The progressive dental practice has evolved considerably since the late 1980’s. Practices are moving towards a “paperless” or “chartless” concept, where records are kept in a digital format. The advantages of this type of system should be obvious to any practitioner. Data is easily available at any location, records never get lost, and clinical data can be manipulated to enhance the ability of the dentist and staff to diagnose and treat disease.

While a significant amount of time is spent choosing the best hardware systems, including computers, networks, digital cameras, and digital radiography sensors, many offices fail to realize the importance of software in this equation. The practice management software is designed to bring all facets of this data together; a poor choice in this software will lead to many hours of frustration. And, not to be ignored, image management software is critical for the clinical side of the practice. In this article, we will limit our discussion to practice management software and the process that dentists can use to choose the best solution for their individual practice.

Practice Management Software

While the hardware infrastructure is certainly important and most be chosen as the first step in a technology system upgrade, there is little doubt that the practice management software is the one component that ties everything together. Every program has strengths and weaknesses. Dentists should try to choose a system based on two over-riding principles: features, and service and support.

Features

The choices that face the dentist are almost overwhelming. Recent consolidations have reduced the “major players” in this area. The “Big Four”, as they are often referred to in online forums like Dental Town and the IDF, consist of Dentrix, Eaglesoft, PracticeWorks, and Softdent. Combined, these four programs account for at least 80% of the market by my estimation. However, there are certainly many smaller companies that have been around a long time and continue to produce excellent products. The trick, however, is to find the program that best meets your specific needs. As different systems are compared, one will see how certain features are handled better on one program than another, while another feature is better on a different program. In other words, there is no one perfect program that is best for each individual dentist. There is not now, nor has there ever been, an answer for the question, “What is the best program?” I recommend you review independent studies and comparisons and ask colleagues for their opinions. Clinical Research Associates and Dental Equipment and Materials recently completed surveys evaluated most of the more popular programs and should be used to help in the evaluation process. When comparing products, there are a few things that I recommend that you keep in mind:

1.You must involve your staff in this decision. As most dentists know, the staff are the ones who interact daily with the software. Many dentists have admitted to me that they barely know how to turn the computers on, let alone learn and understand a complex dental program. It is your staff that will be handling all of the administrative functions that the software handles. If they find the program difficult to use, it will be disastrous to your practice. Many dentists are fortunate enough to hire an office manager who has experience with dental software; someone like this can be an invaluable resource for determining the advantages of a particular program.

2. Every program has numerous bells and whistles, but most dentists end up using only a very small portion of these “features”. There are certain areas of practice management programs that almost all offices use. These include but are not limited to patient registration, scheduling, treatment planning, insurance estimation and processing, recall patient management, and reports of practice parameters, such as production and collections. That being said, there are many elements of modern software that should not be discounted. Dentrix, for example, has a direct link to Care Credit in their software, so that offices can determine a patient’s ability to finance expensive treatment almost instantaneously. Every dentist and every practice is unique and each dentist should decide what is important to him or her before you start to research different programs. Make a list of what’s important to you and compare every program you evaluate using your list.

One method that I have found effective is to take either an existing patient or create an imaginary patient and see how the software tracks this patient. In other words, create the patient record, schedule them, create a treatment plan, post treatment to their account, create an insurance form, re-schedule the patient, etc. In this case, you can compare “apples-to-apples” when evaluating how software handles this. Keep in mind that you should see how well the software can adapt to how you prefer to see and treat patients. Poorly designed software will force you to change how you practice and process patients and you should avoid this at all costs.

3. Although most dental software today involves both administrative and clinical features, it is the administrative component that will, in most cases, be the most important part. This does not mean, though, that the clinical functions are not important. The topic of integration of clinical data with practice management systems is outside the scope of this article, but it is important that the software you purchase today is capable of working with the software and hardware of hi-tech products. Seamless integration provides your practice with the ability to easily access both clinical and administrative data without needing to re-enter patient information in more than one location

Training, Service and Support

It is very unfortunate that the factors that are probably most important when choosing a software package are usually given the least amount of consideration. Most dentists will spend hours evaluating software, choosing features, looking at the price of the program, but will barely even think about the need for training and ongoing support.

Let’s start with training. There is no better way to ensure that your staff never adapts to a software program than to bypass proper training! Unfortunately, many dentists will try to save money by justifying their decision to not spend money for onsite or classroom-based training. Don’t make this mistake. Training is one of the best investments you can make. Dental management software programs are complex; don’t let anyone tell you otherwise. Having everyone in the office (and, yes, that includes the doctor) up to speed on the software is crucial to ensure that it is rapidly integrated into your practice.

Service and support is the other part of this equation. Many dentists make the mistake of looking at the price of the software and do not factor in the costs of ongoing support. I have seen support packages that are as low as a couple of hundred dollars per year to packages that are over $5000/year. When choosing a support package, you need to ask a number of questions:

1.What are the hours for customer service and support?
2. What other means of support i.e. email, web based, fax, etc are offered?
3. Are different levels of support plans offered?
4. Is unlimited telephone support offered as a part of the package or is it on a per-minute basis?
5. How much support is included with the initial program purchase? What will it cost to purchase additional years?
6. Is on-site support offered?
7. What are the qualifications of the support staff?
8. How often is the program updated?

One important question to ask is how soon your call will be answered. Many practices have complained recently of the ever-increasing time that the office waits for a return call. You can, and should, test this out yourself my trying to contact their support departments at different times of the week, such as Monday morning and Friday afternoon. Ask to see performance statistics, such as the average on-hold time and average length of call. This information will provide you with an insight into what’s in store for you. Independent surveys are also available, like the ones I mentioned earlier, that rate customer support for many different systems. Also ask your colleagues for their experience.

As practices continue to gravitate towards the chartless ideal, many dentists will come to realize that their current, outdated software is not up to the task. By taking the time to properly evaluate software, both from their current and long-term perspective, it is hoped that dentists can avoid a costly, and often exasperating experience