Cloud Computing and other Interesting Technologies for the Orthodontist

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1 Cloud Computing and other Interesting Technologies for the Orthodontist Cutting Edge Webinar Series with Steve McEvoy April 16th, 2012

2 Goals Educate you on The Cloud and some of the issues related to it as they pertain to your Practice Talk will be available to you online so you don t need to take notes

3 The Cloud

4 Wikipedia says: Cloud Computing Cloud computing is the delivery of computing as a service rather than a product, whereby shared resources, software, and information are provided to computers and other devices as a metered service over a network (typically the Internet)

5 Cloud Computing What do you think it is?

6 In-House Server Server Files/Images Backups Databases Office Network Firewall

7 Hosted Computing Off Site Server Office Network Firewall

8 Cloud Computing Your Data Your Applications Office Network Firewall

9 Hosted Computing Off Site Server Private Cloud Data Center Office Network Firewall

10 The Cloud The industries current favorite Buzzword Has Momentum Evolving fast

11 What s in a Name? The Cloud As in My Backup is in the Cloud Cloud Computing As in We don t have a Server, all that work is done using Cloud Computing Cloud Apps As in I use a Cloud App for my

12 Pandora Radio Internet Radio Tunes itself to your likes and dislikes Free account (has a few ads) Paid account eliminates ads ($36 per year) Works in a browser or with app (for paid account) Widgets for smart phones, and.

13 Logitech SqueezeBox Media Player Can play music from your PC Can link to your Pandora Account Connects to your office music amplifier Connect to your office network (cable or WiFi) Touch Screen Control No more XM costs or staticky local radio Costs about $300

14 Cloud Computing The Hype is exciting, but does any of it really matter to the Orthodontist? Technology yum

15 Classic Approaches Single Office Networks? Multi Office? Thin Clients? CBCT s?

16 Single Office Network Server Files/Images Databases Firewall Office Network TWAIN 2D X-ray Scanners Photos

17 Multi Office Network Thin Client Remote Office Network PTP T1 Main Office Network Server Terminal Server

18 Cloud Similarities Thin Client Remote Office Office Network Network The Main Office Network Cloud Server Terminal Server App Server

19 Communication Links Internet Connections VPN Tunnels (Secure) Remote Point to Point T1 s VPN T1 Need to Consider Quality Symmetry Costs Main

20 Communication Links Companies are Gaming Us

21 Symmetry Communication Links Is the Upload speed the same as the Download speed? Most Internet Links are Asymmetric (download is faster than upload) T1 s are most often Symmetric Why Does this Matter? Main Office Upload speed usually the bottleneck for Remote Office performance Upload speed is costly

22 Multi Office Network 6Mbps Download 1Mbps Upload 6Mbps Download 1Mbps Upload Remote Office Network Main Office Network Terminal Server Server

23 Communication Choices Point to Point T1 Usually 1.5 Up/1.5 Down Super Reliable Very Costly (~$300 per end) Varies by distance and carriers Your own dedicated, reliable pathway Doesn t scale well More speed means more T1s and more cost PTP T1 Remote Main

24 Communication Choices Internet T1 Links an office to the Internet, not Point to Point dedicated connection. Just an alternative to DSL or Cable. Speeds vary but usually Symmetric and consistent Probably more reliable than DSL or Cable Often bundles with a Voice package 6 phone lines and 1/1 Internet for $275 Less than a full T1 speed since phones use some

25 DSL Communication Choices Delivered across a phone line Speeds haven t kept up with Cable or Fiber Typically 1.5 Down/0.786 Up Can be a little faster depending on situation Quality varies greatly Impacted by distance from Central Office Cheap $60 Usually my last choice Might be good as a backup plan

26 Communication Choices Cable Modem Tremendous Speeds available now Starts about 6 Down/1 Up In some places 100 Down/20 Up Quality is pretty decent Not as good as a T1, but better than DSL Impacted by others on the Network (potentially) Cheap $50 for 6/1 or $200 for 100/20 Usually my first choice Unless.

27 Fiber Communication Choices Not everywhere, but if available it is THE option to pursue Tremendous Speeds available Varies, but packages usually include plenty of upload 5/5, 10/5, 25/10 and up. Quality is very good Same as T1 Can be Cheap $99 for 10/5 or $200 for 25/10 Usually my first choice if available

28 LAN vs WAN LAN = Local Area Network The speed your cabling inside your office runs WAN = Wide Area Network The speed of your Inter-office or Internet connection runs

29 LAN Speeds LAN Speeds 10 Mbps Long time ago (1980 s) 100 Mbps (1990 s) 1,000 Mbps or 1 Gbps (2000 s) 10,000 Mbps or 10 Gbps (2010 s) Fast and getting faster

30 WAN Speeds WAN Speeds 100 Kbps or 0.1 Mbps Long time ago (1980 s) 1 Mbps (DSL in the 1990 s) 10 Mbps (Cable in the 2000 s) 100 Mbps (maybe Cable or Fiber in 2010 s) Fast and getting faster Fast is relative.

