Does abandoning Patterson imaging mean I have to abandon Open Dental?

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kellyb
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Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by kellyb » Thu Oct 14, 2021 4:06 pm

So I have the latest version of standalone Patterson Imaging for Xrays, which is ancient. I have Schick sensors. I am under Patterson Maintenance and there is no upgrade path. Its been 5-6 years without an update, and it is running a very old version of Sybase [which like OD's mySQL/Maria is also not VSS compliant BTW].

I intend to abandon Patterson Imaging soon. Open Dental offers no paid conversion for xrays into OD imaging; and if I'm not mistaken Xrays that are taken via Twain into the OD imaging module are lower resolution (?) than they would be in an imaging solution, so that may not be as clinically desirable anyway.

Apteryx is dead, and most of the imaging options that currently exist are bundled or cloud based with another PMS. So, it seems like it is difficult for find another standalone imaging product that I can convert into from Patterson.

It creates a scenario where I am attracted to moving imaging AND the PMS into a single solution, which unfortunately would then not be OD.

Am I overlooking something?

What are you using for imaging outside of OD?

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jmazzie
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by jmazzie » Thu Oct 14, 2021 4:36 pm

While twain can be a lower resolution it all depends on the twain driver/manufacturer on how they wrote it. Since OD came out with their built in imaging solution our office has taken just over 278K Xrays across carestream and schick sensors and so far we haven't had any issues with the image quality provided both solutions offer configuration options for their twain driver.

If you haven't already I'd try connecting your existing equipment to OD and see if the workflow / option works for your office since the imaging is free. The biggest downside like you mentioned is there is no conversion option which is been an issue for us as we are sitting around 1M xrays in our old imaging solution with no easy method to move them. Our workaround has been moving the xrays manually to OD in reverse date order so the current active patients xray are set as a priority over inactive patients
Jeff

kellyb
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by kellyb » Thu Oct 14, 2021 5:32 pm

thanks for your reply!

The issue with resolution isn't the twain driver, but the number of bits Open Dental recognizes/stores. So, even if the twain driver is perfect, my understanding is that OD simply doesn't store the full bits from images as one would expect in imaging.

However, my bigger goal is to eliminate ancient, unpatchable software which is both a reliability and a security risk (Patterson Imaging). So I'm not interested in adding any Xrays to OD or testing Twain drivers since I can't convert the xrays I already have. I'm either going to find a supported, decently modern & maintained imaging product that I can migrate to, or I'm throwing out the baby with the bathwater and migrating everything, images and patient records to a completely different integrated solution. I don't care if it costs more or I can't write SQL queries against it.

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jordansparks
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by jordansparks » Thu Oct 14, 2021 6:11 pm

I'm not sure such a thing exists at any price. But since cost doesn't seem to be a major factor, can't you just sit a new employee down for a few months and have them manually move images over with export/import? That would cost about $10k. We've thought about doing something along those lines as a service, but we figured nobody would actually want to pay for it.
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dqadri
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by dqadri » Thu Oct 14, 2021 7:01 pm

I've been feeling the same way with my imaging platform (Vixwin Platinum) and the pain points have gotten to the spot where I am seriously considering creating an open source product to replace it. Currently it crashes on some data transfers with no logic or error messages.

If Apteryx was doing it internally, it shouldn't take that long to float a new project off the ground.
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Danish Qadri, DMD

Lake Family Dentistry
296 Lake Ave
Colonia, NJ 07067

kellyb
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by kellyb » Fri Oct 15, 2021 12:46 pm

jordansparks wrote:
Thu Oct 14, 2021 6:11 pm
I'm not sure such a thing exists at any price. But since cost doesn't seem to be a major factor, can't you just sit a new employee down for a few months and have them manually move images over with export/import? That would cost about $10k. We've thought about doing something along those lines as a service, but we figured nobody would actually want to pay for it.
Dr. Sparks - thanks for replying!

When you say that "I'm not sure such a thing exists at any price", does this mean you are of the opinion that there are no standalone x-ray imaging solutions currently sold and supported in the dental market?

Your suggestion of paying an admin to move/migrate x-rays manually is a valid possibility, but I was suggesting that the investment would be in a full-featured replacement of Patterson Imaging, not simply labor to manually migrate. Is it outside the realm of possibility to programmatically migrate images from a system like Patterson (Sysbase db + files), into an open MySQL + files solution like Open Dental? Might it cost around $10,000 or less to author a script/converter that could be used for this, eliminating much of the human error inherent in a laborious manual move of thousands of images?

Thanks,
Kelly

kellyb
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by kellyb » Fri Oct 15, 2021 12:52 pm

dqadri wrote:
Thu Oct 14, 2021 7:01 pm
I've been feeling the same way with my imaging platform (Vixwin Platinum) and the pain points have gotten to the spot where I am seriously considering creating an open source product to replace it. Currently it crashes on some data transfers with no logic or error messages.

If Apteryx was doing it internally, it shouldn't take that long to float a new project off the ground.
Dr. Quadri - I too am considering the idea of developing an imaging solution. I have a background in mission critical/high availability software design and development, and see no immediate technical reasons this could not be done. It would simply be a matter of cost and proper software design & development. However, a rule of thumb I've always believed in is that it is usually better to find and buy a vertical market solution if one exists, and only "roll your own" if you can't find a commercial solution that meets your requirements.

