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Corporate Profile: PracticeWorks Wm. Randol Womack, DDS, Editorial Director, Orthotown Magazine

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Dr. David Sarver, one of the key people who worked on developing Kodak's orthodontic imaging software, shares how the system works and benefits his own orthodontic practice.

by Wm. Randol Womack, DDS,
Editorial Director,
Orthotown Magazine
OrthoTrac imaging in the treatment presentation room is the ultimate in communicating treatment goals to
your patients. There are a number of
tools for image modification for treatment prediction, morph movies, video clips, and other forms of visual communication.
More and more orthodontic offices are changing the way their practices operate - streamlining from paper charts and documentation to the user-friendly and highly effective digital age. For years, PracticeWorks, Inc., the exclusive maker of Kodak Dental Systems, has been one of the leading providers of practice management systems to the orthodontic and dental professions with products that include Kodak SoftDent, PracticeWorks, WinOMS CS and OrthoTrac practice management systems. OrthoTrac is a full-featured orthodontic practice management system targeted toward practice efficiency, which is the strength of this system.

In the mid 1990s Dr. James Davis, co-founder of OrthoTrac, and Dr. David Sarver decided to develop a vision of orthodontic software that would integrate imaging (at that time a separate computer and software) and the practice management software for a seamless system of information management throughout the orthodontic office. Dr. Sarver of Sarver & Yanosky Orthodontics in Birmingham, Alabama, was instrumental in the development of PracticeWorks/Kodak Dental Systems' OrthoTrac imaging software from the early days of its inception. I discussed the personal aspect of owning and using OrthoTrac in an actual practice with Sarver during one of the few moments he could spare from his very busy schedule. Today he uses OrthoTrac version 11.0, to manage clinical information, process financial data, schedule effectively, manage digital imaging and communicate efficiently and professionally.

According to Sarver, OrthoTrac provides total efficiency at each workstation throughout the office. Through OrthoTrac, any doctor or staff member can record patient treatment, make appointments, check payment balances (which can be password protected for business office use only), look up X-rays and photos, forward records securely through the Internet and more. The office has total flexibility with the management of all the digital information. Since many general dental offices have gone digital, the electronic exchange of information is a lot easier and quicker.

One of the important systems that the office of Sarver &Yanosky has benefited from with OrthoTrac is the "patient flow" module. Like many of us, Sarver used light systems in his early office to manage patient and doctor flow. Today, from any workstation in the office, the entire schedule is visible as patient flow is recorded. Through OrthoTrac, the outdated light system has been replaced with digital patient flow screens that track patients from the time they check in to the time they are seated and treated to the time they are dismissed and reappointed.
 
Left: The patient flow module is displayed on a large LCD monitor in the clinic where doctor and staff can easily see patient flow from check-in to check-out, and other valuable information such as where the doctors are and where they need to go next, waiting times, and clinical efficiencies. Right: This same information is displayed on every other monitor in the office, so the doctors can see at a glance the patient flow and status from any point in the office.
"From any part of the office, I am able to see who is in the waiting room, how long they have been waiting, what chairs have which patients in the back, etc.," says Sarver. "So, if I am in a consultation and I notice that there is a red light on the patient flow monitor, that means I have to go to the clinic to place a bracket. I can excuse myself, go to the clinic, take care of business, and then return to the consult. In a two-doctor practice like ours, the lights can be color coded for which doctor is needed so doctor-patient consistency is maintained and we manage our movements well."

The doctors track and review the times for these segments of patient entry and exit. "With OrthoTrac, we now know how long patients were kept waiting, how long a particular procedure took (because each procedure is coded), which assistant was supposed to see the patient, which assistant actually saw the patient and how long it took for that assistant to perform the procedure. Because of the patient flow module, we know that the average waiting-room time in our practice is eight-and-a-half minutes," says partner Dr. Mark Yanosky.

Another benefit of this patient flow system is that it presents an overall evaluation of how the practice is functioning. "If it takes an assistant 30 minutes to do a 15-minute appointment, this signals to the clinical trainers that someone needs some help and reinforcement," says Sarver. The information gained from this function allows the practice to continue to direct follow-up clinical education and to keep patient flow moving according to the module.

