The Worst Advice We’ve Ever Heard About Dental Office Design

This is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

By Steve McNamara, CEO and Founder of  DTC and DIA Board Member


The Worst Advice We’ve Ever Heard About Dental Office Design

A prospective client of ours once had a family member run a practice management software upgrade for them. No database backup was taken prior to the upgrade, and their automated backup hadn’t been completed successfully in over two years. They ended up losing their entire database.

After spending 20 years in the dental IT industry helping dentists design new office spaces and start new practices, we’ve heard more stories like this than we care to hear. With so many people voicing opinions on how a dental office should be designed and set up, it is easy to quickly become overwhelmed and potentially follow the wrong advice. Don’t cut corners and make the same mistakes that we’ve witnessed other dentists make. Here are a few examples of bad advice and situations we’ve experienced over the years, and what to do instead:


  • When inquiring about a backup for a new client, they stated to me their existing technician told them ‘You don’t need a backup, you have a RAID in your server.’
    • What to do instead: Every office should have a managed backup solution in place, whether you have RAID in your server or not. Backing up to an external hard drive is not only in violation of HIPAA compliance, its risky and often ineffective. A cloud-based backup solution will ensure that your database is properly backed up and always accessible in the event of an emergency.
  • One office was recommended to purchase their own wireless access point for patient access and connect to a local network with an unsecured wireless network.
    • What to do instead: Wireless networks should always be secured. You should have one private network for employees and a separate secured and password protected network for your patients.


  • An office was outfitted with exposed network cables hanging from the drop ceiling, running down the wall to the computers.
    • What to do instead: Exposed cables can be hazardous, as well as not looking neat and tidy. Cables should be run through the ceiling or the walls, out of the way of employees and patients. Not only is this safer, your operatories will look much cleaner.
  • We found an unmounted network switch in an office hanging from connected patch cables.
    • What to do instead: Never let any device hang from a cable! Whether it’s a switch, router, or surge protector, letting them hang from cables puts undue stress on the cables and can cause damage. Either mount them to the wall or ensure that they are resting on a solid surface without causing tension in the cable.

Server Closets

  • One of our clients had a shared office space, and their server closet contained network equipment for the two different office networks – nothing was labeled, and the closet looked like this:
    • What to do instead: Keep devices and cables labeled, especially if you share a space. Keeping your IT equipment tidy and organized will make it much easier to troubleshoot if you have issues later. If your server closet has a mess of unlabeled cables, it will take you twice as long to determine which cable goes to the device you need to troubleshoot.
  • Not dedicating enough space for a server closet.
    • What to do instead: Don’t assume you can stick your server in a nook somewhere and everything be fine. Server closets need enough space for the server as well as other network equipment like backup devices, routers, firewalls, and all the cables that go along with them. Keeping them in a closet that you can lock will also help keep you within HIPAA compliance boundaries.


  • At a new office build out, the contractor did not plan for a network closet. The fix was to build a cabinet in the bathroom for all network equipment. They did not vent the new closet and bathroom was 20 degrees hotter than any other place in the building due to the equipment being stored there.
  • In an office remodel, the contractor had to do new core drill for plumbing and cut through main rebar of building structure. They had to call in state engineer to tell them how to fix it, and it ended up postponing the project for 4 months.
    • What to do instead: Make sure you thoroughly review all building plans with your contractors. Ensure that the contractors you have hired are capable and highly rated. Partnering with a managed IT services provider, like one of those found through the Dental Integrators Association, in the early stages of a build out or remodel can help prevent oversights like these.


Steve McNamara is the CEO and founder of DTC, Inc., a managed service IT provider for dental and medical offices in the Mid-Atlantic region. He has been a member of the Dental Integrators Association for nine years and currently serves on their Board of Directors. Steve has had a passion for computers and IT since he first started working with them in 1994. He has helped countless dental offices design seamless and functional IT systems in an increasingly digital industry.

Phone: 410-877-3625 | Website:


Emerging HealthCare Technology

This is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

By Wesley Robinson, President of Integrated Axis Group, LLC and DIA Member


If you could put part of your practice on autopilot, would you?

Every twelve to eighteen months, computers double their capabilities, and so does the information technologies that use them. Currently, there is regenerative medicine in clinical trials using consumer wireless computer-brain interfaces for $300. If we can do this today, what will it be like in twenty years, when technology is a million times better? Three-dimensional processors and memory drives along with biological, photon, and quantum computing will keep the rate of information improvement at an exponential pace.

So, without getting too technical, here are a few of my observations based on current emerging technology and solutions.

