Computer Technology Essentials for Today's Orthodontic Practice

Transcription

1 Computer Technology Essentials for Today's Orthodontic Practice New Mexico Society of Orthodontists Steve McEvoy August 23 rd, 2013 Tamaya Resort

2 Todays Goals To discuss technologies and techniques that might actually be useful to you in your Practice You should be able to head home and implement the ideas immediately This talk will be available to you online so you don t need to take notes

3 Precious Data

4 Oh S..!

5 Show of Hands How many of us have info like this on a home computer or Laptop? Of those, how many of us HAVE a backup solution? Of those, how many are SURE its working and has everything?

6 Simple Solution Easy - Go Home and sign up for an Internet Backup solution Fast takes only a few minutes to enroll and configure Cheap they are ridiculously cheap for home users

7 A Couple of Choices Mozy.com $6 per month 1 PC/Mac 50 GB of Storage (that s a lot) Carbonite.com $5 per month 1 PC/Mac Unlimited GB of Storage

8 Some Details You can add additional PCs or Storage usually for just a few $$ more per month They don t backup your applications They only focus on your data These Personal plans are NOT for business They will not install on a Server

9 What about a Business? Let me tell you a story..

10 Business Backup Might be NOT be appropriate when: Large Amounts of Data (cost) Large Amounts of Daily Change (time) Slow Internet Connection (time) Might be appropriate when: Supplementing an Image Based Backup Can fill in what s missing Usually offers an extensive revision history

11 Backup Options Server External Hard Drive Databases Cheap (<$120) Fast (USB) or Very Fast (USB3) (~10 mins) Files/Images 40GB 500MB of Today s Data Cheap? ($50+ /mo) Tape Drive Portable Hard Drive Not Cheap (>$500) Usually Slow (~163 mins) Cheap (<$100) Fast (USB) (~23 mins) Very Slow (~113 hrs) Internet (~85 mins for today only) Internet Backup Provider

12 Backup Speed But I have a fast Internet connection, why would it take so long? Upload speed is what matters Most connections are Asymmetrical i.e. 6Mbps down, 1Mbps up Test at Internet = 1 Mbps Tape Drive = 42 Mbps USB 2.0 Drive = 480 Mbps USB 3.0 Drive = 5 Gbps or 5,000 Mbps

13 Initial Synchronization Sending out 80GB of data on the first days..

14 Bandwidth Utilization Sending out 80GB of data on the first days..

15 Bandwidth Utilization Configured to 384kbps max during office hours Full nighttime (about 1Mbps)

16 Daily Backups Each days new data tends to be 6 to 8 GB of new or changed information..

17 Business Backup Costs ~$50 per month for <100GB typical $600 per year or more Additional storage is ~$50 per 100GB If you had 500GB of data (CBCT) this would cost $250 per month ($3,000 per year)

18 Summary For Home: It s a no brainer just pick one and do it! For the Office Has to be considered Would be a supplement to a full backup Check out OakTreeStorage.com Internet Backup built for the Orthodontist!

19 The Cloud

20 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)

21 Cloud Computing What do you think it is?

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

23 Hosted Computing Off Site Server Firewall Office Network

24 Cloud Computing Your Data Your Applications Firewall Office Network

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

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

27 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

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

29 What can the Cloud do for You? Practices are constantly looking for ways to improve themselves Improving your IT is part of that process Most would prefer to develop their expertise in Orthodontic matters rather than IT Outsourcing

30 Cloud Promises

31 Cheaper, Faster, Easier It s the Internet right, everything should be simple, fast and free! Well if not free, should save money and/or improve performance Should be simple to learn and use

32 Software Maintenance Reduce costs by having someone else tasked to maintain the software, licensing, Servers, backups, etc. Trained Experts doing it is probably better than self taught in house expert

33 Always on Latest Version Good to have the latest versions of the apps you use everyday Reduce cost by not having to apply updates with internal resources Reduced hassle factor Or is it Improved Happy Factor?

34 Best Practices Setting up and maintaining your software following the best practices Likely to have a better overall result than your own IT having to figure it out and keep up

35 Hardware Done Better It would be difficult and costly to implement the highly redundant and secure setup of the Cloud within your own Practice (no downtime goal) It should be expected that performance will always be better than minimum and kept current

36 Typical In House Hardware Cable Modem Router Storage Server

37 Doing it Cloud Style ISP ISP Router Switch Storage Server Storage Server

38 Security Security of your Data should be paramount Better than your in-house practices Locked in a fortress on top of a mountain surrounded by tall walls And a moat Filled with Angry Alligators

39 Secure in the Cloud

40 Backup Done Right Backup of your data should be done better than your Practice is likely doing on its own Let an expert: Know exactly what to backup Back it up frequently Verify it frequently

