Scan-X with new integrated x-ray feature

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rfacko
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Scan-X with new integrated x-ray feature

Post by rfacko » Wed Nov 10, 2021 12:52 pm

Still working on transitioning away from Apteryx and into OD's new integrated x-ray feature. We use both a Scan-X for phosphor plates and an XDR sensor. The sensor seems to be working flawlessly. I am having intermittent, unpredictable issues with the Scan-x, however. I have it set up to open the TWAIN UI. Sometimes I get a Windows message that says "VistaEasy Error - IdentifierString 'PAN-LCP_TWAIN' is already in use. New job will not be added to queue." Other times it scans multiple images but doesn't import them all into OD, then the next time I open the Acquire button it says there are x-rays still stuck in the system, do I want to import to the current patient? Other times the scanner is still expecting an image from the previous scanning session and will run the plates through but the images don't get scanned. In summary, it's glitchy and inconsistent, and therefore difficult to diagnose. My staff is getting frustrated. I think we have it figured out well enough at this point to at least know when something doesn't feel right so we don't feed the plates into the scanner, restart the computer, and then scan them, so we don't have to re-expose the patient. But having to restart the computer every couple of patients is pretty disruptive for our workflow.

What other details can I provide to help improve functionality?

rfacko
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Re: Scan-X with new integrated x-ray feature

Post by rfacko » Wed Nov 10, 2021 2:31 pm

FYI, the Air Techniques TWAIN UI that it links to is VistaEasy. One issue seems to be that it doesn't completely disconnect from the scanner, and then when you open a different patient and try to acquire it says the scanner is already in use (and it shouldn't be).

rfacko
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Re: Scan-X with new integrated x-ray feature

Post by rfacko » Thu Nov 11, 2021 9:39 am

I'm just going to keep talking to myself here ;) In case it is helpful for anyone else. So I called Air Techniques to ask for help. The tech took a few minutes to look through everything and then said "this isn't going to work, and your problems will only get worse, you should use our software", at which point, without my consent, he installed the Air Techniques x-ray software and wanted me to stick around so he could show me how it works. I wasn't happy but kept things to myself, and just explained that I had an office full of patients and would have to call back for training. Sure enough, I went back to continue to use OD and now my x-rays weren't working at all. Back to Apteryx, and not working there either. End of day. Came in early the next day, and was desperate enough that I called Apteryx to see if they could get it to work again. Fortunately they didn't make me pay for a year of support like they always do (maybe I paid within the past year, I can't remember), but they logged in and said it's a driver problem. Called Air Techniques who said it's a software problem. I spoke with Kevin at AT and expressed my frustration. He uninstalled and resintalled the driver without successfully fixing the problem. Finally, he uninstalled the AT x-ray software and now things are back to "normal". Sure enough, the AT tech who gave me no support whatsoever and only advocated to use the AT software is the one who caused all of this. Ugh. I've run a few tests and have seen a few patients now without the issues that I was having before, but will see how long it lasts.

rhaber123
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Re: Scan-X with new integrated x-ray feature

Post by rhaber123 » Thu Nov 11, 2021 1:09 pm

Very interesting. Thank you for sharing.

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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Thu Nov 11, 2021 3:33 pm

Our assumption with the ScanX was that it could dump all your images to a folder instead of using Twain. That's why we built the "Import Automatically" feature. Does ScanX not let you do that? If it's using Twain, then it's going to want to send a series of image, which Open Dental can't handle. We would need to build support for multiple image Twain. So my main question is whether the scanner can just dump to a folder or if it insists on only using Twain.

Until this is resolved, I've added Scan-X to our list of incompatible devices. This is our only known incompatible device so far. Hopefully, though, we can this to work.
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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Thu Nov 11, 2021 9:49 pm

Someone successfully used ScanX by using their VistaEasy software.
viewtopic.php?t=5903
I downloaded VistaEasy and can't get it to work, but that's probably because I don't have a ScanX device connected.
I ordered a ScanX on eBay, but that will take a little while to arrive.
Jordan Sparks, DMD
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rfacko
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Re: Scan-X with new integrated x-ray feature

Post by rfacko » Fri Nov 12, 2021 9:03 am

Thanks Jordan, I think ScanX functionality would be helpful for a lot of us.

