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Medical Forum / General / Dentistry / March 2007

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digital x-rays

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John & Ninetta - 22 Mar 2007 01:23 GMT
Going digital soon.  What's been the group's experience with various
systems.  Already have Schick cameras, so have that software already on
computers in each operatory.  John
Amatus Cremona - 22 Mar 2007 02:30 GMT
Been digital since 1999.  what do you want to discuss?

> Going digital soon.  What's been the group's experience with various
> systems.  Already have Schick cameras, so have that software already on
> computers in each operatory.  John
John & Ninetta - 22 Mar 2007 10:57 GMT
> Been digital since 1999.  what do you want to discuss?

Got to buy a system.  Schick seems to have most of the market.  Anyone
using it?  Pros/cons of Schick vs other systems.  John
Amatus Cremona - 22 Mar 2007 11:14 GMT
I have a Schick sensor for Endo.  I use Phosphor plates for everything else.

Which PM software do you plan to use to manage the images?

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>
>> Been digital since 1999.  what do you want to discuss?
>>
> Got to buy a system.  Schick seems to have most of the market.  Anyone
> using it?  Pros/cons of Schick vs other systems.  John
John & Ninetta - 23 Mar 2007 00:49 GMT
> Which PM software do you plan to use to manage the images?

My practice management software is Tracker (www.bridge-network.com).  They
have written bridge software such that there is a Schick icon on the
scheduler screen of Tracker.  I just highlight the patient's appointment on
the scheduler, click on the Schick icon, and the Schick CDR software opens
with all of that selected patient's images.  I currently use the Schick
software to only store intraoral camera photos, not x-rays.  You are correct
in saying that the data is stored in 2 different places with the method, but
its relatively seamless to access the images using this method.  You should
know that here in Canada, the Schick CDR software came free with the
purchase of the cameras 2.5 years ago.  Not sure if its still thrown in, but
I do know the version that I'm using is still the same one available.

I never looked into how the images are stored, in terms of format and size.
I will do so.  Thanks.

Just wondering people's experience with the Schick software in terms of
reading the films, ease of use, etc.  I'm not tied to schick as I can always
have Tracker write an additional bridge for the software that I end up
using.  The cost for the bridge is only $250.

John
Amatus Cremona - 23 Mar 2007 12:10 GMT
A big problem with bridging to a different company's imaging software is
support.  If you install a replacement video card and the system begins to
misbehave, the PMS will sometimes blame it on the imaging software and the
imaging guys say it is the fault of the PMS.  The guy who does the bridging
may blame both.  It can sometimes be difficult to trace down weird problems.
When it works good, this is not an issue.

Of course, (I know you already do this), you have to make sure your back-up
software looks at all the various directories where you have data stored
since it is NOT all in one place.

You will want to always contact your imaging software company, your PMS
company and the bridging software company (assuming it is third party),
before changing any internal components in your PC.  You want to be certain
the particular card you want to install has been tested by everyone.  If
not, you will not get any support from them.  They will insist you replace
the card with the recommended one and then call back.  Not all card drivers
will work with all component combinations and software combinations.

Trust me that this is 1000% easier if everything is handled by one software
company.

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>
>> Which PM software do you plan to use to manage the images?
[quoted text clipped - 21 lines]
>
> John
Newbie - 23 Mar 2007 14:38 GMT
>A big problem with bridging to a different company's imaging software is
>support.  If you install a replacement video card and the system begins to
[quoted text clipped - 17 lines]
>Trust me that this is 1000% easier if everything is handled by one software
>company.

I just don't buy this argument.

You only use software from one company on your computer ?

Let's see, you probably have Adobe Acrobat, An Anti-Virus program,
a printer suite, etc... all written by different companies.

Windows programs should run on Windows, and it is the
OEM PMS co that is responsible for making their program
run on the OS platform of your choice.
Amatus Cremona - 23 Mar 2007 15:08 GMT
It is only the high tech software that causes these problems.  Basically,
all the card manufacturers have not written drivers which are compatible
with every other card manufacturer's drivers.  The PMS engineers write a
product that will work with 3-4 different card combinations.  But, they
typically do not have the budget to test for every possible combination of
drivers.  Especially since the drivers change every few months.  I have
found a few different sound card drivers which simply will NOT work with
specific video cards.  That is before you add the PMS.  Now try to use voice
recognition at the same time as you are capturing video images, while
displaying previous images on another screen, plus a patient facial photo,
the daily schedule, and your progress notes all on minimized windows at the
same time.  You are asking a lot of code instructions to interact with each
other.

For all your basic consumer level peripherals, it does not matter.  Once you
try to stand on the top floor of the building, what is underneath you
matters a lot more than when you are on the ground floor.

Your PMS software is not going to offer support for Vista OS, until they
have had Vista in their own laboratory long enough to thoroughly test it.
It may work fine, but they need to know what to tell you when you call in
for support over some issue which does not seem to work right.

