Bridging the gap: When technology interfaces go bad

2011 11 04 14 37 11 390 Rock Bridge Balance 70

As practice management systems become more sophisticated and electronic dental records and dental imaging software become more popular, some dental practices are looking at a best-of-breed approach.

In other words, if their original practice management software vendor doesn't have a good add-on module, then the practice is forced to purchase electronic records or dental imaging software from another vendor that claims its product can interface with the present practice management system.

Utilizing interfaces between different vendor systems is certainly one option. However, a dental practice owner must be aware of some of the pitfalls with this technology integration model and know which questions to ask.

One thing to consider is the number of practice management systems that a vendor claims it can interface with. To have a successful interface that passes the correct data back and forth between the two systems, the two companies should have a technology integration partnership.

What's more, it is worth noting that the more companies a vendor partners with the more difficult it is for the vendor to be technically adept at keeping up with all the systems it claims to interface with. Also, it is harder to keep close partnerships with many vendors.

The right questions

Whether it is a schedule upgrade or a bug fix, what happens if your practice management vendor changes the inner workings, even slightly, of your present system? How can you be assured that the other vendor will be able to adapt in sync to keep the interfaces working smoothly?

Over the past decade, I have run into a number of cases in which there was a good initial interfacing partnership between two companies until one of the companies decided to produce and market software similar to that of its partner.

In a case like this, what generally happens is that the company breaks off the partnership and, after a period of time, no longer supports the interface. So a practice is left with two software vendors and an interface that doesn't work. A technology bridge to nowhere, so to speak.

To avoid a similar situation, you need to ask your technology vendors the following questions:

  • How long have the two partners been interfacing with each other?
  • What agreements do they have regarding their partnership and how does termination work?
  • What will happen if one or both of the partners change their software?
  • If one of the partners creates competing software so that you don't need the other vendor's software anymore, how will your data be migrated?
  • What will each vendor contractually commit to with you to ensure that you are not left in a bad situation should the interface cease to exist or not continue to work as it originally did?

From a financial standpoint, interfacing disparate systems during an implementation can definitely add a level of complexity and cost. Sometimes I think the term "nickel and diming" was created to describe the additional interface costs that come up during the implementation and that were either not discussed or not priced correctly originally during the sales process. No client likes these surprises.

From a technical and IT standpoint, it is more difficult and time-consuming to maintain two or three databases and keep them working at optimum efficiency. This is especially true if the databases use different technologies that actually speak different languages.

Finally, from a technical support and issue resolution standpoint, the potential is there for finger-pointing between the two vendors when and if something should go wrong. I have walked into numerous situations in the past in which there were integration and compatibility issues and each vendor was blaming the other for the problems. I had to act as a broker and mediator just to get everyone talking to each other, honor their contracts, and resolve the issues.

So there is certainly a lot to be said about a best-of-breed approach to system functionality. However, before cobbling two or three systems together, you should be aware of the potential issues and the right questions to ask.

Mike Uretz is founder and executive director of He is now applying his 10 years of knowledge and experience with electronic health records and health IT to the dental industry to introduce dentists to software best practices and help them avoid the pitfalls experienced by other healthcare professionals. Uretz is also director of the EHR Group.

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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