Alan Halls DMD
Alan Halls DMD
As a dentist and software developer, I often get asked technical questions regarding how technology can help an office overcome certain challenges, as well as advice regarding hardware and software for their office. Enjoy and comment.
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Practice Management Software, the Good the Bad and the Ugly - Part 2

9/14/2018 7:41:42 AM   |   Comments: 0   |   Views: 37

Part 2 - How data is organized, and the consequences

Because of there is a limited number of things to store, all systems store pretty much the same info, but HOW they store it creates some interesting situations.

Appointments VS Procedures

OpenDental and EagleSoft both store Procedures in separate tables, this is important because it means whether you store 1 procedure or 80 on an appointment, your database only stores what it needs to, and there is no limit to what can be assigned to an appointment.

Dentrix on the other hand has 20 columns for procedures, and then another 20 to assign a type. That means you cannot ever put more than 20 procedures on a single appointment. Doing full mouth extractions, implants with IV sedation and an immediate denture delivery? Probably going to need to make that a couple appointments.

One interesting thing I noticed when working with Eaglesoft was that procedures only are tied to appointments in the future. Once an appointment has passed and is set complete, there is no longer any connection. I have seen offices that manually attach notes to each appointment describing each procedure so that as they glance at last week’s schedule, they will be able to see what they did without opening up each person’s chart. I have also seen offices that gave up on assigning procedures to future appointments because that relationship got destroyed as soon as the appointment was set complete, so why waste the effort?

Financial Data
When getting numbers for your view from a database, there are two types of numbers you can get. One is a stored value, where you see what is stored in the database. The other is a calculated value. Calculated values would be like your checkbook ledger where anytime you want to know the balance, you have to start at the beginning to add in all deposits and subtract all withdrawals to get a balance, every time.

Calculated values are faster to store, because when updating the ledger, you only have to insert a new row without worrying about what the new balance is. Stored values are faster to view, because there are no calculations involved. To me, you would ideally use a combination, where when you add a transaction to the ledger it would recalculate the ledger, either from the beginning, or from a balance date, and then store that answer as the new balance. That way, when you want to run a report, or see an overview of the data, it doesn’t have to recalculate all that information each time for each patient.

As you would expect, all PMS systems I have worked with have a full ledger history, but only OpenDental and Eaglesoft have a stored balance for what the patient owes. While Dentrix does have a stored balance for the patient which includes the insurance portion, but finding the actual patient balance requires much more computing power.

Personalization of your Practice

This is one of the areas with greatest differences between the PMS systems I have seen. When setting the status of an appointment, how many choices do you want to have, and do you want to be able to define what those are? Appointments generally have 3-4 columns worth of data regarding it’s status.

 1. State (Scheduled, Unscheduled, Cancelled, Broken…)
2. Confirmation Status (Emailed, Texted, Voicemail, Confirmed, Disconnected / Wrong Number, None)
3. Appointment Status (Patient in Waiting Room, Patient in Chair, Patient to Front Desk, Completed, Lab Case Sent, Lab Case Received…)

 Generally 2 and 3 are part of the same column, you can also combine Completed from 4 with 1 or you can just duplicate that data, which I prefer. ASAP really deserves it’s own column since you don’t really want to overwrite any of those other options, and each can only have one selected.

OpenDental and Dentrix both allow you to customize item 2 and 3, Eaglesoft offers no customization that I have seen.

Check Part 3 to learn about the databases used.

Category: database
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