Plugged In: Electronic Records Management


Part 2: Understanding costs associated with electronic records

Dr. Jeff Glaizel

There are approximately 40 practice management systems customized for the Canadian marketplace and countless imaging solutions for digital radiographs. But before choosing a system, dentists should be aware of the associated costs. One strategy for estimating technology-associated costs involves performing a cost analysis according to 4 components: hardware, software, maintenance and support, and long-term implications.


Hardware includes the computers, tablets, monitors, intraoral cameras, digital radiographic systems, CAD/CAM scanners and related accessories. The most costly hardware investment is typically the server, which stores your data and virtually connects all the computers in your office. Servers usually operate constantly and that around-the-clock availability requires robust hardware. Most hardware components have a limited life expectancy so upgrades and updates are usually required after about 3 to 5 years.


Software includes all the programs you use in your dental office, including the programs required for practice management, digital imaging, word processing and virus scanning. Most software comes with an upfront, flat fee for a software license. In addition to the software, the purchase cost usually includes installation, training and support for a limited time.

Maintenance and Support

Both hardware and software will require routine maintenance and support to keep them in optimal working order. Regular checks on your network and physical hardware will help ensure that your systems continue to run effectively. It is well-advised to recruit a trusted expert to provide support and maintenance services.

Practice management software is usually supported for 1 year after the date of purchase. When software is upgraded, the version you originally purchased may no longer be supported. However, upgrading to a new version often requires payment. Another option is to purchase software support services. The ongoing fees allow you to get updates and patches and are usually calculated according to the number of computers running the software.

Finally, new hardware or software must be integrated into an existing system and employees will require training on the new system. These costs related to integration and training should also be factored into your cost analysis.

Long-term implications

A cost analysis for hardware, software and support is relatively straightforward—vendors should provide quotes with no hidden fees or surprises. Perhaps more uncertain are the long-term implications of your purchases, including any potential risks.

Dentists should consider whether the technology fits into their practice plans for the next 5, 10 or 15 years and if it's possible to switch systems if expectations are not met. Currently, practice management and imaging software do not allow patient data to be easily transferred between systems. Costs to transfer data between systems are high—typically between $5000 to $20 000. Moreover, the transfers are often incomplete as data can be lost. As a best practice, risk assessments should be conducted before any technology purchase to assess whether the technology can potentially affect your office on a business, privacy or regulatory level.

Implementing technology comes with costs and risks for the dentist and the dental office. Conducting a thorough analysis prior to making a purchase can help dentists understand all costs and help mitigate risks.