Lorne Lavine, DMD
In the past few columns, we have examined some of the technologies that are part of the digital office, specifically looking at data backup, virus protection, an overview of digital radiography, and monitors. Of all these technologies, digital radiography appears to be generating the most interest right now. While choosing digital sensors and software is certainly important (and will be evaluated in future columns), many dentists do not fully recognize all of the factors that should be considered when purchasing a digital radiography system.
In most cases, dentists purchase digital radiography systems for a variety of reasons — to lower cost, eliminate film and chemicals, and generate images in less time. However, the true benefit of digital radiography can be seen when we involve patients in the diagnosis of their conditions. We often call this "co-diagnosis." To adequately do co-diagnosis, though, we need to address a significant number of issues specifically related to the placement of these systems in the treatment rooms.
It is not enough to choose a computer based on processor speed or hard drive. Other issues that must be evaluated include the need for DVD players, CD-RW drives, and video cards. Just as important — although frequently overlooked — are the sizes and shapes of the computer cases themselves. Many offices have cabinets at the 12 o'clock position, where an area has been designated for placement of a computer. However, these spaces will not fit all computers, and the dimensions of this space should be evaluated before purchasing the system. Dell computers, for example, come in four sizes for its Optiplex systems. It would be easy to say that offices should purchase the smallest case; however, there are trade-offs that are part of this decision. Many add-on cards, such as those used for video capture and digital radiography systems, will not fit into these smaller cases. Dentists may also elect to mount their computer systems on a wall or cabinet, although they should understand how much space is required to do this.
Although we went into more detail in the previous column about how to choose a monitor, the positioning of the monitors is crucial to get the most out of the digital systems in the operatory. The first decision that must be made is whether to have one monitor or two in the operatory. Many offices are electing to have two monitors. One is positioned in front of the patient to show digital images, patient education, DVDs, or TV. The other is located behind the patient and is used to show more HIPAA-sensitive information, such as schedules or financial information.
To properly design this, certain decisions must be made. First, the exact location of the monitor must be chosen. In many cases, an articulating arm, such as those from ICW or Ergotron, is used to give the monitor positioning some flexibility. Most offices will mount monitors on the ceiling, a light pole, or a wall. If mounting to a wall, the location and type of the wall studs will have a major influence on how the monitor is mounted. Secondly, there is the concern over cables and cords. Each monitor requires at least a video cable to be run to the computer, and each requires electricity. Monitors in front of the patient usually will need an audio cable running to the computer. Since most dentists do not want to see multiple cables snaking across the floor and walls, it can be a challenge to determine the best way to run these cables and end up with an aesthetic solution.
While touch screens are an option, their cost often makes them prohibitive for dental offices, so most dentists still prefer to have a mouse and keyboard to input data. Wireless devices are almost mandatory in the operatory, but positioning still is important. If the dentist or staff member has to twist his or her body to use the devices, back and shoulder problems can develop quickly.
As the digital dental operatory continues to evolve, dentists should understand that there are many minor issues that need to be addressed in the planning stages so they can get the most benefit from their new systems.
Lorne Lavine, DMD, practiced periodontics and implant dentistry for more than 10 years. He is an A+ certified computer repair technician, as well as Network+ certified. He is the president of Dental Technology Consultants, a company that assists dentists in all phases of technology integration in the dental practice. He can be contacted by email at firstname.lastname@example.org or by phone at (866) 204-3398. Visit his Web site at www.thedigitaldentist.com.