31 LAN vs WAN In comparison, WAN speed are averaging 1/100 th of the available LAN speeds (10,000) WAN LAN 's 1990's 2000's 2010's

32 LAN vs WAN Applications that are written for the LAN typically don t work well over a WAN link What we have What we need

33 Little b s vs Big B s Communication speeds are described in bits per second or bps File sizes are described in Bytes Byte (8 bits) For the sake of easier discussion lets use 1Byte = 10bits

34 b vs B

35 Why Should You Care? If you have a 10 MB sized file and a 1 Mbps Internet connection, how long would it take to transfer? 1 Second? 10 Seconds? 100 Seconds? 100 Seconds (1 minute 40 seconds) 1 Mbps = approx 0.1 MBps Consider this when thinking about photo upload times and Internet Backup

36 Dropbox Personal Cloud Storage Folder Add-on to Windows Mac istuff (ipad, iphone, itouch) Android (Droid, etc) Accessible from the Dropbox Website You are always near your files, even without your device

37 Dropbox Great way to shuffle data between diverse platforms (like PC and ipad) Great way to sync files between multiple devices (Images at home and work) Acting a bit like an Internet Backup Each of your devices has a copy too!

38 Dropbox Laptop Home PC Internet Web Browser Office PC iphone, ipad, Android Data File

39 Dropbox Costs 2GB Account is Free! Enough for most peoples basic needs Pro 50 Account $10 per month, or $100 per year

40 Where are We So Far? When looking at Cloud services you need to consider these factors and how they apply to your individual situation Is your Application made for LAN or WAN? Link Types (T1, DSL, Cable, Fiber) Internet Speeds and Symmetry

41 Cloud Vulnerabilities What are some of the weakness s of Cloud Services? Reliance on your Link What happens when it s down? The Company providing the Service What happens if they go under? Backup of your Information Where is your Data? You have to move with their Development path Upgrades are not optional

42 Link Vulnerabilities Same liability as your own multioffice scenario: OFF = BLIND Use a Dual connection to indemnify Main Link (Cable Modem $100) Backup Link from a different carrier DSL ($50) 4G Wireless ($50) Need a Dual WAN Capable Router Watchguard XTM-21 Pro

43 Speed too Slow? Link Vulnerabilities Investigate the options you have, get the fastest one you can afford. Only Crappy DSL available? Might need to wait on the Cloud until your connectivity improves.

44 Link Vulnerabilities Link Saturation One of the staff is using 100% of your bandwidth watching NetFlix while you are trying to work. Have a router that can show you who/what s using the connection in realtime Prioritize the traffic to give your important Cloud app precedence

45

46

47 Company Vulnerability Consider the viability of any company you select How long have they been around? Are they growing? Are they responsible? What s their reputation? What if you choose to leave Will they give you your Data? Think about..

48 Backup Vulnerability Ask where your Data is Is it being backed up? How often? How many versions are retained? Likely they will be doing it MUCH better than you would be Ask if you can have a local backup just in case

49 What can The Cloud do in your Ortho Practice Today? Backup Carbonite, Mozy, Oaktree Storage Gmail, Office 365 Music Pandora File Portability Cloud based USB Key - Dropbox Cloud Practice Management Apps

50 Cloud Based Practice Management How might this change your practice? No Servers to Own or Maintain (Can you really have no Server at all?) Equal Performance in each office All offices are the main office Your home office has the same performance

51 What Questions to Ask Bandwidth requirements (Up and Down) for the number of computers you have Requirements for the local Hardware Will it work with what I own now? Will it work with a Thin Client without a Server?

52 What Questions to Ask How will Imaging work? Can I keep using my current application? How will Photos be captured? How are Documents Scanned and stored? How are 2D X-Rays captured? Is there integration for my CBCT? Are files captured locally then sync d to the Cloud? How does the sync work?

53 What Questions to Ask How will Printing work? Will it work with my existing printers? What about labels and appointment slips? Integration with 3 rd party services: Patient Communication like HouseCalls and Sesame Credit Card processing

54 What Questions to Ask Can I Host my own data in-house? Could be a way to minimize the effect of the Internet connection and have your own copy of the data How does support work? How would you get through a day in the Dark? How would you get your data back if it all goes wrong and you want out?

55 What Questions to Ask What are ALL the costs? How much up front for: Software Conversion Installation Training Support How much ongoing for: Hosting Support Additional User

56 Questions?

57 MME s Blog blog.mmeconsulting.com

58 Thank You! Presentation Online at See you at the AAO in Hawaii!

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