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Digital activation and online scheduling.

The modern dental office looks far different than it did as little as 10 years ago. Many offices have started to move towards a goal of a "paperless" practice. While I don't feel that being truly paperless is a realistic goal, there are many offices that are "chartless," in that they have removed the need for a paper chart.

One area where some practices spend a lot of time and effort is scheduling and recall of patients. The typical scenario is that a post card is sent out, followed up by a call from the office. Another call is made shortly before the appointment to confirm the visit, thus expending more time and energy. Fortunately, in the digital age, many other options are more cost-effective and require less staff time.

If you read any studies, you'll see that in the 21st century, the vast majority of patients prefer to be contacted by email rather than by phone at home or work. Since the goal of any practice should be to give our patients what they want and need, this would seem to be an obvious solution. While some practice management programs have this feature built-in, it's often not very well developed and doesn't allow for any interaction from the patients. There are a number of third-party programs, however, that can fill in the blanks. Some use the phone primarily (like Elexity, PhoneTree and SmileReminder), while others are email based (like DemandForce and Uappoint). The most important criteria are that they all allow the patient not only to get the information about the upcoming appointment, but also to confirm the visit and have that information automatically updated by your practice management software.

The other frontier that is just starting to take off is online scheduling. Obviously, few if any offices are willing to turn their appointment books over to their patients. However, especially when we are talking about dental hygiene visits that have a fixed length of time, there is no reason that patients shouldn't be able to request appointments based on a time that is convenient for them. While only a few systems have begun this process (Uappoint), it would seem to be a great option to offer to your busy patients to get them to return for needed care.

As offices continue to evolve and get busier and busier, it's important to look at ways to decrease the workload on everyone in the office, and using your computer systems to handle reactivations and scheduling would certainly be a step in the right direction.


It is clearly time to send patients email. According to Neilsen/NetRatings, there are now over 204 million (75 percent) Americans with access to the Internet from home, with over 55 million having broadband access and "checking email" listed as the primary use for their online activity.

Further, 75 percent of the age group 30-49 access the Internet as well as 22 percent of the group over the age of 65, which makes them the fastest-growing group to embrace the online world. Women are also increasing in email usage, with over 34 million women between the ages of 35 and 54 accessing the Internet at home. (1)

Email messages can be extremely effective for confirming appointments, sending post-op care, new patient welcome and even birthday wish messages.

Cell Phones and Text Messaging

More patients depend on cell phones, pagers and email for their communication needs than ever before. In fact, according to an article in 2003 by CNN, "43 percent of homes in the U.S. use cell phones as their primary phone." (2)

Text messaging, also called Short Message Service (SMS) is a service available on digital mobile phones that allows short text messages (up to 160 characters) to be received and displayed on the phone. There are currently 182,140,362 U.S. wireless subscribers, 52 percent (ages 25-34) of whom sent or received text messages in the previous month. (3) Among younger subscribers, "texting" is ubiquitous, with 68 percent of those aged 18-24 sending and receiving text messages. Even older folks are getting into the act, with 14 percent of those over 65 using text messaging. (3)

The unique benefits of being able to send a text message to a cell phone are the ability to reach patients wherever they are, the speed of delivery of the message reaching the patient in nearly real-time, and reaching the patient directly rather than someone else "giving them the message." Cutting down on forgotten appointments with same-day reminders, as well as being able to quickly fill last-minute cancellations, are two examples of how effective this type of communication can be.

Some companies focus on sending email and text messages for health care practices. Smile Reminder ( is one that specializes in dentistry and can completely automate the process, as they are integrated into the scheduler of the practice's management software. Another benefit of a service like Smile Reminder for email is that they use a secure server to send messages out. There has been a lot of press recently about the new HIPAA regulations as they relates to transmitting sensitive patient information online, so dentists need to be aware of how their "regular" email (for example, Outlook, Outlook Express) might prevent a risk.


Practices can actually increase the "high-touch" factor by making a good impression in their email messaging. HTML email offers the ability to embed a digital image (office logo, team picture, before-and-after) as a jpeg, tiff or other file type within the message. Messages can also include hyperlinks to the practice's Web site.

Many practices have started to realize the benefits of these services, and they are highly recommended for the modern digital practice.


(1.) Nielsen/NetRatings, March 2007. Available at

(2.) Bye, bye landline phones. CNN, August 4, 2003.

(3.) Donovan M. M:Metrics, March 2007.

Lorne Lavine, DMD, founder and president of Dental Technology Consultants, has over 20 years invested in the dental and dental technology fields. A graduate of USC, he earned his DMD from Boston University and completed his residency at the Eastman Dental Center in Rochester, NY. He received his specialty training at the University of Washington and went into private practice in Vermont until moving to California in 2002 to establish DTC, a company that focuses on the specialized technological needs of the dental community. He has vast experience with dental technology systems including extensive hands-on experience with most practice management software, image management software, digital cameras, intraoral cameras, computers, networks, and digital radiography systems. He writes for many well-known industry publications and lectures across the country. In addition, he is a member of the Speaking and Consulting Network. He is also the former technology consultant for the Indian Health Service.
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Title Annotation:technology: update
Author:Lavine, Lorne
Geographic Code:1USA
Date:May 1, 2008
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