Dana's Mixed Bag

One of the difficult things to do in Dentrix’s Document Center is to add a multiple page document. In our office we scan all documents destined to Dentrix Document Center quickly with a ScanSnap S510 scanner. This remarkable printer does front and back scanning at a rate of 3 seconds per page. It is not, however, a TWAIN compliant scanner, so we scan all documents to the Desktop, and acquire them as files from Dentrix Document Center.

Expand the Tree

Dentrix Document Center opens with all of the file tree collapsed. I like to add an additional Expand List icon to the left end of the Acquire toolbar, just above the patient’s photo in the tree. However if you are into using keyboard shortcuts, you may be disappointed with the “+” key’s ability to only expand the tree one level down. A more powerful alternative is to add a script which enables the “+” key on the number pad to open the entire structure.

Import

The steps just for acquiring a one-page document are only easy after burning the pathways into your head. To make things simple I use AutoHotkey to quickly insert a document. The script is loaded at the beginning of the day and enables several keyboard shortcuts using the keyboard’s numberpad. By pressing Alt+1 (“Alt” and then “1” on the numberpad), commands are sent to open the Import screen of the last folder viewed (in our case it is the Desktop folder). Simply double-click on the first page of the document scanned, and the Document Information screen appears.

Add Pages

Adding subsequent pages to a multi-page document is where things get difficult in Document Center. Instead of hunting down icons, we simply press Alt+2 (on the numberpad) and the Import screen reappears, awaiting selection of the document’s next page. This can be executed repeatedly until reaching the document’s final page. After the document is complete, close the editing mode by hitting the Modify Document icon again (on some computers it will be highlighted on the toolbar when it is open).

In order for this hotkey to work correctly, one must assign a hotkey in Dentrix Document Center. Select an existing, unsigned document, and click on the Modify Document icon (alternatively you can hit Alt-E, O). Then right-click on the UltraToolbar1 that appears and select “Customize”…. (it is the toolbar with Copy to Clipboard, Add Page…). Select “Keyboard…”. In the Commands section, scroll down the alphabetical list to “Import From File…” and left-click on it once. At the bottom of the window select the drop-down button under “Specify a Shortcut” and select “Ins” from the list. Then hit Close. (If you have already assigned "Ins” to another key, you’ll need to assign Import from File to another hotkey and edit the script below accordingly).

Sign

One last order of business is signing the documents to lock them up and make them more legally sound. I do not have any signature pads, but I do have a Tablo stylus system (I got for a steal on Woot one day) mounted to a clipboard on my desk. The third script works for me, but you will most likely need to edit this script to make it work for your setup.

One problem with the signature screen in Dentrix Document Center is that it always pops up in the upper left, unlike its behavior in Dentrix Chart. My script opens the signature window and moves it down to the same spot Dentrix Chart puts it. This is key for a clip-on tablet system like I have. You may need to tweak the numbers in order to send the box to the desired coordinates. Nevertheless, if screen position is not important to you, simply remove the WinWait and WinMove lines from the script.

All I have to do after acquiring the document is to hit Alt+3 to pop open the signature window. This system of using AutoHotkey to assign Alt+1, Alt+2, and Alt+3 has made integrating Dentrix’s digital document handling incredibly more efficient.

AutoHotkey can be used for many more tasks in the dental operatory, but that’s the subject of another post.

The Script

In order to get the script to work, just paste the following into an AutoHotkey .ahk file. (For more information, see my previous article about using AutoHotkey to send text messages from Dentrix.)

; Script for acquiring from file in Document Center
#IfWinActive Dentrix Document Center
!Numpad1::
Send !a
Send f
return

; Script for acquiring additional page from file in Document Center
#IfWinActive Dentrix Document Center
!Numpad2::
Send !e
sleep 300
Send o
sleep 300
send {INSERT}
return

; Script for opening Document Center signature pad in a managable location
#IfWinActive Dentrix Document Center
!Numpad3::
Send !e
sleep 300
Send s
WinWait,Sign Document
WinMove,Sign Document,,500,380
return

Tags: Dentistry // 9 Comments »

The latest trend in dental office management is utilization of text messaging to remind patients of their upcoming appointments. Text messaging is wildly popular with young patients, but is also growing rapidly with older patients. A recent survey reported that adults between the ages of 55 and 64 send 38 text messages a month.

