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Thursday, 13 June 2013 13:25

Ascending into the Clouds with Dentrix Ascend Featured

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post48_picIn the April issue of Dental Town I read an interview with Henry Schein’s Kevin Bunker, President of Henry Schein North America Dental Practice Solutions. 

He was talking about Dentrix’s new Ascend product: a cloud-based practice management system. 

Based on this interview and my understanding of dental technology, I’d like to make a few comments and observations.

Before I do this, in an effort at full disclosure, let me say that I work for Dentists Management Corporation (DMC) which sells a competing product. 

It is not my intent to denigrate or criticize Ascend in this post.  A cloud based system is an admirable accomplishment from a company that has been meeting the needs of dental practices for years. 

My company will be looking at doing something very similar, because this is the way all kinds of software solutions will be delivered in the future.

Since DMC has been considering this move, there has been much thought on the pros and cons of cloud-based software within our organization.  Our conclusion is to move ahead with the project, but I would like to share some thoughts we have had that would be applicable to our future product as well as Dentrix Ascend. 

Here are my observations.

◊    Cloud based software is totally dependent on an Internet connection.  If your Internet goes down, you will likely have nothing.  No patient schedule.  No account information.  Nothing.  An outage could be the result of construction in your building, utility work in the street or even an incident with the cloud-service provider.  About a year ago Amazon’s EC2 (one of the largest cloud-service providers) went down for several hours taking Netflix, Instagram and Pinterest with it.  Here’s an article in Forbes about this outage.  If your cloud provider goes down there is nothing to do but wait, but for the more local incidents consider configuring a backup Internet connection for your office.  Perhaps your traditional wired connection along with a wireless backup.  Getting these through separate vendors (i.e. Phone Company and Cable Company) will enhance this redundancy.  The capacity and speed of the backup line can be reduced to save costs because, hopefully, it will not be used very frequently or for long periods of time.

◊    You likely have an Internet connection to your dental practice today.  This is used for sporadic browsing, emails and perhaps a few clinical and administrative functions.  Don’t assume that this will be adequate after you make the move to a cloud-based practice management system.  While it meets your current needs, having every computer in your office dependent on the connection all day for nearly every activity will saturate its capacity.  Internet vendors have a variety of connection speeds at various prices.  Here is a link to Comcast’s Internet connection options.  They range from $69.95/month to $369.95/month.  Be sure to consult with your software vendor on what your new cloud-based system will require in an Internet connection and make sure this capacity is available at your location.

◊    Understand where your data will be hosted and be sure the appropriate security measures are in place.  From the article, it sounds like the hosting options for Ascend are limited to Schein’s facilities.  This is good, because we can assume that the correct HIPAA safeguards are being observed.  Recent HIPAA changes put these types of business partners under the same obligations as you, if you were hosting the product on a server in your office.  Don’t assume that all cloud vendors will protect your data up to HIPAA standards.

◊    A digital x-ray is a huge dataset.  Even a very fast Internet connection will bog down when moving these images back-and-forth from the cloud.  And it will bog down the entire office which is dependent on the connection.  That is why Mr. Bunker says “…most offices do require a server for digital imaging and other server based applications.”  Having a local server in your office resolves the issues around digital x-rays but it also negates some of the advantages of cloud-based computing.  The need for server hardware and your office managing backups and offsite storage will return.  Dentrix has no solution for this and neither will DMC when we have a cloud-based offering.  You end up with what is called a hybrid solution having most of your applications and data in the cloud and the rest on a local server.  If your practice has multiple locations your cloud-based applications will be available in each location, while server-based programs (think digital images) might still be confined to the location of the server.  There are ways to resolve this but they will require some additional technical considerations.

I admire Henry Schein’s 2-year effort to develop a cloud-based product.  If you are considering making the move to this kind of technology, taking into account the four points above would be a right click.

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