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Amatus

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>
>>A big problem with bridging to a different company's imaging software is
[quoted text clipped - 35 lines]
> OEM PMS co that is responsible for making their program
> run on the OS platform of your choice.
Newbie - 23 Mar 2007 15:34 GMT
>It is only the high tech software that causes these problems.  Basically,
>all the card manufacturers have not written drivers which are compatible
[quoted text clipped - 9 lines]
>same time.  You are asking a lot of code instructions to interact with each
>other.

Look I hear what you are saying but most video and sound is on the
mother-board now. If your machine is crashing because of the number
of progs you are using simultaneously perhaps it time for a RAM
upgrade or even a entire machine upgrade.

Saw a video card in the store recently that had 512MB of RAM on it.
My 486/66 had a smoking 1MB of video RAM !
Of course these cards are for high end gamers, but your PMS software
should interface with these cards seamlessly.
Sounds to me your PMS vendor is blaming their shortcomings on
the hardware vendors. And that says to me that the PMS developers
just ain't that good !

>For all your basic consumer level peripherals, it does not matter.  Once you
>try to stand on the top floor of the building, what is underneath you
>matters a lot more than when you are on the ground floor.

Have you seen some of the output on youtube ?
Hardly what I would call low level stuff.
The average off the shelf computer is much more powerful,
than just 2-3 yrs ago.

>Your PMS software is not going to offer support for Vista OS, until they
>have had Vista in their own laboratory long enough to thoroughly test it.

Software writers get the developer releases long before the OS is released
to the general public.

>It may work fine, but they need to know what to tell you when you call in
>for support over some issue which does not seem to work right.
Amatus Cremona - 23 Mar 2007 15:50 GMT
I think this will be less of an issue in the future, but for now, it does
exist.

We don't have to agree, but we can enjoy the debate.

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Amatus

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>
>>It is only the high tech software that causes these problems.  Basically,
[quoted text clipped - 45 lines]
>>It may work fine, but they need to know what to tell you when you call in
>>for support over some issue which does not seem to work right.
Newbie - 23 Mar 2007 16:20 GMT
>I think this will be less of an issue in the future, but for now, it does
>exist.
>
>We don't have to agree, but we can enjoy the debate.

Absolutely.

But I still disagree <g>
John & Ninetta - 23 Mar 2007 19:06 GMT
>A big problem with bridging to a different company's imaging software is
>support.  If you install a replacement video card and the system begins to
>misbehave, the PMS will sometimes blame it on the imaging software and the
>imaging guys say it is the fault of the PMS.  The guy who does the bridging
>may blame both.  It can sometimes be difficult to trace down weird
>problems. When it works good, this is not an issue.

I never thought about that.  Thanks.

> Of course, (I know you already do this), you have to make sure your
> back-up software looks at all the various directories where you have data
> stored since it is NOT all in one place.

Of course.

> You will want to always contact your imaging software company, your PMS
> company and the bridging software company (assuming it is third party),
[quoted text clipped - 4 lines]
> Not all card drivers will work with all component combinations and
> software combinations.

Thanks for the tip.

> Trust me that this is 1000% easier if everything is handled by one
> software company.

Now....back to my original question.....ever used the Schick software or
know of those who have and their experiences.

John
Amatus Cremona - 25 Mar 2007 14:51 GMT
I chose NOT to pay extra for the Schick software.

>>A big problem with bridging to a different company's imaging software is
>>support.  If you install a replacement video card and the system begins to
[quoted text clipped - 29 lines]
>
> John
Newbie - 22 Mar 2007 15:05 GMT
>> Been digital since 1999.  what do you want to discuss?
>>
> Got to buy a system.  Schick seems to have most of the market.  Anyone
>using it?  Pros/cons of Schick vs other systems.  John

Not personally but my endo buddy has Schick and he very much
would like to change, however he has too much $ tied in his system.

Tells me that he would change to Dentrix if it was economically feasible.
Newbie - 22 Mar 2007 15:57 GMT
>>> Been digital since 1999.  what do you want to discuss?
>>>
[quoted text clipped - 5 lines]
>
>Tells me that he would change to Dentrix if it was economically feasible.

Might have been Dexis
Amatus Cremona - 22 Mar 2007 16:12 GMT
I think the software you use to view the images is more important than the
brand of sensor.

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Amatus

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>
>>>> Been digital since 1999.  what do you want to discuss?
[quoted text clipped - 8 lines]
>
> Might have been Dexis
Newbie - 22 Mar 2007 17:10 GMT
>I think the software you use to view the images is more important than the
>brand of sensor.

Well, they usually come as a package.
And the resolution of the sensor is an important consideration.
Integrating with any PMS should be seamless

You should be able to use Photoshop to view images if you wanted.

On second though I gotta take issue with your statement.

