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Cloud-based software

May 1, 2018
Ann-Marie C. DePalma, CDA, RDH, MEd, says the practice management software of today is different than that of the 1980s and 1990s. It’s time for dental professionals to take advantage of the tools that can assist us in improving the quality of care for our patients.
Do you still use your first cell phone? It’s time to take advantage of the tools that can assist us in improving the quality of care for our patients.

By Ann-Marie C. DePalma, CDA, RDH, MEd, FADIA, FAADH

Today’s dental practice is moving toward total digital integration. Practices that still use paper appointment books, ledger cards, x-ray film, or gooey impression materials are being left behind from their digital counterparts. Practice management software, digital imaging with or without 3-D integration, and digital impression scanning are the norms for high-achieving dental practices and teams. Understanding digital integration involves having the necessary training and time to fully utilize the dental digital world.

As in our everyday lives, dental digital integration is constantly evolving. Do you still have the same type of cell phone you had a number of years ago? Cell phones, when first introduced to the general public in 1973 by Martin Cooper, were large, expensive units. It wasn’t until the 1980s when the Federal Trade Commission approved cell phones for public use and Motorola introduced the DynaTAC phone that cell phones became part of our culture. Over the following years, BellSouth, IBM, Nokia, Sanyo, BlackBerry, and others introduced a variety of phones. It wasn’t until January 2007, when Steve Jobs and Apple introduced the first iPhone, that changes in digital communication really occurred.1 Do you still use your first cell phone?

The same is true with dental digital integration. In the 1980s, dental practice management software became part of the dental environment. Dental practices and teams began using the software initially for accounting and scheduling purposes and then added the clinical and imaging portions. Today’s dental practices can choose between becoming chartless or paperless with the variety of practice management software that is available. A chartless practice is one where paper is still generated and various aspects of dental practice, including charting and imaging, are done within the software program(s). The paperless practice is entirely digital—all aspects of the patient record are digital along with all electronic communications. Going paperless is about reducing costs, clutter, and improving efficiency. Many practices say they want to be “paperless,” but, in reality, they are more of a “chartless” practice.

There are a number of physical and technical requirements for a practice to truly become paperless. The software vendor the practice uses can assist in the move to become chartless or paperless with a variety of training options. For example, Patterson Dental offers a number of training possibilities ranging from in-office half- or full-day training, software checkups, online tutorials, or phone trainings—all depending on the practice’s needs. Training for team members—whether about the software or other digital technologies—is an integral part of today’s dental practice and should occur regularly.

Technology evolves as we have seen with the cell phone. Dental teams need to be updated on all aspects of the technology they will be using every day. Practices that do not schedule regular training sessions, as new team members come aboard or as the software upgrades, are at risk for a number of issues and concerns. Dental software vendors constantly upgrade their practice management software and changes occur that can improve the practice’s efficiency and productivity. All team members must be kept updated as software changes.

Dental practice management software vendors are investing in the cloud computing model to accommodate this shift in practice philosophy.

When dental practice management software was first introduced, all vendors had products that were server based. A server is a computer that manages access and processes requests from a centralized resource to other computers over the internet or on a local network.2 In dentistry, most practices utilize a server computer either on-site or remotely via a local network. With the addition of digital imaging, servers have had to increase the amount of storage space they have. A byte, or a unit of measure of digital data—similar to an inch, foot, or yard in the physical world—is used to determine the amount of storage space. As digital imaging becomes more prevalent in dentistry, it is not uncommon to have servers that contain gigabytes or terabytes of storage (giga = one billion, tera = one trillion).3 With each piece of digital integration, servers have needed to become larger and practice management software more agile and integrated. Many practices work very efficiently within the server-based model. The major software products—Eaglesoft by Patterson and Dentrix by Henry Schein, along with many other software vendors—continue to upgrade and improve their existing server-based products.