There are many companies offering text messaging services to dental office, but most are expensive and achieve the same results we can get for free using AutoHotkey and Google Voice with Dentrix.

Google Voice is a free phone service which offers free voicemail services, phone call forwarding, and free text messaging. When you set up your Voice account you have the option to choose a telephone among many available. We chose (919) BRU-SHEM!

AutoHotkey is a scripting application for Windows that allows one to reproduce a stream of keystrokes easily. In order for it to work with Dentrix in Windows 7, specifically, it must be run in XP mode:

• Install AutoHotkey (use the Instaler for AutoHotkey_L option)
• Open Windows Explorer (Win-E)
• Navigate to C:\Program Files\AutoHotkey\
• Right-click on AutoHotkey.exe, and select Properties
• Click on the Compatibility tab
• Select the checkbox for “Run the program in compatibility mode for:”
• Select Windows XP (Service Pack 3) in the dropdown box
• Select “OK”, and close Windows Explorer.

Here is how we handle texting with Dentrix in our office:

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Tags: Dentistry // 14 Comments »

It is really hard to decipher what Microsoft is doing these days, and it is really hard to watch them screw up as badly as they are. Microsoft, a huge conglomerate, proved at CES that it is so far off track and so sluggish, that it cannot and will not deliver what consumers want. It is for this reason that Microsoft should be split and Steve Ballmer should go.

If we look back to the early part of the century, Microsoft was a company putting together some exciting components and creating an accessible ecosystem in response to Apple’s initial successes with the iPod. PlaysForSure worked on multiple devices, Media Center was a growing DVR platform, and the XBox was an impressive gaming system. It looked like Microsoft was well on their way toward growing components of a strong, powerful system. Then Zune happened. It was difficult to see Microsoft abandon PlaysForSure and screw over so many partners when they developed the Zune platform. However it seemed like a good move at the time to do a copycat to iPods/iPhones, just so long as it was part of something bigger. The hardware and software are as good or better than Apple’s and they offer subscription music. That isn’t enough, however, as the Zune needed some drop-dead advantages over Apple’s system. That never happened. Microsoft followed this past year with a copycat phone platform that has gotten good reviews, but honestly, it doesn’t offer that killer advantage over Apple, either, and is doomed for obsolescence, unless…

Microsoft has the pieces, has the chops, and has the money to do something extraordinary with its excellent parts, but it doesn’t. The tragic failure of Steve Ballmer’s Microsoft is that they have no clue, NONE, about what consumers want. It is 2011 and the economy is anemic. We don’t want innovation, we want innervation. We want all of these growing branches whose adoption requires much energy to mesh to make our lives easier. We don’t want to go further out on that proverbial limb. We want those limbs to get stronger. We want this technology to have soul, to know us. I’m sick of working my life around the technology. I want the technology to work for me. Is that so hard to understand?

I am the customer, and I am the boss. It is 2011 and there is no reason I cannot:

• Record an obscene number of TV shows
• Consume recorded, purchased, and rented programming from any device in my domain.
• Execute mundane chores from anywhere in my domain.

I should be able to record premium content from my cable system and send it to a hard drive in my car for my child to watch on a trip. I should be able to watch anything I record from my phone. My phone should recognize that I am coming home after dark and automatically turn on the outdoor lights. My house should know what time I get up, and set the temperature in the house appropriately. I should be able to program my DVR from my phone. I should be able to listen to any subscription music from any approved device in my house. My house should recharge my car with new music every night while it sits in the driveway. My car should be constantly recording video in case there is an accident. My kitchen should have an easy to manage inventory system like I have in my dental office. I should be able to track that inventory with my phone from the grocery store. All of my home’s phone messages should be easily accessible from my cell phone and all of my TVs. Caller ID should appear on all of these devices. I should be able to rent movies from my TV or phone. My car should have full control of the apps on my phone. Finally all of these tasks should be easy.