I tried to set up the other option as you had mentioned. The ScanX does drop images into a folder. I set up the OD listener. I'm not a great computer person anymore so some of this is my interpretation and I don't necessarily know the proper language to use. But from what I can figure out, the VistaEasy software is a TWAIN "listener", when I open it, it just runs in the background and waits for a signal from another program (like Acquire in OD). So there isn't a way to tell the scanner to start scanning so that the VistaEasy software opens and the OD listener can get the images. Does that make any sense?

Anyway, thanks Jordan for picking up a ScanX. When you have it set up the issues will hopefully be pretty evident. In the meantime, based on your explanation of how the Acquire function was set up to work, I'm going to try to scan and then transfer each image individually rather than scanning several images and then transferring multiple. I'm a pediatric dentist so we don't take more than two or four x-rays on any individual patient, so shouldn't be a significant burden.

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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Fri Nov 12, 2021 9:09 am

Sorry about the hassle.
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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Wed Nov 17, 2021 7:15 am

ScanX machine has arrived, so we've begun troubleshooting.
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rfacko
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Re: Scan-X with new integrated x-ray feature

Post by rfacko » Wed Nov 17, 2021 7:43 am

Thanks Jordan, fingers crossed over here!

BTW, none of my work-arounds have been very successful. Based on your comments we switched to just scanning single images, and while it "works" it's glitchy and requires re-starting the computer multiple times per day. But at least we're not losing images!

Thank you again!

Rich

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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Thu Nov 18, 2021 5:55 pm

Support has been added for the ScanX. It will be a few days until these changes make their way into version 21.3, and they can't be backported further than that.
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rfacko
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Re: Scan-X with new integrated x-ray feature

Post by rfacko » Fri Nov 19, 2021 10:56 am

Much appreciated, thanks Jordan, hope you have a great Thanksgiving!

Rich

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Re: Scan-X with new integrated x-ray feature

Post by Nate » Tue Nov 23, 2021 9:37 pm

Wow!!! Great topic. I have a feeling there will be a big migration from Apteryx XrayVision with the end of support mentioned and there push for cloud service. I would feel wonderful if OpenDental can fill the void left with the exit of Apteryx to on site storage of radiographs. I am long-term OD user and never stopped support so maybe this issue alone will be a life saver.

I also use ScanX and have had no issues with Apteryx but I am not going to move to their web based system no matter how much they push its revolution and how Software as a Service is where the industry is moving. I don’t mind paying for support on a regular bases and getting updates and upgrades but I just purchased XrayVision last year and now they are discontinuing it. Poor choice, now I realize my second choice XDR, would have been a better move.

However, if OpenDental can do a descent job with radiographs, then that may be the icing on the cake for the best PMS available.

Is there a guide to set up ScanX with OD? Can you select 2 bitewing, 4 BW, single PA, FMX, pano, then start scanning? Will it allow you to move images around and mount all the images correctly after they have scanned? Are there any filters applied when using ScanX or sensors? Any down sides or areas that can be improved? I would be much more willing to support open dental for improvements with image module then sink money into another company I’m not too familiar with like XDR.

I really just want radiographs to be scanned and imported without loss of quality. Ability to mount images in a handful of layouts. Occasionally lighten or darken an image. Be able to easily export an image or layout, ideally with patient name and date of images. Would be nice to automatically transfer existing Apteryx images into OD so they are all in one place.

Rich, have you tested ScanX with the latest update? What are your thoughts? Limitations or areas that could be improved with integration?
Thanks,
Nathan

rfacko
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Re: Scan-X with new integrated x-ray feature

Post by rfacko » Wed Nov 24, 2021 10:05 am

Nate, just became available today in the Beta. Upgraded just now, so no feedback on functionality yet...

Jordan, it seems to be working for multiple images. First issue we have run into so far - if you scan more images than were in the mount, it comes up with an error and kicks you out of OD. The "extra" images get temporarily lost, but when you re-open "Acquire" it finds one, but not all, of the unsaved images.