Since he started using OrthoTrac, Sarver has found that the biggest benefit the software offers is how it enables him to maintain a profitable practice since, as with about every orthodontic practice, the area of most cost is people. "People cost us 20 to 25 percent of our gross," says Sarver. "Management of their time and our time is, in my mind, the most profitable thing we can do."

At the end of each month, Sarver receives an Executive Management Report (EMR) from his OrthoTrac system. It informs him which patients got their braces off, how many visits they had, what was the projected treatment time, the actual time of treatment, how many broken appointments there were, how many patients showed up late for their appointments, what the fees were for each appointment, etc. With this much detail on each case he can constantly and easily monitor the "no-show" rate, profitability per visit or profitability per type of treatment.
  "People cost us 20 to 25 percent of
our gross. Management of their time and our time is, in my mind, the most profitable thing we can do."

 — Dr. David Sarver
In addition he receives reports on how many new patients they saw, how many were adults or children, how many have records and are in line to start, how many don't need treatment, and how many of them "aren't ready" but go into recall (which helps project cash-flow next year and the year after). He also looks at gross production and collection with month/month and year/year comparisons. "With this kind of information, we can see a year in advance as to whether we are going to continue growing," says Sarver. "We are all guilty of not updating our fee schedules, but if you are watching your production, you need to make sure you are keeping fees up with the cost of living next year."

Sarver has also been instrumental in development of the OrthoCat communication module for the OrthoTrac System. OrthoCat is a system for communicating within the office as well as outside the office with dentists, parents or patients. The input is gathered from the initial clinical examination and is based on observations of the soft and hard tissues. This information is entered into a database program by the treatment coordinator during the exam, and the data is automatically processed through preset parameters, developing the problem list. Pre-developed paragraphs are attached to each problem to generate an automatic report.

In addition, this information can be digitally integrated with a letter system in the management software. Letters can be generated from the patient's problem list or treatment plan and can be sent to the referring dentist and/or parents. According to Sarver, this can be particularly meaningful when issues are noted on the initial exam, which could become "problems" after treatment has been finished. An example might be a TMJ click that the patient says he "noticed" after treatment and it is assumed not to have been there before treatment. If a "click" had been recorded in the initial exam observations and consequently stored in the patient's digital records, it can be documented to have been present before treatment as well as after. This is the strength of a module that, according to Sarver, "makes you go through and document all your observations. It really sets up protection for you down the road when they call back six months later and say, ‘The joint's clicking and it didn't happen until I got the braces off.'" This data is then organized to enable the doctors to develop treatment plans and store them in the patient's digital records. All of this information is retrievable at any time and from any place, even outside the office. Easily accessible treatment plan information is particularly useful in practices with multiple doctors.

Kodak orthodontic imaging software has revolutionized the new patient entry process as well as diagnosis and treatment planning. Digital photos are taken on each new patient before he sees them because they can be displayed immediately for discussion with the parents or patient, facilitating one-step consultations where appropriate. In the clinic, if the doctor wants to review photos or X-rays, the staff doesn't have to search through patient charts. It is instantly available in the patient record at any workstation.

Sarver uses the Kodak 8000C Digital Panoramic and Cephalometric System. One of the primary reasons he likes this unit is that fact that it uses a divergent beam, which has the same magnification factor as previous machines he's used. This means that he can superimpose new cephs taken on the 8000C with cephs that were taken on an older unit, important for growth assessment or progress studies on any patient. The 8000C also embeds a digital "fingerprint" into a digital photo or X-ray image, which can serve to prove that the image has not been altered. This is an important dental/legal issue as we move forward into the digital age.

As we wrapped up our conversation, I asked Sarver about the future of Kodak digital offerings available from PracticeWorks. He said he was excited about the Kodak 9000C 3D digital extra-oral system (expected to be released later in 2008). This unit will give doctors the flexibility of a "regional” 3D image, which could be specifically limited to an impacted cuspid area or the roots of upper centrals or a TMJ area, as opposed to doing a total cone beam CT (CBCT) scan. The benefits of this system will be less radiation output, less need for interpretation, a selected area to view and it would cost less than most CBCT machines on the market today.
Orthotown Magazine
November 2025
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