Using OD for an orthodontics

[jweek]

I am helping my wife evaluate various practice management systems for an orthodontic practice she is transitioning into and I came across OpenDental. Even though it appears mostly geared toward general dentistry, I was wondering if there were any orthodontic practices currently using OpenDental and what their experiences have been? Any and all information would be greatly appreciated!

Thanks in advance,

Joshua

[jordansparks]

Have you seen this page?:
http://www.open-dent.com/manual/orthodontic.html

[jweek]

Thank you for mentioning that resource. I have read it previously, but I was hoping to hear from any doctors (general dentists or orthodontists) who performed a lot of ortho in their practice, to see how well OD worked for them. I am a software engineer by trade, so I may be willing to help contribute any missing OD features an orthodontic office may need. Anyway, thanks again for your reply.

[murmsk]

My practice is about 1/2 ortho 1/2 general. OD is great. The updated payment plan sections works well. Progress notes with the auto code saves alot of time for the girls. Most notes are done with a few mouse clicks. Tooth chart is ok for missing and impacted teeth but not much else. You can't put appliances, wires on the chart. .

Image module is wonderful!!We have a folder for pre, mid and post records. they can se saved as images, txt, or pdf.

steve

[LSOrtho]

Joshua,
I am a full time orthodontic practice and using OD. The orthodontic upgrades and features are very slow developing as it appears ortho enhancements are a low priority for Jordan. I have been using it for over 2 years now, and it works sufficiently for ortho, without all the bells and whistles of the megaortho programs on the market. Last year I asked Jordan, and he has responded positively about adding the Palmer notation/numbering system used by most orthodontists; however, it has not happened yet. Also, patient terminal checkin and patient tracking (time checked in, waiting, seated, procedures by asst/dr and dismissal) and next appointment printed out on computer at checkout have been requested, as well as charting features enabling graphic display of orthodontic appliances. Again, no follow through. All those features would benefit general dentists as well, and should be added at some time in future.
I have other suggestions and you probably do also on how to enhance OD for orthodontics. I think OD would not be on the radar for ORTHODONTISTS, but with increasing amount of ortho being done by GPs it should be a strong appeal to that market for ortho enhancements.
Dr. Don Hartsfield
Lone Star Orthodontics

[jordansparks]

Most of the missing features you listed are already at the bottom of the ortho page as planned improvements. I just added your "patient tracking (time checked in, waiting, seated, procedures by asst/dr and dismissal)", although I don't know what "procedures by asst/dr" means. Since the other are all time stamps, I'll assume that one's a time stamp too. So maybe you mean the starting and stopping time when each provider did each procedure?

I also added the planned feature for letters with images.

Perhaps you could also clarify what you mean by next appointment printed out on computer at checkout. I assume that would be a label printed to a label maker which you could then stick onto the card of your choice? If so, then that feature is very high priority.

As for the slow development, I would say that most of the effort has been going into strengthening the payment plan features. I think that effort is paying off.

So the two highest priorities are the appointment labels and the Palmer notation. Appointment labels are easy. Palmer notation is tricky. The closest we can easily come up with is this
8┘7┘6┘5┘4┘3┘2┘1┘└1└2└3└4└5└6└7└8
8┐7┐6┐5┐4┐3┐2┐1┐┌1┌2┌3┌4┌5┌6┌7┌8
The text above is all in one font without any spaces between any characters. The illusion of spaces is an artifact of the characters. And obviously, the vertical alignment is not ideal. Just to make things interesting, it works in Arial font, but not in MS font or Tahoma font. So anyplace where we use it, we will have to be careful about the font. One way to improve the appearance would be through tricks such as superscript, subscript, and font size changes, but those tricks can only be used in limited situations. On the graphical tooth chart, I think we can make it look nearly perfect because we generate the pixels manually rather than using any font at all. Of course, generating pixels manually takes some initial time and effort. That's about all I have to say. I was just talking out loud here as much as anything; taking an intial stab at the issue.