Softbank Robotics launched its first 58 cm in height NAO Robot in 2006. In 2009, a 140 cm tall humanoid ROMEO Robot project with the goal of assisting people facing a loss of autonomy. Then in 2014, the first personal emotional 120 cm in height Pepper Robot was launched. Pepper can identify the main emotions: joy, sadness, anger or surprise. He is also capable of interpreting a smile, a frown, your tone of voice, as well as the lexical field you use and non-verbal language such as the angle of your head, for example. The combination of all this information enables the robot to determine whether his human interlocutor is in a good or a bad mood. These are just a few of his capabilities.

We recently integrated Pepper a human-shaped robot in one of our Orthodontics offices. Currently, Pepper is just interacting with the patients and families as they enter the office. Both Pepper and NAO are entirely programmable and offer infinite possibilities to enrich the customers’ experience and office assistance. For example, patient education, registration, scheduling, electronic collections, patient photo and questionnaire to name a few. Plans are to also include staff training, inventory assistance, and order supplies.

It still takes time to integrate Pepper into a practice; however, as robotic technology is adopted and can be shipped pre-configured based on application, they will be easier to implement. It’s exciting to see the interaction of employees and patients of all ages with Robotics. To learn more about SoftBank Robotics, visit their website.


If you never had to ask a patient to fill out a registration, history or consent form, would you?

As the Hospitals, Dentists, Doctors, Labs, Pharmacies, Insurers, Researchers, and Patients continue to require improved collaboration, MediChain is solving the problem. For my entire Healthcare Information Systems career, this has been frustrating and inefficient due to proprietary solutions and government regulations.

MediChain is a Healthcare Big-Data platform that provides a safe way to store sensitive information without the need for trust. By using a combination of blockchain and off-chain storage of EMR, MediChain is creating a simple way to transfer information between entities. With this app, a patient can share data from their dentists, doctors, pharmacies including non-prescription medication and devices like smart watches, smartphones. Their complete records are accessible with anyone or any entity they see fit by granting access by exchanging their decryption key. As the records update so are yours, without having to enter or request updated information once the patient grants access.

Emergency access is in an extended version of MediChain even it the patient cannot give consent. This advancement will ultimately save lives by allowing easy access to accurate patient information.

As with any new technology, the current concerns with blockchain are HIPAA, PHI, FDA 510(k), IEC 60601-1 and ISO 12485 compliance. Health Information Exchange security is crucial in healthcare, especially as data sharing becomes more popular. It will need to take into consideration national and international regulations as data travels.

MediChain is currently in trial with a minimum viable product (MVP) at pain clinics in the UK. The trial has already attracted positive feedback from major pharmaceutical companies, medical technology solution suppliers, and an internationally recognized independent research institution.

Other businesses are working on bringing the EMR to the blockchain; however, MediChain has stood out to me based on these scalable and sustainable solution. To learn more about MediChain, visit their website or read their whitepaper.


Wesley Robinson Owner / President & CEO of Integrated Axis Group, LLC  a National Managed Services Provider (MSP) based in Texas. He has been in Healthcare Information Systems for more than 30 years and is a founding board member of the Dental Integrators Association.  Married to Kelly Robinson, DDS a third-generation dentist, they have three sons and a daughter-in-law. He has personally helped countless Healthcare Providers create efficient technology strategies and service solutions that fit their unique needs.

Wesley can be reached at








The Real Cost of Innovation Debt

This is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

By Clay Archer, CEO and Founder of DentalPC and DIA Member


A colleague of mine from Ottawa introduced me to the concept of Innovation Debt, and it struck a chord with me. His basic premise is that we all have a certain level of innovation and technical progress in our businesses/practices. Top performing practices manage their growth in a steady, consistent pace, using budgeting and planning to make investments. Others who don’t make regular, planned progress fall behind, and once they fall too far behind the cost and disruption of making up the deficit become exponentially higher. This gap is called Innovation Debt.

When I first read about this concept, it made me think of some of the first dental practices I worked in back in the 90’s. The practice would have a wonderful older dentist whose office was past its prime. It had aged wooden paneling and the old pastel GE x-ray heads, pink, baby blue and yellow. As you walked down the hall, you would see worn carpet in the operatories. It needed a good paint job inside and out. At some point, it had been a beautiful new facility, but it went downhill from there. In year five the doctor didn’t repaint, in year ten they didn’t change out the wood paneling and carpet, in year 15-20 they didn’t upgrade any equipment. Slowly but surely the practice got to a point where getting back to a nice facility became a six-figure gut and redo that would never get done. In the same building the doctors’ peer, who maintained and planned for upgrades, had an attractive, contemporary facility and a thriving practice. Innovation debt is the same thing when it comes to technology.