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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by dqadri » Fri Oct 15, 2021 3:32 pm

kellyb wrote:
Thu Oct 14, 2021 5:32 pm
thanks for your reply!

The issue with resolution isn't the twain driver, but the number of bits Open Dental recognizes/stores. So, even if the twain driver is perfect, my understanding is that OD simply doesn't store the full bits from images as one would expect in imaging.
When you say it doesn't store the full bits, what exactly are you saying? My Gendex sensor will record 16-bit data and then save it into different formats. I can also record 8-bit data when I take x-rays too.
--
Danish Qadri, DMD

Lake Family Dentistry
296 Lake Ave
Colonia, NJ 07067

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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by dqadri » Fri Oct 15, 2021 3:33 pm

kellyb wrote:
Fri Oct 15, 2021 12:52 pm
dqadri wrote:
Thu Oct 14, 2021 7:01 pm
I've been feeling the same way with my imaging platform (Vixwin Platinum) and the pain points have gotten to the spot where I am seriously considering creating an open source product to replace it. Currently it crashes on some data transfers with no logic or error messages.

If Apteryx was doing it internally, it shouldn't take that long to float a new project off the ground.
Dr. Quadri - I too am considering the idea of developing an imaging solution. I have a background in mission critical/high availability software design and development, and see no immediate technical reasons this could not be done. It would simply be a matter of cost and proper software design & development. However, a rule of thumb I've always believed in is that it is usually better to find and buy a vertical market solution if one exists, and only "roll your own" if you can't find a commercial solution that meets your requirements.
I haven't done an exhaustive list but Apteryx was as the top of my imaging list before the recent acquisition. I haven't seen any other imaging vendors that support interoperability and an open design.
--
Danish Qadri, DMD

Lake Family Dentistry
296 Lake Ave
Colonia, NJ 07067

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jordansparks
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by jordansparks » Fri Oct 15, 2021 5:43 pm

I think we've tried scripting it. This would work by simulating a user clicking on things. I think it breaks after a while for various reasons, so it becomes impractical. The real problem is that they encrypted the files. We can convert from many other kinds of imaging software.
Jordan Sparks, DMD
http://www.opendental.com

kellyb
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by kellyb » Tue Oct 19, 2021 11:46 am

dqadri wrote:
Fri Oct 15, 2021 3:32 pm
kellyb wrote:
Thu Oct 14, 2021 5:32 pm
thanks for your reply!

The issue with resolution isn't the twain driver, but the number of bits Open Dental recognizes/stores. So, even if the twain driver is perfect, my understanding is that OD simply doesn't store the full bits from images as one would expect in imaging.
When you say it doesn't store the full bits, what exactly are you saying? My Gendex sensor will record 16-bit data and then save it into different formats. I can also record 8-bit data when I take x-rays too.
Dr. Qadri - here is the post from Jordan discussing the bit
jordansparks wrote:
Fri Jan 08, 2021 8:17 am
It takes a moment to load a FMX from the hard drives, but other than that, it doesn't bog anything down. The disadvantages:
-Not mature, so there are likely to be a few annoyances.
-Might not have certain features that your current imaging software has. Example: measure distance.
-TWAIN works, but we don't quite have native capture working. This means you will be using 8 bit instead of 10 or 12 bit. Screens can only show 8 bit, so the image quality won't look worse. But if you change your windowing to a narrower range to look for subtle caries, the quality won't match 12 bit.
-No popout to a second screen yet. If you want images on second monitor, open a second copy of Open Dental.
Advantages:
-No bridging between software.
-I personally feel that the feature set and quality are good, but that's subjective and complex.
I'm unclear whether future enhancements/native capture availability will positively impact this; I'm also not a clinician so I'm not personally clear how much of a concern this is to the dentist.

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jordansparks
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by jordansparks » Tue Oct 19, 2021 3:54 pm

As an aside, we do now have popouts and measurements done, so we're whittling down that list.

But for the main issue of 12 bit vs 8 bit: 8 bit results in 256 shades of gray, which is surprisingly few. In spite of your monitor being able to display millions of colors, it can only display 256 shades of gray. There are monitors with high dynamic range that can display a bit more, but most software isn't written to take advantage of that. At 256 shades from black to white, you can easily see each step in the gradient. So the sensor captures a few more bits. For example, if it captures at 10 bits, that gives you 1024 shades which is better. Then, the TWAIN software provided by the sensor manufacturer windows that back down to 256 shades. But it does NOT do it by rounding each pixel value. It does it mostly by chopping off all the black to dark gray and all the white to light gray. It takes the middle range that we are actually interested in and spreads that out. In the end, you don't really lose anything. But technically, it's not the very best because we might want to do that part ourselves. This seems like it would really only be an issue if you had a severely over or underdeveloped radiograph. If it's all washed out, then doing our own windowing straight from the 10 bits would allow us to darken it up without losing any detail.

Layman's version: It probably doesn't matter at all. Everyone's been doing it this way for years.
Jordan Sparks, DMD
http://www.opendental.com

kellyb
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Re: Does abandoning Patterson imaging mean I have to abandon Open Dental?

Post by kellyb » Sun Oct 24, 2021 6:12 pm

Jordan - thanks for this explanation - it helps alot!

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