With Howard A. Fine, DMD, MMSc

OP: How often should an orthodontist back up his data?

Fine: It should be a routine procedure for every orthodontic office to back up the practice data at least once per day. This includes practice-management data, digital x-rays, digital models, and digital photos. I think it is important to assume that it is not a question of if your computer system will crash, but when it will crash! I also feel that redundant backup is important, meaning backup in more than one location. This can mean multiple external devices or off-site backup using a virtual private network (VPN).

OP: How do you personally back up?

Fine: I have two offices. My data is carried back and forth on a laptop, which is backed up every day onto an external hard drive. I have two identical drives, one for each office. I back up my entire computer, which amounts to more than 50 GB because of the digital x-rays, models, and photos that have accumulated.

OP: How do you manage this large amount of backup?

Fine: Let’s start with the type of backup software that is productive for the orthodontic practice. If you look on the Internet under “backup software,” you will find numerous professional packages that you will not necessarily find at the local computer store. The features that are beneficial are: 1) The capability of doing incremental backup, which means that once you have the whole system backup in place, only changes to the databases are backed up. The full backup can take hours. Incremental backups can take minutes. 2) Native file backup. This means that if you look at your backup drive, it should be a duplicate of the main drive. You should be able to navigate through the files on the backup drive as easily as the main drive, because the files look the same and have the same names. A nonnative file backup takes the files and creates a proprietary, compressed format for the backup. You cannot navigate through these files as easily. I recently had a significant error in my management software. The support team told me that the correction was to load a previously saved version of a particular file. By having a native file backup, I was easily able to find the correct file on the backup drive, and within minutes my system was running smoothly. 3) Source-target comparison for incremental backup. This is a little more sophisticated, but a very useful feature. It only applies if you need to back up more than one backup drive or if you are backing up the same main drive in two separate places. For example, with two offices, I back up my main drive onto an external drive in each office. The backup software compares what is on the main drive (source) to what is on the backup drive (target), determines which files have been changed, and backs those up. Some backup software systems only look at the source and back up the changed files onto the external drive. Without a source-target comparison, multiple external backup drives will have different information on them. When the backup software does a source-target comparison, you can be assured that the different backup drives are each duplicates of the source.

The only problem with a source-target system is that when the comparison is made, the computer does not delete files on the target external drive. For example, if you have deleted a file on your computer that had already been backed up, the computer will not show the deleted file, but the external drive will still show that file. If you have to restore your data from the backup drive, the deleted file may “magically” reappear.

OP: What are the advantages and disadvantages of various storage media?

Fine: Backup systems can be external hard drives, CDs, DVDs, tape drives, Zip-style drives, etc. The first feature I look for is capacity. If I am backing up my entire database of x-rays, models, photos, and management, I need a lot of memory. CDs, DVDs, and tapes do not have the capacity. With a large external hard drive, I can easily have a mirror image of my server. The next thing I want is portability. I strongly believe that your backup should never be with the server at the end of the day. If there were to be a disaster, all the data would be lost. As long as I have my data, I can re-create my entire office anywhere, anytime. I or one of my staff always takes the external backup home at the end of the day. Therefore, the backup drive should have a sturdy case and be designed to withstand some abuse.

The only problem I have seen with external backup drives is that, like a computer, an external hard drive can crash. That is why I have redundant backup in multiple locations. I am confident that I have my entire practice databases protected in at least one place at any given time. I know it sounds somewhat paranoid, but if you have your entire practice computerized, you have a medico-legal responsibility to ensure against disaster in any given form, be it a server crash, fire, or hurricane.

Howard A. Fine, DMD, MMSc, maintains private practices in Mount Kisco and Goldens Bridge, NY. He is a member of the National Association of Photoshop Professionals (NAPP). He can be reached at (914) 666-8997 or [email protected]