Now that we have a basic idea about what innovation debt is let’s talk about three things that you can do from the beginning to ensure you don’t fall behind.

  1. Setting an annual budget like clockwork. The most important thing you can do is define what the target is. To be clear, this is not about buying every shiny object you see at a trade show. This is about systematic progress that improves patient experience, clinical care and efficiency of the office. The best way to find the “Goldilocks” amount to spend is to set and drive to a budget. Each year you can evaluate where you stand, what your profit level will be and what you choose to reinvest. If you fell short or spent too much in the previous year, you adjust your goals for the next.


  1. Meet with your leadership team and a Dental Integrator and discuss your innovation path. Make sure you have the buy-in from the staff, and they see the value of CAD/CAM, 3D, Recall Systems, etc.   There is nothing more detrimental to your progress than buying expensive equipment that isn’t used because it isn’t properly adopted. This is an area where your Dental Integrator can help you choose the right technology that is the best fit for your office.


  1. Be an active member of your dental community. Go to the dental conventions, support your component and state dental association, and meet with your peers. The best way to find out what “best in class” looks like is to talk to and visit your peers. See what is working and what isn’t and form your own prescription for your practice. I can’t emphasize enough the importance of visiting other offices, talking to your supply reps and networking. I know everyone is afraid that their reps will “sell” them more than they need, but they are a wealth of knowledge, and the right one will be consultative and help you grow.


Remember, small regular additions are more comfortable for your team to adopt, learn and perfect. Regular expenditures are easier to budget for and afford. If things go well and you exceed budgets, slightly bigger, similar investments can be made. It’s like working out or eating right, you build on success and add layers.

Dentists often put off updating their technology until it’s too late. The longer you put off making technology changes in your practice, the more expensive those changes become. Smaller changes become harder to implement, and the need for much more substantial changes grows. Don’t wait until you are faced with a costly and time-consuming task to update your technology. Be proactive rather than reactive and make sure you avoid falling into Innovation Debt.


Clay Archer is the CEO and Founder of DentalPC, a dental specific IT solutions provider serving the southeastern United States since 1995. He is also a member of the Dental Integrators Association Clay can be reached at









Cybersecurity Training 101- Building the Human Firewall

Mike Whaley, Director of IT Security for CRC TechnologiesThis is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

By Mike Whaley, Director of IT Security for CRC Technologies and DIA Member


It has been estimated that it can cost the victim of a healthcare data breach (the patient) $13,500 to recover after their medical data has been stolen. A Ponemon Institute Study on Medical Identity Theft (publication date 2015) compiled these costs based on credit restoration, reimbursement to healthcare providers for fraudulent claims, and correcting inaccuracies in health care records. Due to HIPAA privacy regulations, victims of medical identity theft must be involved in the resolution of the crime. Those who have resolved their crime spent, on average, more than 200 hours working with their insurer or healthcare provider to make sure their personal medical credentials are secured and can no longer be used by an imposter, and verifying their personal health information, medical invoices, claims and electronic health records are accurate.

Dental professionals are keepers of some very sensitive, embarrassing, and potentially discriminatory data. Dental professionals are also keepers of enough information for one person to easily create a false identity – therefore it is necessary to take measures to keep patient data safe.

Most of a dental practice’s technical security controls are provided by their IT vendor, such as firewalls and antivirus. Hopefully the practice is already taking their IT vendors technical security control recommendations seriously and implementing them. Controls are also driven by the practice, such as security cameras or security policies and procedures, and access controls like door locks and server room locks. Even if a practice has their security locked down, it could easily take only one of their employees to accidently download and run a malicious program delivered by email or a website and BOOM – the practice data is ransomed, or the computers are suddenly being remotely viewed and staff keystrokes logged while login credentials are stolen.

If properly trained, staff can become the biggest guard against cybersecurity threats. They will become the human firewall. Security threats can come from many different directions like email phishing, the internet, phone calls, or an in-person visitor. Training employees on a regular basis about cybersecurity threats is called Cybersecurity Awareness Training.

Ongoing cybersecurity training helps to prevent bad outcomes from threats like phishing, which is when the bad guys trick a person into following a malicious link in an email or downloading an email attachment. A study reported by the INFOSEC Institute reports that, “…26% to 45% of the employees of the chosen companies were susceptible to phishing. With the security awareness program, that percentage decreased by 75%.”

Ransomware is a big moneymaker for the bad guys. If a practice downloads malware that ends up encrypting their patient data and demands money to unencrypt the data, this can cost a practice thousands of dollars in ransom to decrypt the data. Plus, if hit by ransomware, HIPAA requires practices to prove their data wasn’t taken by the bad guys, so it could be a double whammy with fines.

