In the February issue of the Dental News publications, we evaluated the different systems of digital radiography available to the modern dental practice. We have looked at the differences between the sensors and phosphor plate systems, focusing on the raw data and suitability of both for different practice settings. Now that dentists have the tools to choose the best system, it’s time to throw out everything we have learned so far! As most practices have discovered after plunging into digital x-rays, the software has as much and often more to do with the user experience with these systems than anything else. 

Aren’t They All the Same?  

Almost all digital radiography systems come with their own software that allows capture and basic manipulation of the images. While this software is adequate for some offices, it is often under featured in its ability to perform more advanced tasks, such as applying filters to sharpen or improve the contrast, emailing images directly from the program without the need to cut-and-paste, and incorporating images directly into Word documents with a single click. Also, most of these programs are free-standing and do not directly bridge to practice management software. This is important because most dentists want to link the images to their patient data without needing to re-type the patient info when taking images. Enter image management software.  

Image management software is designed to serve a number of functions. It allows an easy method of taking, organizing, and manipulating images. By bridging to the patient record, it permits data to be exchanged without re-typing. And it will act as a central database for all images, including digital-x-rays, intraoral camera images, digital cameras, and scanned photos, slides, and documents.
 

To Bundle or No t

Probably the most difficult decision that the dentist faces is whether to purchase image management software that is sold by the practice management software company, or to invest in a third-party product. Both have their pros and cons.  

Most of the major Practice management Software companies have incorporated imaging suites into their offerings. On the plus side, these programs are tightly integrated with the software; the dentist will feel that they are still in the same program even though the databases are usually separate. This is actually preferred. With the constant consolidation that is occurring in the dental technology field, it makes sense to have images stored in a separate database in case the dentist chooses to switch to another program at some point in the future. Also, with the complexity of these various packages, it’s comforting to have the same company responsible for all aspects of the software. In a few cases, it is possible to have the patient chart and thumbnail-sized images all on the same screen; this is not possible when using a third-party program. Also, since three major companies currently dominate the US market (Schein, Kodak, and Patterson), dentists can be relatively secure that the company will not go out of business or stop supporting their software.  

However, this option may not always be the best. In most cases, the image software is significantly more costly than the third-party programs. Many of the image programs sold by the PMS programs are modular: a dentist would have to purchase separate modules in order to be able to images from digital radiography, intraoral cameras, digital cameras, and scanners. The cost of the fully-loaded image suite from the PMS company is often more than the PMS program itself! Another concern is that some programs will only capture images in a proprietary format, requiring time-consuming conversion utilities if standardized format, such as JPEG, are needed. Finally, the compatibility of the software with digital radiography systems is more limited with the PMS systems. Most are compatible with 8-10 different sensors, while average for the third-party programs is 23-25. Finally, some of the image suites from the major vendors use a word processor that is unique to that software rather than being able to work with Microsoft Word.  

As dentists move towards the chartless practice, there are many systems that must be evaluated to find the best choice for that practice. While most offices will spend most of their time evaluating the hardware choices on the market, the software is often the most important component and dentists should not overlook this factor when choosing their imaging systems.