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Re: Scan-X with new integrated x-ray feature

Post by Nate » Fri Nov 26, 2021 3:07 pm

UPDATED AFTER FURTHER TESTING Ver 21.3.29:
Jordan- I am testing the ScanX directly with OD beta on a new computer connected to the ScanX and I'm impressed with its integration. I had a few things that might help improve implementation. Let me know what your thoughts are.

SCANX SETUP GUIDE:
A guide to setting up the ScanX directly with OD would be fantastic. I loaded the drivers that came with ScanX or can be downloaded from AirTechniques. This sets up VistaEasy Viewer by default but I dont think its necessary or very useful, unless OD can not automatically flip images and save flipped image after scan is complete. Do we need to load or download any ScanX drivers or does the newest beta version 21.3.29 have the latest ScanX driver ready to use?

FEWER CLICKS:
I would suggest making it less clicks to get x-rays. Apteryx was basically set up with single click.
With Apteryx once we click the button in OD (from toolbar at top of any OD module) these are the steps:
1) Click type of mount from top toolbar, then scanner is activated and Air Techniques ScanX module pops up and select type of film (Intraoral standard, high, very high, pano, etc). If its on the option you want (used last), then start scanning. If not then select the correct film type and the scanner re-activates ready for that type of film.
2) Once films had been ran, Select Done to close twain interface(inactivate scanner) and all x-rays are placed on the mount to allow dragging and dropping in the correct position

OpenDental Steps w/ VistaEasy Viewer Activated:
1) Click on imaging module
2) Click mount
3) Click drop down Mount you want
4) Click Acquire or click on an empty mount position (either lets you move to next step)
5) Click Start to activate scanner Twain Interface
6) Click to save all marked images in VistaEasy (never saw VistaEasy when using Apteryx)
7) Click to close ScanX twain interface
-->Ideally there should be an option to place mounts individually in the toolbar (Where the Apteryx button is), so you click 1 time. They could be listed by names 2BW, 4BW, PA, PA/BW, Pano, FMX and/or have icons associated with them. Also that same click of the mount could activate scanner to skip a lot of clicks. Or at a minimum when clicking Acquire it starts, not sure why you would click acquire and then click start.

OpenDental Steps w/ VistaEasy Viewer Inactivated: Probably similar to users of Apteryx
1) Click on imaging module
2) Click mount
3) Click drop down Mount you want
4) Click Acquire or click on an empty mount position (either lets you move to next step)
5) Click Start to activate scanner Twain Interface
6) Click to close ScanX twain interface

MOVING IMAGES IN MOUNTS:
I think once scanned images are transferred into the mount it should default to 'Adj' rather than 'Pan'. Because the first thing you have to do is move images to mount them correctly which requires the 'Adj’ button. The 'Pan' button only moves the entire mount around the screen which should not be done too often if you set up the mounts like you want to see them. I guess after the initial scan is complete and 'Adj' is selected to move images then if you go back into an image it could be on 'Pan' but not critical. Also when you move an image it takes the place of the new image. Is it feasible to move an image outside the mount while you move another image to where it goes then place the one outside the mount where it belongs?

DEFAULT LOCATION OF NEW SCANNED IMAGES:
The images were automatically going into 'Patient Info' folder. They should default to go into the folder that matches the mount. Like BW, FMX, Pano, PA. I imagine that would require an option when setting up the mounts to assign a matching folder to send images to. That way whenever you take BW's the mount BWs is assigned to folder BWs and images go directly there.

ORIENTATION OF NEWLY SCANNED IMAGES:
Another thing I noticed was the images were sent to OD in the way they were scanned (ie all vertical and inverted). Apteryx had an option you could click that would allow all images coming in to be mirror image so you dont have to flip them. I think it might have been option within mounts but could have been global for all mounts. We always run the phospher plates with the white side toward the drum as recommended but want them mounted as looking at the patient from outside the mouth (ie the 'a' on the film looks like an 'a', not inverted). They also had option on individual mounts to auto rotate films 90 degrees. So the BWs that are scanned vertical would be flipped to normal horizontal position automatically. Of course pano would not be flipped as it is scanned horizontally.