Cybersecurity Awareness Training programs aren’t expensive and there are plenty of options out there. Implementing a Cybersecurity Awareness program shouldn’t be a one-time event, it needs to be ongoing and training needs to take place quarterly at a minimum to be effective. The National Institute of Standards and Technology (NIST) of the U.S. Department of Commerce recommends training modules, testing users, simulations, posters, and newsletters as part of the program.

Popular security awareness training vendors include KnowBe4 and PhishMe. KnowBe4 includes phishing, fake voice calls, and they can even send a USB drive to the practice to see if staff will plug it in. PhishMe is one of the more senior companies in the space and has perfected the phish and training that goes along with it. If an end user clicks on a link in a phishing email, it will send them to a training web site. One organization to consider is SANS for their cybersecurity training. They are an organization made up of cybersecurity professionals and have a good reputation for being on the forefront for training end users.

Practices should be on the lookout for cybersecurity training that is offered from their HIPAA consultants or their bank if enrolled in a PCI compliance program. They may have training modules included with their online solutions. The practice’s IT vendor might have some good options for cybersecurity awareness training programs and may already have a program they can refer to or administer.

Rather than a costly breach or a down server do to ransomware, Cybersecurity Awareness Training can help build the human firewall and keep out the bad guys. Loss of patient data can cost not only the practice time and money, but it can cost the patients time and money also. Training programs are easy to find and easy to administer. Stay safe out there!


Mike Whaley is the Director of IT Security for CRC ( ), a managed service provider based in Seattle, Washington. Mike has more than 20 years of client and project management along with a formalized education in Network Administration.

CRC is a proud member of the Dental Integrators Association, a network of leading independent dental technology integration firms from across the country. It was formed to create and deliver a higher standard of quality and care for dental practice technology integration.

Mike can be reached at:









HIPAA: As Easy as…PPT?

This is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

By Amy Wood, President of ACS Technologies, LLC


Wouldn’t it be great if HIPAA was as easy as 123 or even ABC? Well, turns out it can be as easy as People, Process and Technology – or as I like to call it, PPT. Additionally, when you have PPT in place, it benefits many other aspects of your practice as well.

As confusing as HIPAA may be, especially for smaller practices to decipher, it can be broken up into three simple things: People, Process and Technology. If you look at all aspects of HIPAA with these three things in mind, it becomes easy to decode and then implement in your practice.


Let’s start with People. As an employer, if you properly train your staff and then provide tools to enforce that training, your people will become one of your strongest defenses. When training your team, you have many options to choose from. There are pre-recorded videos, webinars, and consultants that offer live trainings to review the basics of HIPAA – where you and your staff can ask pertinent questions and receive personalized answers. In addition, it is imperative that you review the Process and Technology parts of your Compliance Program with your staff, meaning your HIPAA Policies and Procedures as well as the technology vulnerabilities and security. When it comes to training, the best offense is a good defense.

Next comes the Process. The Policies and Procedures that you are supposed to be training your staff on must be created. You could purchase a manual with stock templates or try to find them on the internet, but I’ve found the most comprehensive policies are a joint effort between the practice staff, the doctor, a HIPAA consultant and the IT Provider. This way, what is written on paper is actually what is being done.

For example, if your policy says you will have Business Grade Anti-Virus on all computers that is updated at least daily and documented as such (as is recommended), but you buy an anti-virus license once per year and set it to ‘auto update’, your policy really isn’t being followed.

Last, and often most confusing, is the Technology. While this part of HIPAA is only about 20% of the puzzle, it tends to be the most talked about because it’s constantly changing. Think about it – ten years ago you were just implementing computers to schedule appointments, and now you are doing appointment reminders, patient health histories, and 2D/3D images of the teeth and head. You can access it from home and send it to colleagues to collaborate. The changes over the years have been incredible.

Unfortunately, the same goes for cyber threats. As information becomes easier to create and move, the more vulnerable that information becomes and the more frequently you have to adapt to new threats.

What exactly is the best way to secure your technology?

It used to be that locking the door and buying an anti-virus program was enough to keep the bad guys out. That’s not the case anymore. Now there’s encryption, cages and cables, firewalls, patching and updates, ‘smart’ equipment and lots of backups. Unless you are fluent in Geek, this can be daunting. Many of the programs and tools that automate this are only accessible to larger businesses.

Fortunately, many IT Providers are adopting a Managed Services Provider Model, where they provide a set of these programs and tools within your price range because they can be aggregated across many clients. This type of IT Provider essentially acts as your Systems Administrator, meaning they are an outsourced IT Department for your practice.