41 Disaster Recovery Moving to the Cloud is a Disaster Recovery plan (in Advance!) What would you do now in the event of a Fire/Theft/Flood? Using the Cloud you should be able to just get another PC anywhere and get on the Internet somehow and be back in business

42 Extending Life Get more life out of your existing PCs Processing power is in the Cloud, so your local PCs performance isn t as important anymore If you normally get 5 years of life from a PC, you might be able to get 7 now Equates to lower annual equipment costs

43 Less Expensive PCs When you do need to replace a PC, it doesn t need to be anything special Simpler PC = Cheaper PC

44 Simpler PC Savings Feature Traditional Cloud Savings Model Optiplex 7010 Optiplex 3010 $ 14 Windows Pro Home $ 21 Processor i5 i3 $ 50 Memory 8GB 4GB $ 55 Video 1GB Basic $ 80 Warranty NBD Pro NBD Basic $ 36 MS Office Business Ed Starter $ 173 Total $916 $487 $ 429 You could save about $429 per PC if buying with the Cloud in mind Simpler to setup too!

45 Eliminate the Server Traditional Office Server Redundant Disks Holds all the data Has the backup Has power protection Has software licensing Needs a geek Files/Images Backups Server Databases

46 Eliminate the Server Most expensive part of your Network Just parts and licensing are over $10K Geek is another $2K Capital Intensive 5 year lifespan Dell Server $5,000 UPS $500 Backup System $1,600 SQL 2012 $944 SQL Users $2,187 Server CALs $167 $10,398

47 Work from Anywhere! Doesn t matter where you access it from, works the same. Great for Multi-office Practices Reduce the complexity of your office network Great for working from Home Improve your quality of life by spending less time at the office Even while at a study club or meeting No complicated process to take a case along

48 Freedom of Choice Choose whether to run on Mac or PC PCs are generally cheaper Much more prevalent in Dental Specialties Mac s are pretty And cost a pretty penny!

49 Cloud Options

50 Cloud Options For Practice Management and Imaging Cloud 9 Ortho Dolphin Cloud Ortho2 Edge others coming along

51 Skinning the Cat Each has taken a different approach Does it matter? A Porsche and Prius both have 4 wheels and get you places. Each is unique and yet accomplishes the basic goals. Let s consider.

52 Cloud 9 Truest to the notion of the Cloud Built from scratch to run in the Cloud Runs in your Web Browser Leverages Microsoft Silverlight Doesn t require much of a local computer Works on Macs (with Silverlight Plugin) There are limitations in what you can do in a web browser vs. a traditional application

53 Ortho2 Edge Written from scratch with Cloud in mind Database & Files are in the Cloud Application is downloaded and installed Processing happens locally Needs a good, fast PC (no old dogs) Advantages of a local application Works only on Windows Mac via Virtualization or Bootcamp

54 Dolphin Anywhere Same applications you are used to No need to learn a whole app to go Cloud Your existing data migrates seamlessly Utilizes Virtualization to host your data in the Cloud Uses Microsoft's Remote App technology to deliver the Applications to your Device Runs on PC, Mac, ios and Android

55 Delivering those Promises Cloud 9 New Program to Learn Some limitations of a Web browser Ortho2 New Program to learn Only on Windows Requires a more substantial PC Dolphin Needs decent Internet Bandwidth

56 Cost Knowing if it will save you money need a thorough consideration of your costs No two Practices are the same Some situations are a no brainer, and some are a no way. Lets do an example that you could adapt

57 Assumptions The life of a PC or Server is 5yrs We ll use PCs for the hardware Printers, Scanners, etc will be the same either way so can be ignored An IT guy costs $155 per hour

58 Assumptions The Network will have 11 PCs 2 Reception 1 Sign-In 1 Consult 1 Finance/Admin 1 Records 1 Doctor 4 Chairs

59 Server Cost Savings No big expensive Server Saves Initial Capital Investment $10,328 in hardware and software $2,000 in Labor Totals $12,328 for 5 years = $207 /mo Saves on Ongoing Server Maintenance Assuming 1 hour per month of IT guy $155/mo Dell Server $5,000 UPS $500 Backup System $1,600 SQL 2012 $944 SQL Users $2,187 Server CALs $167 $10,398

60 Workstation Cost Savings Being able to buy the more basic PCs Saves Initial Capital Investment $429 per PC for the hardware Simpler to setup saves 1 hr = $155 ea $6,424 total for 11 PCs $108 per month total Reduced ongoing Support Feature Traditional Cloud Savings Model Optiplex 7010 Optiplex 3010 $ 14 Windows Pro Home $ 21 Processor i5 i3 $ 50 Memory 8GB 4GB $ 55 Video 1GB Basic $ 80 Warranty NBD Pro NBD Basic $ 36 MS Office Business Ed Starter $ 173 Total $916 $487 $ less mins per month per PC = $142 per mo

