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In the age of customization, is there simple, user-friendly software to give me photos and scheduling together with finance—without getting a second mortgage? I'm looking for something simple, flexible, and resonable with no annuity payment.

Al Atta, Deerfield, Ill

Most of today's orthodontic practice-management systems offer packages that bundle scheduling and accounting features. Each offers different methods to store patient photos.

As for taking out a mortgage to get the features you want and need, that won't be necessary. However, you will want to do your homework. There are lower-priced systems on the market, but be sure to get solid, acceptable answers on at least these five basic points:

• Does the system offer all the features you're looking for now--as well as the features you may need as your practice grows?
• Does it use current technology?
• Is it customizable?
• Is it easy to use?
• Is personalized support and training offered as part of the package (at no extra charge), and for how long?

There is an old saying that an ounce of prevention is worth a pound of cure. Ensuring that your practice-management system choice suits your needs and is a good fit for your practice will be well worth the time and budget investment on your part.

Getting the right system in place from the start will increase productivity, save time, and improve cash flow. The wrong system will potentially cost you a great deal beyond your initial purchase price due to lost productivity, system crashes, headaches, stress, and finally, even more money spent to at last get the right system solution in place.

Take the time to explore your options and get the answers you need. New Horizons Software offers a full suite of customizable practice-management
tools and features including the integrated scheduling and accounting you're looking for, and then some. It is a mid-priced option that uses the latest technologies available, and we offer personalized, ongoing 24/7 support to ensure that you get the most out of your investment in your practice. Call me anytime, or visit us at www.NHSoftware.com to learn more.

What is best way to back up my practice and patient data?
Dr. Bruce Osborn, Lake Forest, Calif

First things first: no matter what kind of backup system you choose for your practice, always do a complete backup and not an “incremental” backup. Incremental backups only back up files that were changed since the last backup. What if you needed to restore? With incremental backup, you would have to start with the original backup and restore each backup to the present. This is never a good idea.

For those working with older operating systems, a good backup procedure is to close all applications on each workstation when leaving for the day and before a backup is done. Why? Because on older systems, backups will skip over any open files. This is not an issue with MS 2003 Server or XP Pro.

From there, find out whether your software utilizes “internal” backups. If not, you need to determine what you need to back up. How big is it? There are many methods of backing up: to CDs, tapes, flash drives, or external hard drives, for example (see pros and cons below).

My top recommendation and personal preference for backups is offsite backup companies that do your backups for you automatically. (For one example, see Subterranean Data Services.) With offsite backup companies, you have true peace of mind in that your data is secure and protected even from physical threats such as theft or accidents.

Here are some back-up system pros and cons in order of my preference.

1) Professional Offsite Backup Company

PRO
• Worry free: no need to remember to do backup (unlike other methods)
• Security: patient data is protected
• Less hassle: no staff time/responsibility required

CON
• Requires internet connection
• Ongoing fees versus physical media backup purchases

2) External Hard Drive

PRO
• Backs up data in original format
• Holds more data than CDs, tapes, or flash drives

CON
• Portable; easily subject to physical theft or accident (HIPAA concerns)
• Requires staff time/responsibility

3) CDs

PRO
• Simple to burn
• Data is in original format

CON
• Limited data storage capacity
• Requires backup application and CD burner
• CDs are easily subject to physical theft or accident (HIPAA concerns)
• Requires staff time/responsibility

4) Tapes

PRO
• Usually set to back up the full hard drive

CON
• May be slow; best used for after-hours backup
• Limited data-storage capacity
• Tapes are easily subject to physical theft or accident (HIPAA concerns)
• Requires staff time/responsibility

5) Flash Drives

CON
• Tend to be slow, especially when backing large databases
• Can loose or degrade data
• Limited data-storage capacity
• Portable; easily subject to physical theft or accident (HIPPA concerns)
• Requires staff time/responsibility

Are there any concerns with moving to Microsoft Windows Vista? I need to ensure my practice runs smoothly without any downtime.
Dr. Gerald Kinoshita, San Jose, Calif

As can be the case with any significant change to a computer’s operating system, moving to Microsoft’s new Vista operating system can be tricky. Here are some things to keep in mind to help you determine whether or not you and your practice are ready to make the change.

• Software
Check compatibilities. Is your practice-management system operable under Vista? Ask your provider and find out. Don't forget to also check all the other programs you may be using that are not connected with the practice-management system—for instance, QuickBooks, automatic phone reminder programs, and so on.

• Hardware
Make sure your computer is capable of running Windows Vista. According to Microsoft, some Vista features may require high-end graphic options and more advanced hardware. Visit the Microsoft Windows Web site to check the system requirements. Printers, scanners, and other peripherals may not work if they don't have a driver for Vista. Usually most of the major brands (HP, Dell, etc.) will have a driver update ready, but it’s best to double-check first versus suffering the repercussions of lost time and productivity when you discover incompatibilities after the fact.

• The Upshot: Do your homework before making the jump. You’ll be glad you did.