This is a different type of engagement than most dentists are used to and is still relatively new in this space. Most dental practices are used to calling the tech guy when something is broken. Personally, I miss those days. We were the smart guys who were like knights in shining armor. Things have certainly changed in the last few years. With all the malware, ransomware and hacking that has been happening, now if something happens we are the guys who ‘let you get hacked’. It’s no longer about fixing broken things; it’s about preventing things from being broken into. 

There is baseline security that can not only thwart most attempts to get into your business, but can also have all the tools in place proactively if something does get past all your defenses. I call this the ‘Magic Bullet Theory’. If you remember the initial reports of the JFK assassination, they talked about this ‘Magic Bullet’ that had an abnormal and impossible trajectory. Using that same theory, if you think about a threat to your Protected Health Information, in a secured and managed system, that threat would have to get past multiple layers of defense that have different points where they overlap. With all of these defenses in place, the likelihood of something getting through is extremely low.

If your IT Provider isn’t doing these things, someone needs to – whether it be you, your team or another vendor. You stay up on current standards of care for patient treatment. It’s worth it to have a conversation regarding the current standards of care about your digital security.


Amy Wood is President of ACS Technologies, LLC. She utilizes her experience as a Data Breach Consultant and a Healthcare IT Provider to provide comprehensive education with real and relatable examples, ensuring that practices are addressing HIPAA proactively, rather than reactively, in a reasonable and appropriate manner.

Amy educates to private practices and clinics, dental associations, study clubs and disability groups as well as to vendors and Business Associate practices. She runs ACS with her husband, Scott, and lives in Santa Rosa, CA with their three daughters. 

Amy can be reached at







Business Intelligence – The Next Big Thing in IT

DentalPC - Clay ArcherThis is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here


Over the last few years we have heard a lot about the cloud and “big data”. But isn’t all that for big companies like Walmart and Amazon? The short answer is not anymore. Platforms like the cloud are allowing small business to look at their data like big companies traditionally have. Third party plugins and applications can look at your practice management data and dissect it in a more approachable way. “That’s great but how does it affect my Dental practice?” In the short term, it will change the way dental practices use their data in three major ways.


Dashboards/Score Cards. It’s the old proverb “what gets measured gets managed.” Business Intelligence in its simplest form comes in the shape of gadgets or apps that display simple management numbers. Whether it is number of new patients/month or Hygiene production/day, these “widgets” let you quickly see how the practice is doing in certain defined parameters. Unlike traditional reports, you don’t have to look through lists or dropdowns, the numbers are simply presented in whatever form you want. If you want to go deeper into details you can click on the widget and the underlying data will be displayed. Score cards are a wonderful tool for positive reinforcement, variable pay (bonus) and team contests. It is all about clarity of message and goal attainment. These are great for morning huddles or monthly staff meetings to review where the practice is on specific goals. Then the staff can use them on a constant basis to review progress. We have several offices who display a dashboard of widgets in the staff room so the data is always top of mind.


Enforcing Systems/Training. As a simple extension of the what gets measured gets managed proverb, the staff now knows what numbers are important. They can more efficiently use their time and effort towards making the appropriate changes or reinforce the things that they are doing well. We can use the information to create best practices and training around what best affects the bottom line. When goals are clearly defined it is much easier to train staff to a system. These types of process driven training programs have until now been the domain of larger corporate organizations.


Benchmarking. Traditionally Dentists have not shared much practice management information and have essentially practiced alone. Because most of these Business Intelligence tools have many users there is an ability to “benchmark” across the user base. Now not only can you look at the numbers inside the practice you can see how you stack up against your peers. From customer satisfaction ratings to overhead costs and margins you can see how your practice is performing against others in your region/specialty/etc. Because the data is looked at in aggregate and individual results are anonymous there is no reason to worry about competitive forces. This allows smaller individual practices to take advantage of large sample sizes like corporate dentistry does. A few possible examples would be fee optimization, revenue per procedure, frequency of procedures, procedure duration, the list goes on and on.


The reason that I stated that these are the main changes in the short term is that Business Intelligence is a rapidly evolving arena. It won’t take long for these technologies to evolve into different aspects of the practice. The next generation of Business Intelligence will actually “learn” and provide information based on data. Think of a recall system that tailors messages based on past interactions. Or a forecasting system that raises goals based on unscheduled treatment or Insurance benefits. The next generation will change the way you interact with patients, vendors and employees.

The bottom line is that you have a ton of very valuable information inside of your Practice Management system. These new tools help you mine it for the relevant information to more efficiently manage your practice. There are quite a few of these tools in the marketplace right now and the list is growing. Choosing the right one for your practice will depend on the features you are looking for and the integration with your specific Practice Management software.