[LSOrtho]

Jordan, thank you for the positive response. I believe the added features will add significant appeal to the orthodontic practitioner at any level of ortho practice.
Yes, all were time stamps... to track procedure times by each assistant for efficiency. Also printed reports to quantify the tracking of each "item" time stamped, would obviously make the data more useful.
Yes, printed labels with next appointment. Thanks
Also, please add .... printed "school excuse slips" with all patient/appointment info, as schools require these for all the kids dental/ortho appointments. This is a standard feature of all ortho programs.
It appears you have a good handle on developement for the Palmer notation. Obviously, text wise reference is by quad and #, UR1, LL8, URA, LLC...etc.
Any hope for ortho graphics on the CHARTING in the near future?
Is the patient check in terminal on the radar?
Thanks again Jordan, for all you have done and are doing for dentistry through OD!

[jordansparks]

It is very very tricky to answer the question of when a particular feature might be added. Essentially, we have to take into account:
1. How easy is it to add the new feature?
2. How critical is it? In other words, is there a workaround?
3. Utility. How many people will it help, and how much will it help each of them?
4. What's the simplest implementation that will answer the questions above?
The parameters above are all constantly changing, and there are thousands of features fighting to climb to the top of the priority list. So that's one reason why I put the priority list for ortho on its own page. Whenever we tell someone when a feature might be added, we are wrong 100% of the time. So, as a policy, we do not ever say when a feature might be added.

Keeping that in mind:

Ortho graphics on charting. The best solution is to let the user draw on the chart with a mouse or with a pen. The main reason why we have not added this feature is that we are concerned about future proofing. What happens if we change the layout of the teeth? The written annotations won't change. So they might no longer line up with the teeth. It looks like we are just going to have to accept that risk. The hard part has already been done when we added the signature feature. We already know how to store ink drawings in the database. I can't possibly say when this will happen.

The patient check in terminal is a planned feature. Aren't you worried about HIPAA? I am.

[LSOrtho]

Jordan,
Thank you for taking the time to explain the enhancement priority process.

BTW.. I know you want to keep all OD materials professional and no typos...
On the ORTHODONTIC page referenced, the following typo exists..... "......features specific to orthodondists..."

Ck in terminal, hipaa? I think there are ways to make it effective, personable, and private. A biometric or keyboard check in brings up "Welcome to Lone Star Orthodontics, Jordan! Your appointment time is at 9:00 am. Thank you for being 10 minutes early. Be seated you are NEXT on our schedule" (stays on x # of seconds?)
OR
"...Your appointment time was at 8:30 AM. You are 10 minutes late. We hope you are OK. Please be seated. You are the 4th to be seated. Your approximate wait time is 30 minutes." ....screen with your smiling pic, and time stamp to begin tracking process. This may be too detailed now, but that would be the vision. But a simple Welcome and time stamp would be a good start.
Thanks again!

[jordansparks]

I was thinking of the problems related to picking a name from a list. I guess having the patient type in their last name would be a good alternative.

[drforlano]

I do 30% ortho, 30% general and 30% implant sx. Been an OD user for about 1.5yrs and it is very versatile. The frequent upgrades and the personal attention to requests from Dr Sparks is exceptional.

[jordansparks]

Palmer numbering has been added. Used the simple UL5 etc format rather than the graphical representation.

[LSOrtho]

THANK YOU, Jordan!!!!

[mnpbds]

Hi all,
Based on the article "The Palmer notation system and its use with personal computer applications" by Jim Ferguson
http://www.nature.com/bdj/journal/v198/ ... 2303a.html

Daniel Johnson has kindly put together some Palmer Tooth Notation TrueType fonts. They can be downloaded here:
http://www.markpreston.co.uk/fonts/FreePalmer.ttf

They are covered by the GPL 3 license.
http://www.markpreston.co.uk/fonts/FreePalmerLicense
This font is descended from FreeSans, part of the Freefont project:
http://www.gnu.org/software/freefont/

http://www.markpreston.co.uk/fonts/palmer5.png shows how,once installed, they can be used in OpenOffice 2.4 (under Linux in this case). OpenOffice can also export the file as html - see http://www.markpreston.co.uk/fonts/palmer6.png
(FreePalmer fonts need to be installed for this display to work).

Please let me know any ideas for improvements, or additional characters that might be useful. If anybody would like the Fontforge .sfd file for editing please send me an email.