Recent surveys from various dental journals suggest that the vast majority of dentists have become computerized in the last decade. Most dentists would have difficulty handling their schedules, billing, insurance, and a host of other functions without the use of a practice management system. While the use of a computer system in the front office has become almost mandatory, these computers are nowhere near as prevalent in the treatment rooms. According to a latest poll, only 1/3 of dental offices report having at least one computer system in the operatories. The purpose of this article is to discuss some of the reasons why computers belong in the operatory, and to make some recommendations of some products that will allow us to reach this goal.

Decentralization

Speak with any dental office receptionist, and the concept of decentralization will make them smile! Imagine an office where patients don’t have to wait for other patients to check out of the office, where the assistant doesn’t mishear the doctor’s instructions to the receptionist, and where every practitioner, whether it’s a dentist or hygienist, has access to all patient data from any room in the office. This is the idea behind decentralization. In order for decentralization to happen, there needs to be three components in place: an electronic scheduler, computers in the treatment rooms, and a computer network.

The electronic scheduler is a must for the modern office. Among the many advantages of electronic scheduling, it allows for a rapid means of finding patient appointments, easy methods of changing appointments, and scheduling to achieve production goals for the day. However, contrary to popular belief, the scheduling is best handled from the operatory. The doctor and assistant often require that a patient’s next visit be longer or shorter than is normally required. In a typical dental office, the assistant walks the patient up front and relates specific instructions to the office manager or receptionist. However, if that person is busy or has another patient to handle or is on the phone, those instructions are often not heard and the patient is improperly scheduled. This doesn’t happen if the assistant schedules the next visit right from the treatment room. In many offices I’ve seen, the assistants are trained to collect payments and process insurance claims right from the operatory.

Another advantage of having computers in the treatment rooms is that it will eliminate the need for a high-priced messaging system. As long as the dentist or assistant can have easy access to the computer monitor, they can be alerted to patient arrivals, phone calls, etc, and even be allowed to respond. One program that works particularly well for this is SoftCom (http://www.kcinternational.net/), which retails for between $300 to $500. There is a fully functional demo at the web site that can be downloaded.

For the office that is considering digital dentistry, computers in the treatment room are obligatory. Digital extra-oral cameras will require either a direct connection to the computer through a special port called the USB port, or through use of a card reader attached to the computer. Most digital x-ray systems and intra-oral cameras need to be hooked up through a video capture card or SCSI card. And, obviously, computer and voice-activated charting need to be done directly on the computer.

When considering computer systems for the treatment rooms, we clearly need to consider the various limitations that exist. Most dental operatories are small, and when you add in the chair, lighting, rear or side delivery units, cabinets, and doctor and assistant stools, that space becomes even smaller. Modern methods that have evolved to deal with these limitations include modifying the size of the computer, eliminating the wires, and using smaller and flatter screens.

As far as the computers are concerned, we often need to find systems that are small or have a very low profile that will allow them to be hidden out of sight. PC Power and Cooling (http://www.pcpowerandcooling.com/) makes a Slimline series of computers that are only 2 inches tall, yet very powerful; these systems easily fit under a countertop. IBM (http://www.ibm.com/) also manufactures a line of computers like the NetVista X series that have the computer parts built into a monitor, so that the entire system takes up 75% less desktop space.

Wireless options have also become very popular recently. Many dentists have been reluctant to run wires through the walls in order to connect their systems to the office network; it is often expensive and may be impossible in older buildings. A new wireless standard evolved, known as Wi-Fi, that can transmit data at close to the speed of wired networks (and an even newer standard, which is 5 times faster than Wi-Fi, has just been released). The use of wireless computers requires an access point and a receiver card. Some of the better access points for a dental office are the Cisco Aironet 350 series (http://www.cisco.com/) or the SMC Barricade Router (http://www.smc.com). The best wireless cards are the Orinoco Gold or Silver PC Cards (http://www.orinocowireless.com/).

Monitors are the final piece of the puzzle. When flat screen monitors were first released, they cost over $1000 each. Now, better monitors, such as the Samsung Syncmaster 151P (http://www.samsung.com/) or the Viewsonic VE150 (http://www.viewsonic.com/), can be found for less than $400. The consideration when choosing a monitor that is more important, though, is choosing the right mounting. Monitors can be mounted to light poles, ceilings, or even hung on a wall. There are companies that specialize in computer monitor mounting, such as Ergotron (http://www.ergotron.com) and JetMaster (http://www.lcdmonitorarm.com/). These mounts are often more expensive than the monitor itself. Be careful when considering monitor position, though…there are many ergonomic issues that must be well thought-out (more on this in a future article).

Many modern practices are moving forward and putting computers in the treatment rooms. This allows for better communication, improved patient flow in the office, and the opportunity to incorporate modern technologies, such as digital cameras and digital x-ray systems, into the practice. Years from now, we’ll wonder how we ever practiced without computers in the operatories. Now is the time to begin!


Bio

Lorne Lavine, DMD has practiced periodontics and implant dentistry since 1992.He is an A+ Certified Computer Repair Technician as well as Network+ Certified. He is the president of Dental Technology Consultants, which assists dentists in all phases of technology integration in the dental practice He can be reached via his website at http://www.dtc4u.com, by email at dtc@dtc4u.com or toll-free at 866-204-3398.