The first step is to work with a professional IT company. The Dental Integrators Association is an organization dedicated to educating IT professionals. To be sure you have cutting edge knowledge on your side you can find a professional at the Dental Integrators Association website


Clay Archer is the CEO and Founder of DentalPC, a dental specific IT solutions provider serving the Southeastern United States since 1995. Clay can be reached at

There is Hope

“A Match Made in _____”
Cyber Threats and HIPAA Compliance – There is Hope

By Patrick Jacobwith, Sunset Dental

President, DIA

Guest Writer for Sally McKenzie


Are we at the beginning, middle or end?  Please let it be the end.  Recent events have caused many in the business community to think these thoughts, especially in healthcare.
Cyber Crime has exploded.  The global cost of cybercrime will reach $2 trillion by 2019, a threefold increase from the 2015 estimate of $500 billion.  Last year, IDG detected 38 percent more cybersecurity incidents than the year prior.  Source – SecurityIntelligence by IBM
HIPAA enforcement is real.  Due to the intensity of compliance and regulations, the costs per breach to organizations in the health care and financial services sectors top all other industry groups, according to the Ponemon study.
Small Business Beware!  Small and midsized organizations (SMBs), defined as those with less than 1,000 employees, are hardly immune to cybercrime — actually quite to the contrary.  According to Keeper Security’s “The State of SMB Cybersecurity” report, a staggering 50 percent of small and midsized organizations reported suffering at least one cyberattack in the last 12 months.
A Cyber Attack may be considered a HIPAA breach according to the OCR’s Wall of Shame and as outlined in the following headline from HealthITSecurity.

“Cybersecurity Attacks Leading 2016 Data Breach Cause
The top 10 healthcare data breaches of 2016 were mainly caused by cybersecurity attacks, including ransomware and unauthorized access.”

So the marriage has been made.  Cyber-attacks are directly linked to HIPAA breaches.  This presents a real and present risk to all dental practices.  As we know, a breach can occur at any time and many dental practices are still open doors for cyber criminals.
We are not at an end, we are more near the beginning.  Cyber criminals are well-funded and becoming increasingly organized.
Ransomware – the latest wave
What is ransomware?  Ransomware is a virus designed to block access to the data in a system until money is paid.  Ransomware usually is planted in a clinic’s network environment via an attachment to an email.  The virus immediately does three things:
1. Begins encrypting data on the computers
2. Sends the decryption key to their own “secret” location
3. Grabs all contacts and forwards the nasty email (then it looks like a “friendly email”)

There is Hope
What can we do?  In the IT Managed Services arena, the Dental Integrators Association (DIA) recent national conference discussed this topic at length with guests from the FBI Cybersecurity Division.  DIA member companies are well aware of the threats and have been working diligently to create solutions.  The best thing you can do, is work with a managed IT provider who will secure your systems before you have a breach.
In closing below are a few simple short-term tips for each of you.  Beyond the short term, please build a plan for the long term.
Simple and Practical suggestions for all dental practices:

• Partner with a credible IT/Cyber Security company.  The DIA and its member companies take these matters seriously.
• Make Cybercrime and HIPAA a higher priority and invest resources in solutions
• Cyber Tips

o Allow the partners to deploy a credible firewall
o Allow the partners to deploy a credible back-up solution that includes Business Continuity
o Do not open email attachments!  Make sure the attachment is clean.  Clean can be because the email was sent via encryption, or just call the sender and verify they actually sent the email.


o Build a comprehensive plan to address HIPAA in your organization
o Begin with a HIPAA risk assessment
o Train your staff
o Get Business Associate agreements in place
o Go back to your comprehensive plan

Most importantly, please work with a professional IT company. The Dental Integrators Association is an organization dedicated to educating IT professionals. To be sure you have cutting edge knowledge on your side you can find a professional at the Dental Integrators Association website


sunset-p-jacobwithPatrick Jacobwith is the CEO of Sunset Dental Technologies a multi-state organization based in Minnesota.  Patrick is also the President of the Dental Integrators Association.  He believes in excellent service and building healthy and productive relationships.  Patrick’s core values are built on three words: Service, Humility and Love.

Patrick can be reached at


Selling Your Practice? Beware of This Scam

Selling Your Practice? Beware of This Scam

Amy Wood, ACS Technologies

I can’t believe I have to write this, but I’ve been told of this scam by several dentists as well as practice transition consultants.

 The scam is this:  A local doctor comes in looking to expand their patient database by purchasing your practice.  Seems legit, right?  They then ask for access to your computer or server to get an idea of your patient pool, or to run a report in your practice management program.  This is when they install a spyware program to secretly take your patient information to directly market to them.

Seriously?  As if we don’t have enough security threats to worry about, now we have to worry about your fellow dentists?