61 Other Costs Internet Backup Assume 50GB less of Data = ~$50 per month Internet Connection A wash for your primary connection, you d have one either way Add an additional Cost of $50 per month for a secondary service (if you feel you need one)

62 Other Savings Didn t account for extra savings from: Sales Tax Shipping Financing/Money Costs Less Hassle Factor = $??? per month Happier Staff = Priceless

63 Total Savings Expense Capital Annual Monthly Server Hardware/Software $ 10,398 $ 2,080 $ 173 Server Setup Labor $ 2,000 $ 400 $ 33 Reduced Server Support $ 1,860 $ 155 Simpler PCs (11 of them) $ 4,719 $ 944 $ 79 Simpler to Setup PC (11) $ 1,705 $ 341 $ 28 Reduced Workstation Support $ 1,705 $ 142 Internet Backup $ 50 $ 18,822 $ 7,329 $ 661

64 Multi-Office can Save More No additional Terminal Server Perhaps $6K with setup No need for Terminal Server Licensing $80 per remote user one time fee No need for expensive T1 lines to link the offices Can cost $600 per month per link

65 Solutions Comes Standard With Peace of Mind that others are focused on: Security Backup Monitoring Updates More Time Leaves you with more time to use for other things

66 Is it Right for Your Future? Crappy Internet? No (for any Cloud option) If I was building a new Practice Yes (start with a clean slate) If I was a new Grad Yes (no capital required) If I was multi location Probably (model for the answer, and most certainly a yes if you have T1 lines)

67 Is it Right for You? If I had an existing network 4+ yrs old Maybe (model for the answer) If I had a new network already Probably not till next time (but model to be sure) If I was frustrated with my network or IT Probably (to reduce the frustration)

68 Final Thought Choosing a Practice Management Solution is a Religious Decision You will live with it a long time Once you ve picked the best tool for your Practice then put in the proper network to support it Don t choose Mac or Cloud first

69 Your Internet Connection What do you have now? What type is it? How fast is it? What does it cost?

70 Types of Internet Connections Wired 1. Fiber Optic 2. Cable Modem 3. DSL 4. T1 Wireless 5. WiFi 6. 4G 7. Satellite

71 Internet Speeds What do South Korea, Hong Kong, Luxembourg and 22 other countries do better than the USA? USA ranks 26 th for Download Speed US Average is 18Mbps Download About half what the best have 40Mbps USA ranks 39 th for Upload Speed US Average is 5.5 Mbps Upload About 1/6 th the leaders with 30+ Mbps

72 Internet Costs Cable Modem offered in Typical Tiers Entry Level ~ 16Mbps Down, 3Mbps Up $85 per month Mid Level ~ 27/7 Mbps $125 per month High End ~ 50/10 Mbps $200 per month Some places have Fiber options now running to 100/100 Mbps

73 How much is enough? More is generally better DSL isn t great (typically <3Mbps) Smaller offices can do just fine with the entry level plan (16/3) Sweet spot in pricing is the Mid Level plan (27/7) Cloud people will want as much as they can afford.

74 Steve s Picks Check what you are paying for now Go fiber if you can get it Cable Modem Mid-Level good value If Cloud, look at getting a redundant connection from another provider Cheapest DSL to go along with Cable Need a Dual WAN router to failover properly

75

76 Lobby WiFi HotSpot Patients are more connected than ever Many have mobile devices that can use a WiFi connection if available Another form of entertainment to someone waiting in the Lobby

77 HotSpot Concerns We don t want them accessing your business network We don t want them accessing inappropriate content We don t want them using all the Internet connection leaving you none We don t want your neighbors bootlegging Internet from you

78 Guestgate Purpose built to be a public waiting area HotSpot Works much like an Airport HotSpot

79 Custom Splash Screen Upon initial connection the visitor gets a customized Welcome screen

80 Simple Guest Controls

81 Network Settings } Connect directly to your Internet connection to eliminate any access back into your network Set the DNS Server to point to OpenDNS.com service and setup a Free account to filter access

82 Redirection Can be used to send them to a specific site after they accept & connect

83 Time Restrictions Turn if Off when you aren t at the Practice

84 Guestgate Costs about $140 A little difficult to find since it s a specialty product Search Amazon.com for Guestgate Mk II Has a few quirks, but it s the right tool for the task

85 Tablets

86 Tablet Promises About the size of a piece of paper Light enough to tote about We just write on them Can type if we choose Run forever Battery life shouldn t be an issue Run the Applications we need Not much point if the programs we want to use don t work on it

87 Apple ipad Great Device Battery life is excellent Cost is reasonable Size is great But, it s not great at: Writing on screen Running your specific Ortho Apps It s not a Windows Laptop

88 Slates and Ultrabooks

89 New Generation of Tablet PCs Great Devices Battery life is excellent Cost is reasonable Size is great Competition Exists And even better that they: Write On Touch Screens These are mainly Windows Laptops They can run Ortho APPS!