Some of these actions are currently available, but most of those require difficult setup and management. For example, my CableCARD enabled Windows Media Center system is the best DVR on the planet, but it doesn’t “just work”. Setting up home automation in this era should be relatively cheap and easy to setup. I shouldn’t have to become a home automation controller expert in order to turn on the spotlights from my car when I get home at night.

Some of these actions are being blocked by lawyers. However Apple, Zune, Rhapsody, and many others have shown that DRM can work. They register hardware and software to your group account, and that data is safe.

Microsoft has some of the best pieces to this puzzle that exist today.

• Zune – Zune hardware and software is quite comparable to iPods. The advantage is its subscription music service. However as a stand alone ecosystem, Apple dominates this space and the only way to win here is to offer things that Apple can’t; leveraging the other items in this list.
• Windows Phone 7 – The phone is outstanding, but lacks a mature app market. It will never catch the iPhone App store and Android Market. It has to be able to do things these phones can’t. That key is innervation with the other items in this list.
• Windows Media Center – Everyone passionately hates their cable provider’s DVR. Many would agree that Media Center is the best in class here, and it isn’t even close. How can Microsoft pull people away from their easy, loathesome DVRs? Make it easy and reliable, and leverage the items in this list.
• XBox360 – This and Windows 7 are currently the only bright spots in the company. The XBox and Kinect make the best gaming platform available, and the box is powerful enough to be a great point of entry for control of other items in this list.
• Ford Sync/MyFord Touch – Microsoft and Ford have put together a very impressive first generation car system. Others are coming from behind, but Microsoft can do what others can’t, leverage the other items in this list.
• Home Automation – Currently this is an area that is extremely difficult for DIY consumers, and every option is expensive. However people do want these controls, and are willing to spend some money on getting basic controls in their house. This is a wide open field that can easily be dominated, especially if Microsoft can leverage the other items in this list.

Unfortunately Microsoft seems to have absolutely no intent of ever getting these components to work together. This could be a unified brand that makes our live easier. Instead Microsoft seems intent on running another copycat down our throats (Windows Phone 7), offering a 3D chatroom (Kinect neat, but really, Microsoft?), forcing Windows 7 on tablets, and partnering with video content providers for content we already can access.

Steve Ballmer’s vision is severely flawed. Apple’s renaissance came not with its computers, rather their ability to make our cumbersome, annoying music collections easy. We hate our DVRs. We hate managing groceries. We hate closing and opening blinds in our house. We hate walking in the dark. We hate having to listen to the radio in our cars. We hate listening to voicemails in a cumbersome audio stream, We hate being tied to watching content we’ve watched or recorded to one setting. Instead of addressing any of those options, Microsoft has spent the last three years trying to wow us with things that don’t make our lives easier.

There can be great advantages to having a large company. Multiple sources of research can exist and a wide platform can be created under secrecy. However if Microsoft refuses or is not able to manage these sectors adequately, they then become a liability. Microsoft is a blind lumbering dinosaur that needs to be broken up because they will not use any advantages they have. They are doomed for many, many more failures to go along with Kin, PlaysForSure, Zune, WebTV, Live Mesh, Windows Mobile, Home Server, and many more.

2011 feels like an ominous year for the company. After only 9% stock growth in a 5-year period, stockholders are getting antsy and want results. Apple enjoyed great success with the iPad, but the second year for that device will be enormous, and will represent yet another space where Microsoft will be too little too late one day. The key is to make an ecosystem that works. However it is clear that with Ballmer at the helm, the company will not do what it takes to make our lives easier. They can choose to ignore Joe Consumer’s needs, but it won’t be long before someone else comes along and gets his attention.