You can easily protect yourself by adhering to this simple rule: NO ONE gets access to your computers, server or network unless they are your staff or one of your HIPAA Business Associates.  If a potential buyer needs reports or information, you provide it to them.  This applies to consultants too.  They are not staff and they are not hired to interact with, create, receive, maintain or transmit Protected Health Information on your behalf, so they don’t get access to your systems.





Amy Wood is a HIPAA Data Breach Mitigator specializing in making dental practices compliant and secure.  She is president of ACS Technologies, LLC, a Northern California HIPAA Compliance & IT firm.  Amy has written many articles for various dental publications and spoken at dental associations, study clubs and private practices.  She runs ACS with her husband, Scott and lives in Santa Rosa, CA with their three daughters. 

Amy can be reached at

HIPAA Compliance: More than Just Data Breaches

DIA Board Member, Amy Wood, recently wrote this article for Sally McKenzie.  It can be seen in whole on her site HERE


Amy Wood, ACS Technologies

HIPAA Compliance: More than Just Data Breaches

By Amy Wood, President of ACS Technologies, LLC


At this point we have all heard about the data breaches and million dollar fines, and how your HIPAA security alleviates these major concerns. But have you ever thought about all the other ways HIPAA compliance helps your practice?

Human Resources Issues
Imagine a problem employee. The one who casually browses the internet instead of working, even though you’ve told them not to. Worse yet, one who thinks they know enough about HIPAA and holds you hostage for the things you don’t yet have in place.

Proper Training is key to ensuring your staff actually knows and understands HIPAA regulation. Policies & Procedures are another component. Your entire staff should review and sign an acknowledgment of reading which includes privacy, security and technology policies. The most important one is a sanction policy which should outline what happens should the employee violate HIPAA or security in the practice – write up, termination or even jail depending on the violation or repeat violation.

Business Insurance
It’s become commonplace for business insurance carriers to ask about basic security. Do you have business grade antivirus? Do you have a firewall? Do you use secure email? Do you have backups? The new trend in insurance is cyber-liability and data breach coverage, as most data breaches are happening in the digital data space. Their questions are even more comprehensive. Do you have the knowledge to answer these questions? If you are covered by a managed service IT provider, they can help you answer all of these.

Patient Insurance Audits
MACRA, the Medicare Access and CHIP Reauthorization Act which was enacted late last year, tied Medicare reimbursement rates to a practice’s level of security and thus, HIPAA compliance. Early in 2017, we started seeing major dental insurance carriers ask for proof of basic security practices as well as HIPAA risk assessments, other HIPAA related documentation and cyber-liability/data breach insurance. Failure to have these things results in lower reimbursement rates after the audit. These are basic business best practices anyway – protect those margins!

Patient Complaints
Over the years, I have fielded many patient complaints regarding HIPAA and security. One complaint asserted that the doctor, let’s call him Dr. Compliant, had sent multiple patient records to a single patient via unencrypted email. As it turned out, Dr. Compliant had used an encrypted secure email system to send several patient records to a second doctor, Dr. Not-So-Compliant, which was proved through the secure email program.

When the patient requested the x-rays by email, Dr. Not-So-Compliant forwarded the emails with all the files sent from Dr. Compliant on to the patient without checking the contents first, thus breaching the other patients. The patient demanded free treatment in exchange for silence. Thankfully, Dr. Compliant had embraced security and the use of encrypted secure email, and we were able to prove Dr. Compliant did not breach data.

Payment Card Industry (PCI) requires an annual questionnaire that asks numerous questions about paperwork and security, including your technology equipment and setup. Many of these requirements overlap with HIPAA requirements, which are, again, basic business best practices. Unfortunately, many doctors protect credit card data better than full PHI contained in their patient charts.

When we are talking about digital data security, there are simple ways to do it right and many ways to do it wrong. Talk to your IT provider to ensure you are using current standard of care for things like backups, anti-virus, firewall, secure email and patching. Most IT providers will provide you with a package of these services, as it is commonplace as well as expected by the Office for Civil Rights. Your provider doesn’t provide this? Find a healthcare specific IT provider at the Dental Integrators Association.


Amy Wood is a HIPAA Data Breach Mitigator specializing in making dental practices compliant and secure.  She is president of ACS Technologies, LLC, a Northern California HIPAA Compliance & IT firm.  Amy has written many articles for various dental publications and spoken at dental associations, study clubs and private practices.  She runs ACS with her husband, Scott and lives in Santa Rosa, CA with their three daughters. 