90 Microsoft Surface

91 Microsoft Surface(s) Microsoft Surface RT More like an ipad $499 Slow Processor HD Screen (1366x768) Great Battery life 1.5 pounds Windows 8 RT (Runtime) Only Runs Apps from Apps Store Can run a RDP Session Microsoft Surface Pro More like a laptop $799 Fast Processor (i5) HD Screen (1920x1080) Good Battery Life 2 pounds Windows 8 Professional Runs any apps that works on Windows 8 Ah-Ha! Freedom!

92 Tablet friendly Apps The device is only as useful as the software we run on it Applications can be improved to utilize the Tablets features Vendors can optimize for: Touch Screens (bigger buttons) Pinch-Pull zoom techniques Writing input rather than typing

93 Other Thoughts The Type keyboard for the Microsoft Surface is much better than the Touch The RT might be a good fit If you run a Cloud app If you just run RDP in a remote office RT includes Microsoft Office 2013 You have to buy Office on the Pro

94 Microsoft Windows 8 Should I care? Should I wait?

95 Windows 8 Your in a position to have to deal with it Retail PCs come with it already Built to Order PCs can still get Windows 7 But not in all circumstances Mostly a mid-term version Remember Windows Vista and Windows Me? Mostly Windows 7 under the hood The Big Change is the Metro Interface

96 Windows 8 Metro Desktop

97 Windows 8 Metro They removed the Start Button and Desktop and made the default the Metro Tile interface Microsoft Convergence - The Metro Interface was developed for the Windows Phone interface You ll either Love it or Hate it

98 Touch-centric They ve made a real effort and making it ideal for using with a TouchScreen Acer has the Touch HD series that include nice 23 ($550) and 27 ($700) models

99 Should I Wait? Windows 8 Professional can work fine mixed with your XP Pro and 7 Pro workstations and existing Server Check with your software vendors BEFORE you make the jump Don t assume - verify Personally - I would wait

100 Microsoft Office 2013 You re in a position to have to deal with it New PCs come with it already Not playing well with PM Apps (so far) IMS Ortho2 Dolphin CANNOT be undone! The app can uninstall, but the problems persist afterwards

101 Microsoft Windows XP Microsoft is Discontinuing Support for Windows XP in April 2014 No tech support No patch development It s not going to turn off Does anyone use Ortho2? Discontinuing support of their products on XP What about X-ray equipment? Lots of our old gear doesn t work on Win7

102 Clean Your Screen

103 Simple Solution Clean Micro Fiber Towels

104 Simple Solution CLEAN Towels One Damp with clean warm water One Dry Simple Wipe from one side to the other No Swirling or Scrubbing If Gooey then try bowl of water with a few drops of dish soap

105 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

106 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!

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

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

109 What if? What if you could just take the picture with the camera and have it magically fly over and land on the Server? Saves: Time (and therefore $$) Wear and tear on the camera, card and reader

110 The Records 10-Step 1. Take Pictures 2. Shut off camera 3. Open camera door, remove card 4. Walk to PC with card reader 5. Insert card 6. Open software, capture images 7. Remove card 8. Walk back to camera 9. Insert card, close door 10.Turn on camera

111 The Records 2-Step 1. Take Pictures 2. Whenever you like, anyone at any PC can open the software and capture images. Photos can continue to be taken while this is going on.

112 Wi-Pics AJO-DO Techno Bytes Article WiPics: Wireless and beyond American Journal of Orthodontics and Dentofacial Orthopedics, Volume 137, Issue 1, Pages A. Revankar, N. Gandedkar, S. Ganeshkar

113 Eye-Fi Card SD card that has a built-in Wi-Fi connection

114 Supports most any * SD Camera

115 How does it work?

116 Costs A normal 4GB SD card ~ $20 Eye-Fi has several models: 4GB Connect X2 model is most basic, and does everything that an Ortho Practice would need for about $39. BestBuy carry s several models, and you could easily return it if needed.

117 Caveats Your camera must be supported Your camera must be ON to transfer You need to have a Wi-Fi setup at your practice

118 Good WiFi A very good Wireless Access Point you could use is the Linksys WAP4410N About $179 from

119 What if it doesn t work? It s still a 4GB memory card, so you can do the old 10 step process. If you can wait, it will store the images on the 4GB card until the Wi-Fi comes back online, and will catch up then.

120 MME s Blog blog.mmeconsulting.com

121 AAO Technology Blog AAOTechBlog.com

122 Thank You! Presentation Online at