Thursday, August 1, 2013
Where to put the treatment room computer monitors is a dilemma for many offices.
A monitor needs to be positioned so the assistant can access it easily to input data—such as chairside charting—while maintaining eye contact with the dentist and patient. The monitor must also be close enough for the dentist to view radiographs or photos for diagnosis, or to read the chart. And finally, a monitor needs to be in a position that the patient can view in order to see his or her own radiographs or photos as well as patient education programs.
There is also the public/private issue. Some things we want the patient to see such as his or her own chart, x-rays, photos or patient education materials related to the case. On the other hand sometimes you just don’t want the patient seeing what is displayed. That would include another patient's chart or even the daily schedule. That is practice information.
One solution is a single monitor on a movable bracket or arm. The problem with this solution is, like all movable equipment, it is never where you want it. Because if it was where you wanted it you wouldn’t have to move it. Moving it to the proper position takes time, breaks asepsis and tends not to get done. Also the brackets needed to support the equipment often cost more than the computer.
A second much better solution is multiple monitors. The private practice monitor is placed at the 12 to 2 o’clock position behind the patient for the assistant and the public patient monitor is placed at 5 or 9 o’clock for the patient and dentist. The practice monitor can be small 19″. The public monitor will be used for patient display and should be large and impressive, 24″ or bigger.
Dual monitors allow the user to have two monitors showing completely different things. This is done by extending the desktop. That means you can view different windows, such as a chart behind the patient on the practice monitor and patient education in front on the patient monitor. However, a drawback to this set up is that you cannot input data simultaneously in both monitors. One computer is running both screens so there is still only one active window even though there are two monitors.
Additionally, you need to have sound in the treatment room for patient education, applications that talk to you such as the Florida Probe and patient entertainment. Some LCD flat panels come with built in speakers. These are ideal. However, many monitors do not have built in sound and you will need to add speakers or a sound bar to the patient monitor.
The practice monitor can be placed on a rear delivery cabinet shelf behind the patient on its own stand. This works but it takes up valuable clinical space and has asepsis issues. A better option is to mount the monitor using a VESA compliant arm coming from the rear wall and to discard the base. The arm should be long enough to allow the assistant to easily view the screen for data entry and should rotate so it can be turned toward the dentist for x-ray viewing.
There are four ways to mount the patient monitor.
If your dental chair/unit has a light pole, the obvious solution is a pole mount. Pole mounts work, however they are less stable than wall or ceiling mounts. Every time the light or chair is moved the monitor can shift. They also are often in the way when seating or dismissing the patient. The dentist may not be able to reach the monitor or will have to reach way across the patient to get it.
If you have a track system and no light pole there are several monitor brackets that can be mounted on the track along with the dental light. Track mounts seem to be an elegant solution but there are several issues to keep in mind. There is a constant battle between the light and the monitor for space and placement. Also they are dental specific and require more complex installation.
Another option is a track light and a monitor mount combination such as the TLC (Technology Lighting Center, formerly known as the dental chair potato). The TLC eliminates the battle between the light and the monitor; it is cleverly designed and uses an innovative fiber optic light. But it is still complex.
A less complex solution is a ceiling mount separate from the track light. If a ceiling mount is not possible, longer wall mount or cabinet mount options coming from the side wall are available.
Whichever solution is used, the patient monitor needs to be positioned directly in front of the patient when he or she is sitting up and then be out of the way during treatment.
There are numerous monitor mounts available from general technology supply companies such as ICW and Ergotron, or from dental equipment manufacturers. I will leave it to experienced dental shopper to figure out which is more expensive. The future is coming and it will be amazing!