EXPORTING IMAGES & ORIENTATION:
I also noticed after correctly flipping and mounting images that when exporting a single image they were in the unflipped or unrotated form, however when exporting the the entire mount they were in correct mounted position. The single image should also be exported in the same correct mounted position.

DELETING IMAGES:
Lastly, when deleting an x-ray there should be an extra warning 'Are you sure you want to delete this x-ray' to prevent loss of such critical data. I guess that too could be an option but I personally think it should be defaulted to on. When right clicking on a single image I could not delete a single image in a mount. It would delete the entire mount of images regardless if I had selected 'Adj' or 'Pan' buttons. I think it would be rare to delete an entire mount and if so it can be done by deleting in the folders to the left side of the screen. When right clicking and selecting delete on the image it should only delete the single image.
Last edited by Nate on Tue Nov 30, 2021 8:19 am, edited 1 time in total.

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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Mon Nov 29, 2021 11:32 pm

Thank you so much for all the great feedback. We will work hard to make this smoother. Most of the complaints will need to be added as new features, but one of them is already done: Exporting single images from a mount is better in 21.4. 21.4 also has a lot of other improvements that are unrelated to ScanX, but which makes it a better experience.
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Re: Scan-X with new integrated x-ray feature

Post by Nate » Tue Nov 30, 2021 6:44 pm

Jordan,
Thanks for the update and review of some of the improvements that can be made to the imaging module. Would you suggest each idea below should be added as a new feature request or combined as one?
1) Fewer clicks to acquire images
2) Moving images in mounts
3) Default location of new scanned images corresponding to name of category folder
4) Orientation of newly scanned images (automatically flip mirror image of scanx images)
I think #4 is the most important to be able to use ScanX with plates toward drum but have images mounted as looking at the patient without individually flipping each image. I think this could be a clickable option based on user preference. Please let me know if it is already an option that I may have overlooked.

I look forward to evaluating 21.4 once its released.
Thanks again,
Nathan

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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Thu Dec 02, 2021 12:02 am

This area is developing so quickly that the feature request system is really too slow to keep track of it. I'm tracking it all here:
https://www.opendental.com/site/imaging ... ments.html
I just haven't had a chance to work in your new suggestions, but they are great. So if the rapid progress slows down for some reason, then you might add them to the feature request system, but probably hold off to see how far we get first.
4-I think this would be done in the mount setup, just like the rotations currently are.
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Re: Scan-X with new integrated x-ray feature

Post by Nate » Thu Dec 02, 2021 6:08 pm

Jordan,
I agree the mirror image option could be a selection in the 'Edit Mount Def' similar to how the image rotations are defined. Another issue that can be planned ahead of time is for offices that use both ScanX and sensor and require different mount settings based on the acquisition device (Sensor or ScanX). I know there is an option to select the type of device but the device should actually be able to dictate the mounting options.
For example, ScanX device would allow setting all the mounts to have mirror image and flip all BWs 90 degrees based on how image is scanned in
Sensor mounts would not require mirror image or flipping a BW since image is acquired in horizontal position
I'm not exactly sure how to reconcile the options above and not create a redundant mount other than somehow allow setting up acquisition device to dictate any manipulation of image in each position of a mount. I also dont know how Apteryx or other imaging software handled it when an office used multiple imaging devices like different sensors and ScanX. We are certainly happy with our ScanX but might plan a supplemental sensor in the future and would like to have it set up to acquire images into the same mounts but likely different orientation.

Thinking about the future, I also wonder if OD imaging will be able to support acquisition of digital panoramic directly into imaging module?

I suspect rather than Denticon/Apteryx converting OpenDental users to utilize their practice management platform they are going to find out a lot of OpenDental users migrate away from Apteryx and utilizer OpenDental for all practice management and imaging needs. I look forward to updating DentalTown users of all the great improvements OpenDental is incorporating into imaging since many Apteryx users seem upset about their phasing out support for XrayVision 4. I know they have started to focus more on DSO's and corporate dentistry that require multiple offices but have failed the many smaller private dental offices that prefer onsite data management.
Thanks again for looking out for the dental community!

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Re: Scan-X with new integrated x-ray feature

Post by jordansparks » Thu Dec 02, 2021 7:42 pm

My understanding is that digital panos are easy. That's just a single image.
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