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Inside Dentistry
November 2016
Volume 12, Issue 11

Digital Integration Insights

The Ease of Digitally Integrated Systems

Gerald Bittner, DDS

One of the most transformative changes in dentistry that I have noticed in more than 30 years in the field is the improvement of dental imaging. While you no longer have to wait for an image to develop on a tiny filmstrip, one thing remains the same—the need to be able to diagnose and show the patient an image quickly and elegantly. Whether it is a radiograph, photograph, or close-up of a 3D scan, imaging is the No. 1 instrument we use to communicate with our staff and patients.

Planning for Technology

We either begin as an associate in a predesigned office or buy an existing practice, and eventually we get to build our dream practice. We get architectural plans drawn for the front desk, lounge, business office, reception, and consultation room. We hire a team to build it, but do we have a plan for our imaging and communication systems? What does the practice need right now, in 1 to 3 years, or 5 years?

I started with a UNIX computer, which just did accounting, and eventually added another computer that had an appointment book. Periodontal charting was a separate unit. Every time there was new technology, I purchased it. I was always looking for better functionality. The problem was that none of it was compatible with each other. I spent a lot of time and money trying to secure faster components and systems, but what I should have realized $100,000 later was that system integration was key. Therefore, you must have a plan and a foundation to build on, which will likely begin with your practice management software system. Without integ­ration and having a robust practice management system, added technology gets very expensive—not necessarily as a result of cost of the system but the cost to run multiple non-integrated databases, which have to be patched and bridged together to work. These constantly must be rebuilt and updated by a computer technician, which adds another cost.

As an example, I purchased eight sensors at approximately $8,000 each, and then built a bridge so I could use them with my existing management system. It took a lot of memory and three to seven clicks of the mouse to get it to work but we were up and running. The fact that it added 4 to 6 minutes to every patient visit did not sink in until much later. Approximately 2 years later, we got a major upgrade to our main practice management program and everything fell apart. It took an IT wizard 3 days to rewrite a program and get my imaging system to function again. We then purchased a 3D CBCT scanner from a third party vendor, another bridge that was supposed to work seamlessly with the other two, but after 4 months of more difficulty, I made a decision to sell the CBCT and sensors for pennies on the dollar and purchase a fully integrated system.

Fully Integrated Versus Non-Integrated Systems

The non-integrated system took 4 to 6 minutes to get digital radiographs versus 1 to 2 minutes with the new system. Using very conservative math, you have at least two hygienists with at least four patients times 5 minutes equals 20 minutes times 4 days per week, which equals one hour per week times $45 an hour (average hygienist pay). Multiply that by 48 weeks, and it equals 192 hours or $8,640 per year lost. Using the same equation for the doctor, at a fee of $500 an hour, the doctor’s production lost $24,000 per year. This doesn’t include wasted staff time to print photos, x-rays, billing insurance, and the biggest and most expensive waste—the loss in productivity and patient satisfaction. I was indirectly spending $40,000 to $60,000 per year just to keep all those systems running separately.

This prompted us to get help to guide us with our practice management system as the foundation and make sure that all components would be seamlessly integrated. Any system that did not integrate easily was not a candidate. We made this transition 3 years ago and we do not miss the crashes and problems with various systems not playing well together.

Final Thoughts

Dentistry is a great profession. It is demanding for us as doctors and business owners to keep up. Patients not only deserve it, they expect it. We want to give our patients the best we can offer, but it is more difficult without a fully integrated imaging system within your practice management system. The fully integrated system gives you more time to listen with the intent to understand, build relationships, and treat your patients with compassion and excellence. This allows us to give the gift of a healthy smile, happiness, and longevity to our patients.

About the Author

Gerald Bittner, DDS, is in private practice in San Jose, California. His practice offers a wide range of comprehensive dentistry and spa services, with an emphasis on cutting edge cosmetic and restorative dentistry. He also lectures extensively nationwide.

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