Emmott On Technology: Opening the Industry to Open Technologies

Emmott On Technology: Opening the Industry to Open Technologies
Thursday, February 28, 2013

Imagine a world where cars are managed like dental technology.

If you owned a Chevy you could only fill up at a Chevy filling station using Chevy gas. Honda gas won’t work. You can only drive in the Chevy lane and take the Chevy off ramp. If the Chevy off ramp is closed for repairs you can’t take the Ford or Toyota off ramp.

That whole scenario is ridiculous but it is essentially what happens when we use proprietary dental systems.

At the recent Chicago Midwinter Meeting, Stanley Bergman, the Chairman and CEO of Henry Schein, Inc., introduced a new Schein initiative to advance the future of digital dentistry. He made the point that the future success of digital technology will depend on the easy transfer of data from one system to another.

This is called interoperability. The opposite of an interoperable system is a proprietary system.

The Pride Institute technology awards committee also met in Chicago to discuss and determine the awards for 2013. The issue of interoperability came up with almost every technology discussed, and the committee strongly supported open interoperable systems in opposition to closed proprietary systems. The belief of the committee was that dentistry as a profession is far better served by open systems than by closed proprietary ones.

At this time there are three major digital systems in dentistry that are largely closed, walled gardens keeping dentists and data captive. These are patient records, radiography and impressions.

If open systems using common standards existed, you could create a complete patient record using Eaglesoft and then transfer that record to a dentist in another state who uses Dentrix. That is not possible now. In fact, right now it is not even possible to transfer the digital record to another Eaglesoft user down the hall.

With an open system you could use the newest Schick 33 sensor to capture an x-ray, save it to the new Dexis Imaging Suite software and then export it to a colleague who imports it to his old Kodak software for analysis viewing and storage. That is not easy to accomplish with dental radiographs, but something similar is done every day with digital photography. We routinely take a photo with a Kodak camera, save the image to a SanDisk memory disk, load it into a Dell computer, view and process it with Adobe Photoshop software, save the image, and email it to our friend who looks at it on a Mac.

A quick way to check ease of use and interoperability is to examine the file format the software saves the images in by default. The file format is the three letters after the dot. Common image files are .jpg .tif and .gif. If the image software insists on using a proprietary file format rather than an industry standard, it is an attempt to keep you in their walled garden and it makes the transfer of images more difficult than it should be.

Let vendors know that open systems are an important buying factor. For example when shopping for a digital impression system ask the salesperson if you can transfer the digital impression to any lab of your choice or if you can load the impression into design software of your choice to design the digital crown. In almost all cases the answer will be no. Let the salesperson—or better yet the sales managers and product managers—know that you won’t buy a closed system.

I guarantee you when you do this, the salesperson will be prepared with a very plausible sounding reason that their closed system is better, and it is in your best interests to play in their private sandbox. They may also tell you they want to be open, but it is their dastardly competition that won’t play nice.

The fact is closed proprietary systems benefit the manufacturers and vendors. They do not benefit the profession and our patients. Vendors will not provide interoperable systems until dentists demand it as a condition of purchase.

A primary factor that keeps dentists from adapting new technology is high cost and the fear of buying the wrong thing that will become obsolete the week after it is installed. Open compatible systems will reduce much of this issue and make buying new technology less risky.

Henry Schein, Inc. is the world’s largest provider of health care products and services to dental offices. Having Schein on board the open system interoperability bandwagon is a tremendous step toward an open future. The future is coming and it will be amazing!

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