Cloud Computing and other Interesting Technologies for the Orthodontist
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1 Cloud Computing and other Interesting Technologies for the Orthodontist Mississippi Association of Orthodontists Steve McEvoy February 11 th, 2012 Jackson, Mississippi
2 Goals To discuss technology in a way that might actually be useful to you in 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 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 WatchGuard Monitoring
46 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..
47 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
48 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
49 Killer Uses for the ipad
50 Apple ipad Cool Personal Gizmo New niche not quite a computer, not a toy With it you can: Surf the Internet Music and Video Run Applications! Cooking Games
51 ipad Versions WiFi Only 16, 32 and 64GB models $499 to $699 Wireless and WiFi Add another $130 to WiFi model pricing $15 or 25 per month for Data plan Internet anywhere! Cheapest $499 model is ideal for office You ll need a WiFi at the office
52 the Ortho Practice Patient Entertainment In the chair, maybe lobby Patient Communication View your website or signup online tool Remote Control Use the ipad to control a real PC Ortho ipad Apps
53 ipad for Remote Control Allows you to use the ipad to remote control another PC at the Practice You can do most anything at the ipad you could do at the PC Might be ideal for the Doctor roaming around, using as a reference mostly Battery life is great, 8+ hours Ties up a PC (if you have a Terminal Server, you re all set)
54 Wyse Pocket Cloud Is an inexpensive App (<$15) Uses Microsoft's RDP Protocol to connect to your PC or Terminal Server Available for the iphone or ipad (Android too!)
55 Wyse Pocket Cloud
56 ipad Ortho Apps Better than remote control, they actually run the program on the ipad An extension of your existing Practice Management and Imaging Applications Dolphin Mobile Orthotrac Point of Care Patient Education Software Dolphin Aquarium Solutions by Design iscreenplay More to come!
57 Signing Documents Desire to use an ipad to allow a patient to sign a document Replace the digital signature pads the we are already using (or not) Your Practice Management app can t do this (right now)
58 PDF Expert ipad app that gives your ipad additional PDF capabilities Allows you to use your finger to sign any PDF document Allows you to transfer PDFs to and from the ipad easily Costs just $10
59 The Process Create a PDF of the Document you wish to have signed Copy it to the ipad Open, Sign and Save using PDF Expert Copy back from ipad Add to your Patient File
60 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
61 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?
62 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?
63 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
64 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?
65 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
66 Cloud PM Apps Cloud9Ortho Ortho2 Edge MME Online Services Others coming.
67
68 cloud9ortho Background Built to as a True Cloud App Probably not Geographically dispersed (yet) Runs in your Web Browser Fast Performance
69 cloud9ortho Software/ Hardware Requirements : Can be accessed either by PC/Mac, tablets, mobile phones ipad & iphone apps in the works Dual Monitor capable (1280x1024 resolution preferred)
70 cloud9ortho Database/ Imaging conversions:
71 cloud9ortho Software Demonstration Test Drive at Jump
72 cloud9ortho Summary Built from Scratch for the Cloud Young Company but with Experienced Leaders Definite Contender if the Features you need are there
73
74 Background Well respected Company Private Cloud Not Geographically diverse (yet) Your database and images are in The Cloud but your PC is still doing most of the thinking (like Hosted Computing)
75
76 Database/ Imaging conversions:
77 Software Demonstration Learn more at Jump
78 MME Online Services Clients that want the benefits of the Cloud without changing their current applications MOS is Hosting and Maintaining a Server(s) with your applications on it out in the Cloud
79 Multi Office w/cloud Similarities Thin Client Remote Office Office Network Network The Main Office Network Cloud Server Terminal Server App Server
80 MME Online Services Your Office Network MME Online Services Virtual App Server Virtual Server
81 MME Online Services Customer Profile 35+ Offices in 2 States Dolphin Imaging & Management One Database
82 MME Online Services MME Online Services Data Center Fast Secure Monitored
83 MME Online Services Perhaps the first step on the way to the Cloud Move your existing Application into the Cloud No need to update your existing Server No Hardware costs Monthly fee per login
84 Summary of Cloud PM Apps Choose the right PM app then choose the technology to run it on If I was a New Grad Would look at all options Single Office and all was well I wouldn t bother If all my Hardware needed updated, maybe then Single and about to expand to Multiple, worth a look Multi Office and struggling I would give the options a serious look
85 Summary of Cloud PM Apps Review your Internet speed in-depth and complete changes to it before committing to the Cloud Try before you buy Not just a 10 minute demo. Have several key staff beat on it for a couple of hours. Be skeptical and make them convince you Its still the early days for the Cloud
86 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
87 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
88 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.
89 Wi-Pics Recent 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
90 Eye-Fi Card SD card that has a built-in Wi-Fi connection
91 Supports most any * SD Camera
92 How does it work?
93 Costs A normal 4GB SD card < $20 Eye-Fi has several models: Connect X2 model is most basic, and does everything that a Dental Practice would need for $49. Online only at Best Buy has several models in store
94 Caveats Your camera must be supported Your camera must be ON to transfer You need to have a Wi-Fi setup at your practice
95 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.
96 MME s Blog blog.mmeconsulting.com
97 Thank You! Presentation Online at See you at the AAO in Hawaii!
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