If we extrapolate your statement to digital cameras then
by that token we could use a JoeBob camera and turn
the image into a masterpiece with the 'right' software.

I think not, it is definitely comes down to the resolution
of the sensor. Or quality of the optics in a camera's case,
plus the megapixel resolution of said camera.

Bet you don't own a Walgreen's 2MP digital camera,
bet it is a Nikon 8 MP.

BTW finally bit the bullet and ponied up for a
PMS package. Gonna need some hints on how to file electronically.
Amatus Cremona - 22 Mar 2007 17:52 GMT
Sensors all come with software, but you save money if you elect not to use
their software.  You simply tell the salesman.  The software which comes
with the sensor (or the phosphor plate system) works good, but it forces you
to store data in two separate databases, and some sensor software will not
import patient data from your PMS, so you have to enter patient data by
hand.  You are much better off using a PMS which can handle imaging.  You
want your data all in the same folder, and you want the imaging software to
be part of your PMS, not a third party software which someone was written a
bridge to interface with.  Also, different software packages will store the
image in different formats.  Some create huge image file sizes, while other
make much smaller ones.  Every program I have looked at will allow you
export the image as a gif, tif, jpg, pdf, etc.  So,,,,,,,,, sharing images
with other offices who have different software (or no image viewing software
at all), is no problem.

Dental x-ray sensors all come with higher resolution than you need.  The
software scales down the resolution to the smallest file size which will
still magnify and show you everything you want.  If you use the full
resolution, the image will take a long time to acquire and a long time each
time you try to access the stored image.  Think of setting the resolution on
the TWAIN software for your flat-bed scanner.  I suppose it may be possible
that one of the cheap sensors out there cannot capture a high resolution
image, but I doubt it.  But, I have not looked into the cheap brands which
seem to only be on the market for 2-3 years before disappearing.  If you
want to compare this to Megapixels in a digital camera, you have to limit
yourself to only comparing profession devices designed for professional use.
There are *NO* digital x-ray scanners designed for entry level home
enthusiasts.

My Nikon CoolPx is only 5.0 megapixels,,,,,,,,,,, But, I have had it for a
number of years now.  I had it when we went for the sail-boat ride.

Which PMS did you get?  Dentrix I imagine.  I don't know which toolbar
buttons they use to launch electronic claims, but imagine it has to be easy.
In ES, it is one click to pre-view a list of claims ready to send, open
selected claims only if you need to double check them, two more clicks to
send the claims, then close the window.  Takes all of 15 seconds usually.
Much faster since they went to internet submissions rather than modem
transmissions.

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Amatus

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>
>>I think the software you use to view the images is more important than the
[quoted text clipped - 21 lines]
> BTW finally bit the bullet and ponied up for a
> PMS package. Gonna need some hints on how to file electronically.
Newbie - 22 Mar 2007 20:04 GMT
>There are *NO* digital x-ray scanners designed for entry level home
>enthusiasts.

But they do make a DIY ortho kit !

>My Nikon CoolPx is only 5.0 megapixels,,,,,,,,,,, But, I have had it for a
>number of years now.  I had it when we went for the sail-boat ride.

Yep, I remember.

>Which PMS did you get?  Dentrix I imagine.

Nope EZDental

> I don't know which toolbar
>buttons they use to launch electronic claims, but imagine it has to be easy.
[quoted text clipped - 3 lines]
>Much faster since they went to internet submissions rather than modem
>transmissions.

Thanks but what I need to know is how to get or sign up for my
provider numbers. Isn't there a national number ?
And don't we need a e-claims clearing house provider ?

Supposed to get RR today in the orfice. Whoops ! Office. <hehe>
Amatus Cremona - 22 Mar 2007 21:23 GMT
There is a web-site to get the new NPI number.  I think you can file
electronically for a little while longer without it, but don't quote me on
it.

I don't know how EZdental does it.  ES connects to a clearing house they
have negotiated with.  There are independent ones as well.  I prefer to have
it a seamless as possible so you don't have a learning curve for new staff.
My system requires about a minute of time to submit claims every day.  Cost
is still less than the cost of envelope, postage and paper.

Setting up electronic claims the first time will take a bit of time.  Each
carrier will require a unique number to identify it with the clearing house.
Without that number, the clearing house will print the claim to paper and
mail it for you.  That costs about 10 cents per claim more, and takes longer
to get paid.  ES has a utility you run to get most of the numbers.  You then
print out a report and have your front desk person call the carriers which
did not come up with a number in the system.  Some carriers who are not set
up to accept claims electronically, can still have the claim processed by
the clearing house, as they have machines to print, fold, stuff and add
postage to the claim.  Still much better than doing it in your office.

Signature

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Amatus

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>
> Thanks but what I need to know is how to get or sign up for my
> provider numbers. Isn't there a national number ?
> And don't we need a e-claims clearing house provider ?
>
> Supposed to get RR today in the orfice. Whoops ! Office. <hehe>
 
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