Orthodontic Software Interoperability

Unleashing the potential of orthodontic software

Presentation Goals

Raise awareness in topic of Interoperability
Become part of AAO's Strategic Plan

Problem 1

Intra-office Connections

Problem 2

Inter-office Connections

Problem 3

Research

Today's research is embarrassingly based on a tiny fraction of our population (< 100 patients)
We have the technology in place to bump up sample size by 2-3 orders of magnitude.

Problem 4

Data Conversion

A lot of time and resources spend for data conversion (import and export)
Data conversion is a tedious repetitive process: developers keep reverse engineering and don't share their work.

Problem 5

Data to Patient

Awareness of data ownership is growing and governments are adding regulations (21st Century Cures Act, Information Blocking)
Providers don't know how to give patients their data.

How can we solve the problem?

We make use of standards.

Humans and Standards

Humans have a history of making significant progress by adopting standards.

Language/Alphabet

Measuring things (SI Units)

Tire Codes (ISO-83.160.10)

Containers, Rail Track Gauge

RCA Sound Tape Cartridge, Elcaset, Compact Cassette

Wall Socket (NEMA 1-15, NEMA 5-15)

Screws (ASME-B1, ISO-68,261,262,724,725

TCP/IP Networking (the Internet), Email, SMS

No Standards: Nintendo, Xbox, Playstation, ...

Tesla Open Source Patents

...

Strategic Plan of the Past

Attempts have been made in the past, but they failed. Why?

We have used closed interoperability
Fear of losing customers
It's work to follow standards
No request from customers
Lack of Information

Master Plan

How would the future look like?

How can the AAO get involved

Regularly publish articles to educate domain on Interoperability.
Require applicants for AAO/AAOF funding to include interoperability and data sharing as part of the proposal.

Interoperability Guidelines

A developer should always make use of existing standards
If there are no standards, a developer is expected to invent their own standard.
When a new standard is invented, it shall be made public, and eventually adopted by and SDO.

A developer should always make use of an existing, public, open, machine-readable and recognized standard format for exporting, importing and interchanging all of the data. (The intention is to prevent developers from holding on to the data the user has added).
If a developer is developing a novel product, for which no such standard exists yet, the developer can invent their own format, as long as it is made public, and open for usage by anyone. (The intention is to allow technological innovation, while maintaining interoperability). In such circumstance:

the developer shall facilitate/promote the standardization of this format through a recognized SDO. (The intention is that this new format becomes official and implemented by others as well)
if a new versions of the format is necessary, the developer shall maintain backwards compatibility with the previously used format, either directly (within the new version of the product itself), or by developing and making publicly available open-source conversion tools.
in any event, any subsequent format changes and revisions shall be made publicly available for usage, implementation and development, just as the first one. (The intention is to prevent possible abuse of this regulation by making the first format public and open, but then making revisions closed and proprietary)

The "FAIR" Guiding Principles for scientific data management and stewardship

FINDABILITY: (meta)data are assigned a globally unique and persistent identifier; data are described with rich metadata; metadata clearly and explicitly include the identifier of the data it describes; (meta)data are registered or indexed in a searchable resource

ACCESSIBILITY: (meta)data are retrievable by their identifier using a standardized communications protocol; this protocol is open, free, and universally implementable, and allows for an authentication and authorization procedure, where necessary; metadata are accessible, even when the data are no longer available

INTEROPERABILITY: (meta)data use a formal, accessible, shared, and broadly applicable language for knowledge representation; they use vocabularies that follow FAIR principles; they include qualified references to other (meta)data

REUSABILITY: (meta)data are richly described with a plurality of accurate and relevant attributes; they are released with a clear and accessible data usage license; they are associated with detailed provenance; they meet domain-relevant community standards

Ask you software's support these questions

Find out if you really have control over your data.

The day I decide to move to a different software product, what will the process to export my data and import it into the new software be?
I would like to use Software B to send out my email reminders. Can you please ensure the two software products can share data both ways?