Location isn’t everything to the cloud

In recent years, the dental practice model of a single dentist or several dentists practicing in one or two locations, with a small team of business and clinical team members, has shifted to include more dentists and more team members in multiple locations. This shift is known as midmarket dentistry or the DSO market (dental service organization or dental support organization). DSOs work with dental practices within a centralized framework to provide support regarding the nonclinical and clinical aspects of dental practice.4 DSOs utilize technology to provide patient care across multiple locations.

This shift has resulted in the need for nonlocation-based storage and access. Additionally, the growth of nontraditional hygiene practice has influenced the need for nonserver-based resources.

In 2006, with Amazon’s introduction of cloud computing5—the use of remote servers over the internet to access and process data rather than through a local server—these practices have access to unlimited data. Even the traditional dental practice of one or two dentists in one or two locations can benefit from cloud computing. Dental practice management software vendors are investing in the cloud computing model to accommodate this shift in practice philosophy. In addition to server-based products, a number of vendors and products—including Dentrix Ascend, Open Dental, Curve Dental, Mogo, and others—are providing cloud-based practice management software services. SaaS (Software as a Service) is a major component of cloud computing, where the software license and delivery are based on a subscription model and hosted by the company. With the server-based model, the practice pays a one-time fee for the software rather than the subscription fee that is SaaS. Think Netflix versus standard television stations—you pay for the monthly subscription to Netflix to view programs instead of watching programs over the free standard airwave.

Whether a server- or cloud-based product is right for the practice is determined by a number of factors, many of which are beyond the scope of this article. All team members should be involved in the decision-making process, since both the business and clinical teams will be using the software, often more than the doctor(s), and the software needs to fit into the current practice workflow.

A new addition to the cloud-based dental practice management software world is Patterson Dental’s Fuse—a browser-based, cloud software that can be used across multiple locations and platforms, including smartphones, tablets, desktops, Windows, Android, or Apple products. Fuse is designed to manage revenue, reports, schedules, and clinical information in an easy-to-use, intuitive format for better practice productivity. It integrates complex data and presents it in easily understandable format. With input from practicing dental teams, both business and clinical, the company worked to develop software to fit the needs of the dental practice in today’s digitally integrated environment, which will also allow for future growth. Components such as Smart Screens, Clinical Timelines, and WalkMe assist teams in achieving goals designed with individual practice workflow in mind. Patterson offers support from its Patterson Technology Center to its local technology advisors.

As technology in our own lives has progressed, so has dental practice management software. No longer are schedules kept in paper appointment books or clinical notes written in paper charts. Server- and cloud-based programs are constantly evolving to improve practice productivity and patient care.

Although there are currently no generally accepted mandates for dental practices to be paperless (other than specific requirements within certain states), the practice management software of today is different than the programs of the 1980s and 1990s. Software vendors now strive to stay ahead of the needs of practices. As dental professionals, we need to understand the technology and software that our practices use so that we can take full advantage of the tools that can assist us in improving the quality of care for our patients.

Author’s disclaimer: Ann-Marie DePalma is a technology advisor for Patterson Dental and did not receive any compensation from Patterson for this article.


1. Five major moments in cellphone history. CBC News website. http://www.cbc.ca/news/technology/5-major-moments-in-cellphone-history-1.1407352. Published April 3, 2013. Updated April 3, 2013. Accessed December 27, 2017.

2. Server (definition). Dictionary.com website. http://www.dictionary.com/. Accessed December 27, 2017.

3. Gigabyte and terabyte (definitions). Dictionary.com website. http://www.dictionary.com/. Accessed December 27, 2017.

4. Dental service organizations. Wikipedia website. https://www.en.wikipedia.org/wiki/Dental_Service_Organizations. Updated August 28, 2017. Accessed December 27, 2017.

5. Cloud computing. Wikipedia website. https://www.en.wikipedia.org/wiki/Cloud_computing. Updated February 21, 2018. Accessed December 27, 2017.

6. Polack PJ. Pros and cons of cloud based or web based EMR systems. MedPage Today Professional. KevinMD.com Website. https://www.kevinmd.com/blog/2011/05/pros-cons-cloud-based-web-based-emr-systems.html. Published May 18, 2011. Accessed December 27, 2017.