Comparing Orthodontic Software
Date of Article: June 2009
Author: Charles A. Lewis
Orthodontists looking for orthodontic software frequently do web searches using terms such as 'Comparisons of Orthodontic Software,' 'Evaluations of Orthodontic Software' or some variation thereof. What they are looking for is a document that will lay out everything about each software for them, side by side, so they can easily reach a decision about which program to purchase. However, these doctors rarely (if ever) find exactly what they are seeking. Why, you might ask? What is so difficult about comparing orthodontic software? Don't all the orthodontic management programs basically have the same functions?
Difficulties Encountered in Preparing Comparisons
Although there are many reasons why it isn't easy to do such comparisons / evaluations, the most simple explanation is: No two offices use the software in exactly the same manner! So, while it might be relatively easy to put together a list of each program's features for comparison / evaluation purposes, that doesn't mean that the features will function the way you want them to in your practice. For instance, take a look at some of the factors that influence how an office operates:
How / where the orthodontist was trained
The staff and the sum of their orthodontic office experiences (including in other practices)
The region of the country in which the office is located
Whether the office uses electronic or paper records, digital imaging systems, etc.
Is billing done by the practice or are outsourcing services used (such as OrthoBanc)
Are patient contracts outsourced to a lender (such as ChaseHealthAdvance)
The type of communications used between the office and patients
How patient progress reports are provided to referring dentists
There are many other factors that contribute to how management software is used, but you probably get my point. Obviously, an outsider that is simply collecting data for comparison purposes isn't going to know how your practice operates, so only general information can be furnished. And even though all the programs might provide functions for charting, billing, scheduling, etc, those features might not work in a way that accommodates your particular needs (charting is an excellent example). For these reasons, unless you are able to find out how the software under consideration works, in relation to how you plan to use it, the odds are great that you and your staff aren't going to be pleased.
The next section contains some important topics for you to consider when evaluating software; and I'll bet that most of them aren't covered in any other comparisons you might find.
Important Questions You Really Should Ask
Can job duties define each user's access within the program? Most doctors really appreciate software that allows them to strictly control, on a need-to-know basis, what data can be viewed by each staff member. Example: Those who handle financial transactions only see financial records; front-office personnel only see administrative information; and clinical staff only sees clinical data. The ability to generate reports can be similarly restricted to those involving the staff member's duties, i.e. the chairside staff can only obtain clinical data - they can't generate financial reports. If the software you choose is designed correctly, the doctor (or the office's system administrator) controls these procedures via the login access rights granted to each staff member.
Are key components such as charting, scheduling, reports, etc easily customizable? With the right software, digital charts can be effortlessly customized to be suitable for the different treatment methods used in your orthodontic office. For this reason, your system should offer a variety of charts that are specific to particular treatment methods. As an example, trying to use a chart designed for treatment with wires and brackets doesn’t work too well if you are using a removable appliance system such as Invisalign. Therefore, you should be able to create an aligner treatment chart that accommodates that appliance. With charting customized for your treatment methods, data entry is greatly simplified. The same flexibility should apply to the way you schedule patients and the types of reports you want to generate.
Because of its importance, our company’s software makes customization a simple process. Although we provide several charts (designed by various orthodontists) that most doctors seem to really like, these charts can also be easily altered by users to meet their specific demands. For instance, our most popular aligner charts were jointly designed with a client who speaks internationally for Invisalign and those charts were featured in a 2007 article in the Journal of Clinical Orthodontics (‘JCO’). 1 In introducing the article, JCO Technology Editor W. Ronald Redmond, DDS, MS included these remarks:
"Today, Advanced Ortho Systems is ideally positioned to provide treatment chart options because it is one of the few true 'online' orthodontic management systems. The company can easily customize your programs, including your choice of charting systems, because the software resides not in your office, but on remote 'server farms'."
1 'The Cutting Edge: The Aligner Treatment Chart' Author: Mark J. Perelmuter, DMD, MS. Journal of Clinical Orthodontics Volume 41: Number 04: Pages (217-220) April 2007.
What options are available for purchasing and/or licensing the software? Some doctors don't mind paying cash for the software license (if they have it available), others might need some financing from the software vendor or a financial institution of their choice; other doctors might use a credit card. However, experience has shown that purchaser's appreciate having yet another option; one that is offered only by Advanced Ortho Systems and called Software as a Service ('SaaS'). The reason that SaaS is so successful in the current economic climate is because users can opt to use state-of-the-art software via subscription services that allow them to pay only for what they use, when they use it. No capital expenditure is required. (For more information visit http://www.advanced-ortho.net/articles/SaaSforOrthodontics.asp.)
What delivery options are offered for using the software? With only one exception, all the orthodontic management software currently offered is for use on a client-server where all the workstations are connected via a local area network ('LAN'). The single exception is the software offered by Advanced Ortho Systems; it is the only paperless-capable program delivered from a state-of-the-art data center over the Internet. To discover the major differences between a LAN and what Advanced Ortho calls Internet Program Delivery ('IPD'), read the article LANs vs. IPD at http://www.advanced-ortho.net/articles/lanvsipd.asp. Advanced Ortho is in its 7th year of offering IPD services and once you discover IPD's vast advantages, you'll probably ask yourself why the other software companies are so far behind . . . technology-wise.
Is software training provided? Is recurrent training offered? If yes, what is the cost? These are important questions for these vital reasons:
Comprehensive orthodontic management software, regardless of how intuitive and user-friendly it is, requires that its users be trained to use the program properly; and, since every office experiences staff turnover, it is essential that new personnel are also suitably trained when hired.