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First of all, DON’T BUY AN iPAD RIGHT NOW (Jan ’11). Reliable sources say that Apple will be announcing the next generation iPad in 3-4 weeks, and presumably will release the product in March.

I am still using paper charts for storage of pans and forms…and I’m really sick of it. I think that the final barrier has been the awkwardness for patients signing forms. Until 2010 the cleanest option was to hand patients an expensive, heavy tablet PC. However that was not without its problems. As much as I hate Apple, I really think that the iPad will be the device that finally sends medicine and dentistry into true paperless charting.

The advantages to the iPad are relatively light weight, are an impressive tech statement to patients, have great battery life, and have fantastic resale value (a 1-year old iPad usually sells on eBay for $100 less than purchase price. We don’t see this great resale value with Android devices). With 35 competing tablets introduced this week at CES, there will be a strong push toward this form factor for intermediate computing, and that’s nothing but good for us in the dental field.

Currently it looks like there are three different options for using an iPad in the dental offfice:

eCentral’s Kiosk

Dentrix already has the forms functionality working with the iPad. It requires an eCentral Kiosk subscription that is $50/mo. Once you are subscribed you can upload items from the Dentrix Questionnaire module for patients to complete at home or in your office using any type of PC. Because this is all handled as a web app, the user’s computer shouldn’t matter, however they have not worked out kinks in Android. With a Droid X and a Galaxy Tab, the forms do not render correctly (the virtual keyboard has an assortment of upper and lowercase letters, and borders are incorrect). As voiced earlier in this forum, the interface does NOT have a true signature. Rather, you type in initials and the transaction apparently is as legal as any other transaction that occurs on the internet (however this makes me a bit nervous because who is to say that one of our staff members didn’t go in and create a fake document for the patient). For me, though, the $100/mo cost is pretty hefty and is offputting. (the $100 includes unlimited text messaging to your patients, but we already use Google Voice and Autohotkey to send them for free). Dentrix ran all over the country last year doing $25 seminars that primarily served as sales pitches for eCentral. The message I got is that they stand to make a LOT of money getting us addicted to their service.

Pros: clean interface, seamless data importing into Family File (no double entry), simple.
Cons: lacks true signature. costs.

Correction (1/10/11): I apologize that my notes were incorrect. Kiosk is not a part of the communications manager, but rather a part of Website Manager. The $50/mo also includes the ability for patients to log in and check appointments, make payments, and more.

PDF Completion

One could put completable PDFs on their website. Patients then complete the document in their Adobe Reader and print it, bring it to your office, your office enters the necessary data, then scans it to Document Center. For patients who are in the office (most common scenario), they would use an iPad for forms completion using an iPad app for PDFs that allows signatures (you would buy a cheap stylus that works with capacitive touch screens). The completed form is then synced automatically from the app to a Dropbox account which is synced to the receptionists computer. She then enters necessary data and easily imports the completed PDF into Document Center.

Pros: Cheap, offers true, legal signature, online forms access for patients.
Cons: double entry, requires scanning step for pre-completed forms, ?Dropbox HIPAA compliance?

Remote Desktop

One could set up a couple of old computers that are expressly used for being remoted into by an iPad app. The staff member runs the remote app, and brings up the patient’s necessary questionnaires, hands them the iPad, and afterward, assists them in creating a signature in Dentrix Questionnaire Signatures.

Pros: Cheap, seamless data importing into Family File (no double entry).
Cons: No internet forms access, staff must be trained to access these machines and set it up for patients, additional, headless machines must be maintained (must have a Professional version of Windows, not Home), Security (patient could potentially access network from the iPad’s remote desktop application).

