July 2013, Volume 9, Issue 7
Published by AEGIS Communications
Disaster Planning Considerations for Dental Technology
Prepare for seamless data retrieval in an emergency
Disasters make their own schedules and tend to strike at the most inopportune time and typically with high cost. Some dentists will choose not to prepare. It’s been said that “ignorance is bliss,” and a dentist can certainly go to and from the office day after day and deal with disaster when and if it happens. Given the inevitability and serious consequences of disasters, however, preparation is a prudent course of action.
Disasters: A Spectrum of Problems
Consider Superstorm Sandy: Some practices were totally submerged and others had significant water damage. After the waters subsided, nothing was left to salvage: no charts, no chairs, no computer systems. Some offices were just gone overnight.
After the storm passed, the support lines for the prominent dental software vendors lit up, crowded with dentists hoping for a solution to a huge problem. Unfortunately, the best these vendors could do was to send duplicate installation disks and inquire about data backup. In those offices that had backups, the backups were typically sitting in the practices, right next to the submerged servers. Of those who had backups elsewhere, many of those failed to restore.
It is also not uncommon for a burglary to greatly disrupt the practice. Stolen computers can be replaced. But the information on the computers might very well be a different story.
Disaster can also strike in a less dramatic way, such as hardware failure, but the results are the same. Eventually all computer hardware will fail. A server may provide signs that it’s on its last legs or it just may stop working without warning. When this happens, days of lost production and wasted staff time add up quickly. All too often, hardware failure costs an office several weeks in lost production.
The Client-Server Approach
Consider the ideal prevention plan needed to address the risk of disaster for the typical office with a client-server setup. Redundancy and power are the major points to address.
First, the practice will need a second server, equal in capacity and speed to the first. Redundancy means that the practice should have sophisticated software that manages the storing and retrieving of duplicate data from two separate servers to ensure that if one fails, the other is ready to take control. Those two servers should be in different physical locations, sufficiently separated to ensure that a fire, earthquake, or flood would not affect both. Second, a separate power source should be secured so that power to the practice would not be a single point of failure.
In short, to prepare for uninterrupted service for a client-server system, a dentist will spend significant resources on equipment, configuration, and line and power services, and then contract with an IT professional who would spend a lot of time on setup, maintenance, and monitoring.
For some practitioners, these requirements may sound unreasonable. Does that mean that they will just have to live with the risk? If a practice is using a client-server–based dental software system, the answer is “yes.” There are things they can do to help mitigate the risk incrementally, but they cannot, for a reasonable price, craft a solution that addresses every scenario and nearly guarantees no loss of production.
An Answer in the Cloud
In a web-based system, there is no on-site server. With no server to be flattened in a collapsed building, destroyed by a flood, or stolen by an intruder, and no server hardware to fail, patient data to lose, or backup tapes to make or restore, recovery is much easier. All that is required is a connection to the Internet.
In the case of a geographic disaster, the office may be destroyed, but patient information is intact and insurance collections can continue. In the case of a localized event, such as a stolen computer, a quick trip to a nearby retailer can have the practice operational quickly.
Saljae Aurora, DDS, of Vancouver, British Columbia, experienced the benefits of a web-based system firsthand. One morning he arrived at his practice and quickly realized that all was not well. His computers were gone, but his cloud-based system meant that his doors need not close. Using his personal laptop, the practice was able to see and treat all the patients scheduled for that day.
Keeping Data Secure
Web-based applications (Table 1) secure the practice’s patient information, including digital images, in multiple professional data centers. Patient data are stored in a totally redundant data center located in separate regions. All information is stored simultaneously in multiple locations, and if for any reason one of them is made inoperable, the others pick up the slack. In the case of hardware, when something breaks, the system moves primary operation to another server in an instant. A practice using the cloud to manage its practice would most likely not realize a failover switch had occured.
Transfer of patient data between the data center and the dental office is encrypted and HIPAA compliant. A host of firewalls and detection systems are employed by the data center to thwart unwanted access. A typical data center is usually surrounded by a physical barrier; entry is limited to authorized persons and may be monitored by video surveillance or security guards or both. In the dental practice, security may be provided by a consumer-grade router and firewall, a single deadbolt, and perhaps a perimeter security system monitored by an unknown person with an unknown degree of training.
Having patient data residing on the cloud is akin to having wealth in a bank. Would the typical person feel more secure with a wad of cash under the mattress or deposited in the bank? The bank is in the business of storing and securing wealth. Data on the cloud are more secure than data in the dental office because a data center is in the business of storing and securing data.
With patient data in the cloud, the chore of backing up data nearly disappears. With multiple locations housing the information, a backup copy always exists on multiple servers—not just a daily backup, but a backup that’s never older than 15 minutes. With data in the cloud, the dental team doesn’t have to remember to make a backup and take it home at night (which would additionally raise some HIPAA concerns). IT professionals will rightly argue that responsibility for patient data resides with the practice. It seems prudent that the practice should also keep a copy of the data in a safe place within reach. A good web-based system will allow the practice to download data at its convenience.
Of course, the benefits of the cloud hinge on one assumption—that the practice has a dependable Internet connection. In the case of Superstorm Sandy, the crux of the problem was not data access but data preservation. With a web-based system, the preservation of the data is without question. But even with Sandy, standard 4G cellular service remained in service in most areas during the storm, which would provide access to patient information.
Web-Based Practice Management Software
CS OrthoTrac Cloud: www.dentalaegis.com/go/id778
Curve Dental: www.dentalaegis.com/go/id779
Dentisoft Office Cloud: www.dentalaegis.com/go/id784
QSIDental Web: www.dentalaegis.com/go/id785
Umbie DentalCare: www.dentalaegis.com/go/id786
Unique scenarios may throw a monkey wrench in the works, which is a good reason for dentists to consult with experienced IT professionals. The Dental Integrators Association is a good resource for researching and choosing an exceptional organization that can help. Experienced IT professionals can explain in depth how a web-based system can benefit the practice with little implementation and maintenance expense.
Very few dentists can afford to build and maintain the type of infrastructure associated with traditional client-server systems. In addition, these systems can’t always offer the degree of redundancy and data protection that is native to a web-based system. When it comes to disaster recovery planning, web-based dental software may provide an ideal solution.
About the Author
Andy Jensen is the chief marketing officer for Curve Dental, Inc., a developer of web-based dental software based in Orem, Utah. Mr. Jensen has 20 years of experience in the dental software market. You can reach him at email@example.com