Because a good vendor will consistently provide software updates, users need frequent re-training sessions so they always know how to use the program efficiently.
In most cases, training is not inexpensive. The larger orthodontic software vendors typically offer training for a daily fee ranging from $600-$850 dollars, and many require 3-5 days of initial training.
One thing that all orthodontic software vendors know: Although doctors want (a) all their staff to be initially trained on the software; (b) new-hires trained; and (c) periodic re-training for doctor and staff - none of them like paying for that training!
For that reason, Advanced Ortho Systems designed online audio / visual training modules that are available for users . . . at no charge! When the training modules are used in combination with the program's extensive online help tutorials, users have access to complete, detailed training anytime they want it. A curriculum designed to use the training modules for complete, systematic training on the Program Director software is included. The syllabus is broken down into a 5-day format that promotes learning program functions in the correct sequence. However, users can also select only the modules that contain the functions on which they want instruction. This unique service allows purchasers of our software to obtain their training online so they can (a) spread out the training and not have to get it all at one time (i.e. 3-5 consecutive 8-hour days); and (b) avoid incurring travel and living expenses for a trainer. AOS' clients also find this tool invaluable for training newly-hired staff members.
Are technical support services immediately available during business hours? Technical support for your software never seems important . . . until you need it! And as you've probably experienced, problems always seem to occur when your office is the busiest. Although our software is probably the most stable in the industry (approaching 10 years of use without a 'crash'), The AOS support department is staffed at a level that allows your call to be taken immediately during business hours (8:00 AM - 8:00 PM ET, Monday-Friday). No more leaving voicemail messages or waiting for a callback!
Here's another bit of information vis-à-vis technical support that you will consider important: In ten years of operation, Advanced Ortho Systems has never increased its support fees. In fact, after we began offering IPD services, our support experience was so favorable that we actually lowered support fees for IPD users!
Is the software updated frequently to take advantage of new technologies? Surprisingly, many orthodontic software vendors provide updates on an infrequent basis. Advanced Ortho Systems wants its users to be able to use the latest technologies - once they are proven stable and worthwhile. To accomplish this, we typically provide 4 updates annually and completely new versions every 3-4 years. Perhaps that is one of the reasons our clients often use the word innovation in describing our software, our Internet Program Delivery, and the other unique services we offer them.
Are current users happy with the vendor, the software, and the support? Several years ago, our company ceased advertising and exhibiting at the national and regional orthodontic society meetings because we no longer found those activities necessary in order to be financially successful. (Our reasons are detailed and published at http://www.advanced-ortho.net/different.asp.) At Advanced Ortho Systems, new software sales come primarily from client-referrals and the great number of global visitors to our web site; a secondary source is my lectures and published articles. We believe that this is a very good indication that clients are happy with our company, its software and support. However, we will gladly furnish you with references and let the users tell you how they feel about us.
When it becomes mandatory to use electronic health records, will the software be capable of full compliance? Whether you like it or not, the United States and the rest of the world is moving toward adopting electronic health records (‘EHRs’) for use by all healthcare providers. 2 (I first began talking about EHRs in 1991; providing orthodontic software to make them possible in 1994; and writing articles on the subject that were published in 1996.) For those reasons, you might not find it surprising that Advanced Ortho Systems has always ensured that its software uses available technologies to make EHRs and paperless operations available. We've even made sure that the newest version of our Program Director software conforms to established international standards for the interoperability and interchange of EHRs. You can always count on AOS to 'have you covered' when it comes to meeting the clinical / information / management requirements of your specialty!
2 Consider these two provisions from the Economic Stimulus Bill signed into law by the President on February 17, 2009: “The National Coordinator shall perform the duties…consistent with the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and that…facilitates health and clinical research…” and “The utilization of an electronic health record for each person in the United States by 2014.” From article, Economic Stimulus Bill Mandates Electronic Health Records for Every Citizen without Opt-out or Patient Consent Provisions.
Summary
The objective of this article is to provide a new viewpoint on what is involved in selecting the right management software for your office. Many doctors aren't aware of the numerous factors that influence how these complex orthodontic programs are used in the practice and, as a result, they don't endeavor to ascertain whether the software will actually meet their specific needs.
If you were paying special attention to the section titled Important Questions You Really Should Ask, you probably noticed that many of them pertain to features / functions / services that aren't available with some of the software you might be considering. It's difficult to ask questions about such things or include them in your evaluations . . . if you don't even know that they exist. As CEO of an orthodontic software company, I get to talk to lots of doctors seeking new programs and learn the specific reasons for the discontent with their current systems. Based on those conversations, all of the questions that I have listed are important if you are to be successful in selecting software that you can consider a 'keeper.' If you don't get the right answers, you're probably just choosing a candidate for future replacement. Orthodontic management software is expensive, so changing systems is very costly; conversions are also stressful to the doctor, staff, and patients.
Advanced Ortho Systems finds this an exhilarating time to be in the software business! And although new technologies are becoming available at an unprecedented rate, at this point we have only begun scratching the surface of the full potential in our industry. The best is yet to come and, as a proven innovator, you can count on AOS to always be at the vanguard in making these important new systems available for use in the orthodontic practice.
Charles A. Lewis
About the Author: Charles A. Lewis is the Chairman and CEO of CPI Technologies Corporation and CEO of its subsidiary companies; Advanced Ortho Systems, LLC and Advanced Dental Systems, LLC. His many published articles on paperless operations, practice automation, and Internet-based delivery of management software have worldwide readership. Charles lectures at seminars and dental colleges on increasing practice efficiency through paperless operation and the use of Internet-based systems. He can be contacted at 877.803.4412.