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Tags: Dentistry // 5 Comments »

2010 was an excellent year in tech. Windows 7 became the first widely-adopted OS in 9 years by Microsoft, Apple shook up intermediate computing by introducing a large version of a current product, Microsoft introduced the first device-free controller in Kinect, eBook readers finally gained traction, Android operating system exploded, Microsoft released a strong OS for phones, 3D TVs hit the shelves, Google TV and Apple TV launched, and much, much more. Here’s a look at what will happen from 2011

• Apple will unveil the iPad2 and it will be an enormous success. It will include a front-facing camera with FaceTime as well as a higher resolution screen, period. Apple doesn’t need to add any more features than that for the device to continue its domination. In fact, in the face of a slew of tablets at the same price point, sales of the iPad2 will actually increase based on the maturity of the ecosystem.
• Apple’s next foray with iBooks will be an aggressive move to adopt textbooks.
• Seeing the impressive Ford Sync system, Lexus/Toyota and BMW will join Google or Apple to create an automobile integration system that leverages one’s iOS or Android phone to deliver content beyond A2DP Bluetooth audio to the car’s system. Key selling points will be navigation and Pandora.
• Nintendo will release a controller-based, HD game console that will play legacy games. In early 2012 they will announce a Kinect-like sensor for the system.
• Microsoft will still have a phenomenal set of components but still will not connect the dots. Their home DVR, cell phone, Zune subscription, XBox360, Kinect, and Ford Sync systems are all incredible products. Add an inexpensive home automation system and allow all of these parts to talk to each other, and you have a killer lifestyle ecosystem. Unfortunately they will still be tripping over details of the trees instead of selling people on the forest.
• Yahoo will merge with someone like Time Warner, AOL, or Viacom.
• Barnes & Noble and Borders will close 25% of their brick & mortar stores.
• Blockbuster Video will dissolve, but their assets will be purchased by independent, local merchants in vacation destinations.
• Fuel prices will inhibit the economy so much that many new, innovative products this year will not get off of the ground.
• Apple’s device division will have an outstanding year, but adoption of OSX will still be slow.
• There will be no more upgrades with cable companies’ rented hardware. Time Warner Cable will introduce a cloud DVR service that allows fast forwarding, but is so inaccurate that it cannot be used to skip commercials. Hollywood lawyers will require that the shows be set to record up to the episode’s actual presentation time (they will not allow TWC to record 1 instance of our local “Modern Family”, for example, and apply it to subscriber’s accounts as requested. They will require TWC to have one instance per request of that episode on their servers). Subscribers will not be able to request recording of a show the following day, as this constitutes “on-demand” viewing, and is a different legal entity.
• Time Warner will work with local outlets to carry online access through cable boxes to streams that currently exist on the internet. Local news streams, for example, will be provided in a crappy, slow 10-foot interface.
• Prices for sheet-fed document scanners will fall, enabling people to easily scan documents and sent them to mobile devices.
• Apple will release an iPhone on Verizon in March along with the release of the iPad2.
• Terrestrial radio stations will begin showing a noticeable weakening. XM will be in real trouble in Q4.
• No improvements will be made with the BCS bowl system.
• No significant improvements will be made regarding the quality of content available to stream from TV devices. (ie. “cutting” the cord – from cable systems – will still not be a viable option).
• Social networking specific to food and music will be big trends this year.
• Environmentalists will protest the ritual of putting up a natural Christmas tree.
• Violence will break out regarding the actions of the World Bank.
• Serious discussions will take place regarding dissolution of the ACC Basketball Tournament.
• Indian food will make its first step toward being America’s next food fad.
• City officials will discuss separate disposal of styrofoams and certain plastics to landfills.
• Mobile HDTV units will become ubiquitous, but will be poorly adopted by the market.
• An Android tablet will have a dock that allows the tablet to be used as a computer monitor. The tablet’s document system will be available as a drive to the computer’s operating system.
• A very big, new rock band we’ve never heard of will emerge.
• Tablet computers (and their ability to offer a paperless questionnaire) will be the final step in getting medical practices completely paperless. It will be a 5-year process, but there will be a significant adoption rate in 2011.

So there it is. It could be complete rubbish, could be mostly true. I don’t care. Just one man’s thoughts!

Tags: Tech // 1 Comment »