Amy can be reached at

IT Security: What Every Doctor Needs to Know

DIA past-president and member, Bryan Currier, recently wrote this article for Sally McKenzie.  It can be seen in whole on her site HERE


Bryan Currier, Advantage Technologies

IT Security 101: What Every Doctor Needs to Know


What is IT Security?

Defining IT Security is a good starting point since it can have different meanings to different people.

According to Wikipedia,

IT Security is the process and mechanisms by which computer-based equipment, information and services are protected from unintended or unauthorized access, change, or destruction. It is of particular and growing importance in line with the increasing reliance on computer systems in most societies worldwide.



What does IT Security involve?
As you can see from the definition, IT Security encompasses certain things that most people don’t consider. For example, when you think of IT Security for your practice, what comes to mind? If you’re like most, you probably concern yourself with safe-guarding your system against hackers and crashes – which you should be doing.

However, notice the first words I emphasized – process and mechanisms. Process implies people, which has more to do with IT security than anything else. Additionally, you may have considered protection against unauthorized access and destruction. What about unauthorized change?

No one would dispute we are exponentially more reliant on computer systems now than we were just ten years ago. For instance, when I first started in dental IT a computer crash was nothing more than a minor inconvenience. But today? A crash can have major consequences and directly affect patient care – so protecting this information should be of paramount concern in any practice.


What is a high-level overview of the threats to IT Security? How can you mitigate those threats?

Viruses: The key here is complete anti-virus protection that you can prove is monitored, managed, and automatically updated. Additionally, you need a secure firewall with a gateway anti-virus.

Malware: An anti-malware system is a must – think CryptoWall and CryptoLocker. In addition, you need content filtering as part of a sound firewall strategy.

Hacking: Your primary defense against hacking is a solid firewall that is continually updated, monitored, and managed. Also, you should only be utilizing secure remote access. Using free tools to remotely access patient information from home or an iPad is simply a recipe for a data breach.

User Error: Often overlooked, user error represents one of the most common causes of unauthorized data change and loss. Staff training is your best bet to mitigate this risk. A great starting point is finding the answers to such questions as:

When was my team last trained on how to effectively use the practice management system? How much turnover have we had since the last training?

Are new staff members correctly trained in the current version of the software? How many bad habits are being picked up because someone at the front desk is just “showing them how to do it”?

Plus, you need to check their access credentials. Not everyone in the practice needs full administration rights to your management system, so take time to audit that.

Phishing: The key here is telling staff members to not check personal email at work. When you do check email of any kind, be extremely careful what links you click on. Not 100% sure? Simply don’t click on them. Another great defense against phishing is content filtering at your firewall.

System Crash: What’s the best prevention against a crash? First, you need to be using servers and workstations with business class pedigree and warranties — think Dell and HP systems.

Second, and more importantly, you need to have a managed IT service. This is a provider that is managing your system – servers, workstations, firewalls, anti-virus, etc. – on a continual basis. Someone essentially acting as your IT department. The Dental Integrators Association is a great resource to help you find local, independent IT companies that will work with you and on your behalf to help reach your goals.

Natural Disasters: This once again emphasizes the importance of having a dedicated IT provider that is supporting you with a solid backup and recovery plan. In addition, they should be providing you with a clearly defined contingency plan in the case of a disaster.


What are 5 practical steps to take into my practice?

1. Implement an acceptable use policy – what they can and can’t do on your computers.

2. Use ‘need-to-know’ access. This means auditing all user names in your practice management system. For example, Susie the hygienist cannot make changes in a patient’s ledger balance.

3. Protect your key data by ensuring your IT provider sets up a secure, backup, and disaster recovery strategy that is HIPAA compliant.

4. Make sure you’re only using secure remote access.

5. Confirm your IT provider offers a working knowledge of HIPAA, HITECH, PCI, and any other regulations that you may be subject to. It is extremely important that they have a solid understanding and are designing systems that work for you.

Again, a great resource to get you started in the right direction is the Dental Integrators Association. Their sole job is to provide a system which educates IT providers to a manner in which raises them above the norm.


Bryan Currier is the President of Advantage Technologies, an IT company that focuses on dental and dental specialties. It serves as the leader in utilizing cutting-edge technology to keep its customers in the forefront of dental technology. In the last 15 years, he and his team have worked with more than 1,000 practices, helping them effectively integrate computers and digital technology. Bryan has spoken at numerous conferences throughout the country, and has served on the Microsoft Partner Advisory Council and published articles in the Doctor of Dentistry magazine and The Journal of American Association of Oral and Maxillofacial Surgeons. 

Bryan has a bachelor’s degree in Business Leadership as well as various dental and technological certifications. He lives in Nashville, TN with his wife and four children. He can be reached via email at:

You can find Advantage Technologies online at and the Dental Integrators Association can be found at