually measures the difference in brightness between the screen, displaying all white versus all black. A higher number gives you better color differentiation. For clinical use, we need a minimum contrast ratio of 400:1. But a higher ratio is better, especially if you are reading digital radiographs. Some practitioners have found that problems in reading new digital images were due to low-quality monitors. At the recent ADA meeting in Philadelphia, Exorvision unveiled a medical-grade monitor (water-sealed so it can be wiped clean) with an impressive 600:1 ratio.

The viewing angle is an important specification of these new monitors. Older LCD screens require direct (in front) viewing while newer units have a range of up to 160 degrees. Laptops sometimes have a low viewing angle in order to secure them from prying, adjacent eyes.

Although there are other numbers, such as DPI, pixel pitch (the lower the number is better) and native resolution (set your Windows program to the recommended number), watch for the connector - the familiar VGA plug may be replaced with the newer DVI or DVI-HDCP plugs. These will not fit existing video cards. When buying a new computer, be sure you know which plug is in that unit. There are adapters for these plugs, but they tend to compromise image quality.

Prices of LCD screens have plummeted. So put some new monitors in this year’s budget, but do your homework and beware of bargains - just like we warn our patients.

Dr. Paul Feuerstein installed one of dentistry’s first computers in 1978. For more than 20 years, he has taught technology courses. He is a mainstay at technology sessions, including annual appearances at the Yankee Dental Congress, and he is an ADA seminar series speaker. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site (www.computersindentistry.com) and can be reached by e-mail at [email protected].

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