Carestream Dental
Implementation PlaybookDSO · Group Practice

Carestream Dental

Step-by-step implementation guide — pre-implementation checklist, onboarding, staff training, go-live runbook, and ROI tracking.

Carestream Dental — Implementation Playbook (DSO)

Carestream Dental Diagnostic Imaging AI Implementation Playbook

For Dental Service Organizations (DSOs)

1. Executive Summary

What This Tool Does

Carestream Dental's diagnostic imaging AI platform leverages advanced algorithms to analyze dental radiographs (periapical, bitewing, panoramic, and CBCT images), automatically detecting pathologies including caries, periapical lesions, bone loss, calculus, and other clinical findings. The system integrates with existing imaging workflows to provide real-time diagnostic assistance, standardized annotations, and clinical decision support directly within the image viewer.

Why DSOs Specifically Benefit from Diagnostic Imaging AI

Scale Advantages:

  • A single AI implementation decision impacts diagnostic consistency across 15–50+ locations simultaneously
  • Per-location licensing costs decrease significantly with enterprise agreements (typically 30–45% below single-practice pricing)
  • Centralized deployment infrastructure reduces IT overhead versus 50 separate implementations

Standardization Benefits:

  • Eliminates provider-to-provider diagnostic variability—a critical quality control challenge when managing 75–250+ providers across your portfolio
  • Creates uniform documentation standards that reduce malpractice exposure and improve clinical defensibility
  • Enables apples-to-apples clinical performance comparisons across locations for the first time

Data Aggregation Value:

  • Aggregate diagnostic data across all locations creates proprietary clinical intelligence unavailable to competitors
  • Population-level insights enable proactive care model development (e.g., identifying geographic caries patterns)
  • Enterprise-wide detection accuracy metrics support quality improvement initiatives and payer negotiations

Expected Timeline: Decision to Full Deployment

Phase Timeline Milestone
Pre-Implementation Weeks 1–2 Vendor contract, technical requirements, stakeholder alignment
Pilot (Wave 1) Weeks 3–6 2–3 locations live, initial learning captured
Wave 2 Weeks 7–12 Next 5–10 locations deployed
Wave 3+ Weeks 13–20 Remaining locations deployed
Optimization Weeks 21–26 Full deployment, enterprise-wide optimization

Total Timeline: 20–26 weeks for a 30-location DSO (adjust ±4 weeks per 15 locations above/below this baseline)

2. Pre-Implementation Checklist (Weeks 1–2)

2.1 Technical Requirements

Hardware Requirements

☐ Workstation specifications per location:

  • Minimum: Intel i5 (8th gen+) or AMD Ryzen 5, 16GB RAM, SSD storage
  • Recommended: Intel i7/i9, 32GB RAM, dedicated GPU (NVIDIA GTX 1650+) for CBCT analysis
  • Display: Minimum 1920x1080 resolution; diagnostic monitors recommended for primary review stations

☐ Imaging equipment compatibility verification:

  • Confirm sensor/phosphor plate manufacturer and model at each location
  • Verify panoramic unit models and digital capture capability
  • Document CBCT units (if applicable): manufacturer, model, software version

☐ Server requirements (if on-premise hosting selected):

  • Dedicated server: 32GB+ RAM, multi-core processor, 2TB+ SSD storage
  • Redundant power supply and backup systems
  • Estimated time: 2–4 hours for inventory, 4–8 hours for procurement decisions

Software Requirements

☐ Operating system compatibility:

  • Windows 10 Pro (21H2+) or Windows 11 Pro required
  • macOS support limited—confirm with Carestream if any locations use Mac workstations

☐ Imaging software versions:

  • Carestream Dental Imaging Software minimum version: 8.0
  • Document current versions at all locations
  • Flag locations requiring upgrades (estimated upgrade time: 1–2 hours per workstation)

☐ Browser requirements (for web-based components):

  • Chrome 90+, Edge 90+, or Firefox 88+
  • Estimated time: 1 hour per location for software audit

Network Requirements

☐ Bandwidth specifications:

  • Minimum: 50 Mbps symmetric per location
  • Recommended: 100+ Mbps symmetric for locations with CBCT
  • ⚠️ Locations with <25 Mbps will experience unacceptable latency—prioritize network upgrades

☐ Network configuration:

  • Static IP addresses for imaging workstations (recommended)
  • Firewall rules for Carestream cloud endpoints (ports 443, 8443)
  • VPN requirements if using centralized hosting model
  • Estimated time: 2–4 hours per location for network assessment

Integration Requirements

☐ Practice Management System (PMS) integration:

  • Document PMS vendor and version at each location
  • Confirm API availability and current integration status
  • Identify locations using non-standard or legacy PMS systems

☐ Imaging system integration:

  • Verify TWAIN/WIA driver compatibility
  • Confirm DICOM compliance for CBCT integration
  • Document any third-party imaging software in use
  • Estimated time: 4–8 hours for enterprise-wide integration mapping

2.2 Vendor Onboarding Steps

☐ 🔵 Execute enterprise agreement with Carestream Dental

  • Master Service Agreement (MSA) covering all locations
  • Business Associate Agreement (BAA) for HIPAA compliance
  • Service Level Agreement (SLA) with uptime guarantees (target: 99.5%+)
  • Estimated time: 1–2 weeks (legal review dependent)

☐ 🔵 Establish key vendor contacts:

Role Purpose Response Time SLA
Enterprise Account Manager Commercial relationship, escalations Same business day
Technical Implementation Lead Integration, configuration, deployment 4-hour response
Training Coordinator Training scheduling, materials 24-hour response
Tier 2 Technical Support Complex troubleshooting 2-hour response
Customer Success Manager Ongoing optimization, QBRs 48-hour response

☐ 🔵 Schedule enterprise kickoff call:

  • Attendees: Your implementation team + all vendor contacts above
  • Agenda: Project timeline, communication protocols, escalation paths
  • Estimated time: 1.5 hours

☐ 🔵 Obtain vendor implementation documentation:

  • Technical requirements specification
  • Integration guides for your PMS systems
  • Training curricula and materials
  • Go-live checklist templates
  • Estimated time: Vendor provides within 3 business days of kickoff

2.3 Data/Access Prerequisites

☐ Administrative access setup:

  • Enterprise admin portal credentials (1–2 C-suite/VP-level users)
  • Regional admin credentials (1 per region)
  • Location admin credentials (1 per location)
  • Provider-level credentials (1 per licensed provider)
  • Estimated time: 2–4 hours for credential structure design

☐ API credentials:

  • API keys for PMS integrations (one per PMS instance)
  • Secure storage protocol for API credentials (password manager or secrets vault)
  • Documentation of API rate limits and usage policies
  • Estimated time: 1–2 hours per PMS vendor

☐ Imaging archive access:

  • Read access to historical imaging databases at each location
  • DICOM archive access for CBCT historical data
  • Decision: How much historical data to ingest (recommendation: 12–24 months)
  • ⚠️ Historical data migration can significantly extend timeline—scope carefully
  • Estimated time: 4–8 hours for archive access audit

☐ Single Sign-On (SSO) integration credentials:

  • SAML 2.0 or OAuth 2.0 configuration details
  • Identity provider (IdP) administrator access
  • Test user accounts for SSO validation
  • Estimated time: 4–8 hours for SSO setup

2.4 Enterprise-Level Requirements

Network Standards Across Locations

☐ 🟣 Determine hosting model (executive decision required):

Model Pros Cons Recommendation
Carestream Cloud (SaaS) No infrastructure management, automatic updates, fastest deployment Less control, ongoing subscription cost ✅ Recommended for most DSOs
Centralized On-Premise Maximum control, one-time cost model IT burden, update management, disaster recovery responsibility Consider for 50+ locations with mature IT
Hybrid Flexibility, redundancy Complexity, dual maintenance Consider for CBCT-heavy portfolios

☐ Establish network standardization requirements:

  • Minimum bandwidth standard for all locations
  • Standardized firewall rule templates
  • VPN requirements and approved vendors
  • Network monitoring requirements
  • Estimated time: 2–4 hours for policy documentation

Centralized Credentialing

☐ Define role-based access control (RBAC) structure:

  • Enterprise Admin (full access)
  • Regional Admin (regional locations only)
  • Location Admin (single location)
  • Provider (clinical features only)
  • Staff (read-only/limited features)

☐ 🔵 Configure SSO integration with Carestream:

  • Provide IdP metadata to Carestream
  • Configure attribute mapping (name, role, location)
  • Test SSO flow in sandbox environment
  • Estimated time: 8–16 hours

☐ Establish credentialing automation:

  • New hire provisioning workflow
  • Termination de-provisioning workflow
  • Location transfer credential updates
  • Estimated time: 4–8 hours for workflow documentation

2.5 Internal Stakeholder Alignment

Stakeholder Alignment Map

Stakeholder Role in Implementation Information Needed Approval Required? Timing
Board/Investors Strategic oversight ROI projections, competitive positioning, risk assessment 🟣 Yes—budget approval Pre-vendor selection
CEO Executive sponsorship Implementation timeline, resource requirements, strategic rationale 🟣 Yes—project approval Week 1
Chief Dental Officer Clinical governance Clinical workflow changes, quality implications, provider impact 🟣 Yes—clinical protocols Week 1
VP of Operations Operational oversight Rollout plan, resource allocation, location readiness 🟣 Yes—rollout sequence Week 1
CFO Financial oversight Total cost, payment schedule, ROI timeline 🟣 Yes—vendor contract Week 1
VP of IT/CTO Technical governance Infrastructure requirements, security review, integration approach 🟣 Yes—technical architecture Week 1
Regional Managers Regional execution Training responsibilities, location selection input, escalation role Informed Week 2
Office Managers Location execution Go-live preparation, staff scheduling, local coordination Informed Week 2–3
Providers Clinical adoption Workflow changes, clinical expectations, feedback mechanisms Informed Week 2–3

☐ 🟣 Executive steering committee formation:

  • Members: CEO, CDO, VP Ops, CFO, VP IT
  • Meeting cadence: Bi-weekly during implementation, monthly post-deployment
  • Decision rights: Wave advancement, budget changes, timeline adjustments
  • Estimated time: 2 hours for charter creation

☐ Regional manager briefing sessions:

  • Schedule 1-hour briefing per region
  • Provide rollout timeline and expectations
  • Identify regional concerns and constraints
  • Estimated time: 1 hour per region × number of regions

☐ Provider communication plan:

  • Draft announcement communication
  • Schedule Q&A sessions (virtual acceptable)
  • Identify and address early skeptics proactively
  • Estimated time: 4–8 hours

2.6 Baseline Metrics Capture

Critical: Capture These BEFORE Go-Live

⚠️ Without baseline metrics, ROI measurement is impossible. This step is non-negotiable.

☐ Standardize metric definitions across all locations: Create a data dictionary ensuring every location calculates metrics identically.

Metric Definition Data Source Capture Method
Case Acceptance Rate (Accepted treatment plans / Presented treatment plans) × 100, measured at procedure level PMS Automated report
Average Diagnosis Time Time from image capture to diagnosis documentation in chart PMS + observation Manual sampling (20 cases/location)
Radiograph Retake Rate (Retaken images / Total images captured) × 100 Imaging software Automated report
Caries Detection Rate Caries diagnoses per 100 bitewing series PMS Automated report
Pathology Documentation Completeness % of radiographs with documented findings (including "no findings") Chart audit Manual audit (50 charts/location)
Treatment Plan Value per Patient Average dollar value of treatment plans presented PMS Automated report
Claim Denial Rate (Diagnostic) Denials for diagnostic imaging codes / Total diagnostic imaging claims Billing system Automated report
Patient Wait Time Arrival to operatory, operatory to provider Manual measurement Time study (1 day/location)

☐ Execute baseline data collection:

  • Pull 90 days of historical data for automated metrics
  • Conduct manual audits and time studies at each location
  • ⚠️ Allow 3–5 business days per location for manual data collection
  • Estimated time: 4–8 hours per location for complete baseline

☐ Create baseline dashboard:

  • Aggregate all location baselines into central dashboard
  • Enable location-to-location comparison
  • Identify outlier locations (both high and low performers)
  • Estimated time: 8–16 hours for dashboard creation

☐ Document baseline by location:

Location Case Accept % Avg Dx Time (min) Retake Rate % Caries Rate/100 BWX Doc Complete % Denial Rate %
Loc 001 ___ ___ ___ ___ ___ ___
Loc 002 ___ ___ ___ ___ ___ ___
... ... ... ... ... ... ...

3. Location Readiness Assessment

3.1 Scoring Framework

Rate each location 1–5 on each factor using the criteria below, then calculate a composite score.

Factor 1: IT Infrastructure Maturity (Weight: 25%)

Score Criteria
5 <2 year old workstations, 100+ Mbps internet, current OS, recent imaging software version
4 2–3 year old workstations, 75+ Mbps internet, current OS, imaging software within 1 version of current
3 3–4 year old workstations, 50+ Mbps internet, supported OS, imaging software within 2 versions
2 4–5 year old workstations, 25–50 Mbps internet, requires OS upgrade, imaging software update required
1 >5 year old workstations, <25 Mbps internet, unsupported OS, major imaging system update required

Factor 2: Staff Tenure & Adaptability (Weight: 20%)

Score Criteria
5 <15% annual turnover, recent successful tech implementation, staff actively requests new technology
4 15–25% turnover, successful tech implementation within 2 years, generally positive tech attitudes
3 25–35% turnover, mixed history with tech implementations, neutral attitudes
2 35–50% turnover, recent failed or difficult tech implementation, some resistance to change
1 >50% turnover, significant tech implementation failures, active resistance to change

Factor 3: Patient Volume (Weight: 20%)

Score Criteria Strategic Note
5 Top quartile volume High impact, high ROI—but higher risk if issues occur
4 Second quartile volume Strong impact, moderate risk
3 Third quartile volume Moderate impact, moderate risk—good pilot candidates
2 Bottom quartile volume Lower impact, lower risk—good for testing
1 New/ramping location Too unpredictable for early waves

Factor 4: Tech Stack Compatibility (Weight: 20%)

Score Criteria
5 Carestream imaging + supported PMS + no conflicting software + prior successful integrations
4 Compatible third-party imaging + supported PMS + minor integration work expected
3 Compatible imaging + supported PMS + moderate integration complexity
2 Compatible imaging + legacy or non-standard PMS + significant integration work
1 Non-standard imaging system + unsupported PMS + major integration uncertainty

Factor 5: Local Champion Availability (Weight: 15%)

Score Criteria
5 Tech-savvy provider + engaged office manager, both expressed enthusiasm, proven training ability
4 Either tech-savvy provider OR engaged manager with enthusiasm, some training experience
3 Willing champion identified but no track record, or champion with limited availability
2 No clear champion, would need to recruit/develop one
1 Key staff actively opposed to implementation, no viable champion candidates

3.2 Composite Score Calculation

Formula:

Composite Score = (IT × 0.25) + (Staff × 0.20) + (Volume × 0.20) + (Tech × 0.20) + (Champion × 0.15)

Score Interpretation:

Composite Score Readiness Tier Rollout Recommendation
4.5–5.0 Tier 1: High Readiness Wave 1 candidate (with diversity consideration)
3.5–4.4 Tier 2: Moderate-High Readiness Wave 2 candidate
2.5–3.4 Tier 3: Moderate Readiness Wave 3 candidate, may need pre-work
1.5–2.4 Tier 4: Low Readiness Wave 4+, requires remediation before deployment
1.0–1.4 Tier 5: Not Ready Defer until significant improvements made

3.3 Location Assessment Template

☐ Complete assessment for each location:

Location IT Score Staff Score Volume Score Tech Score Champion Score Composite Tier Notes
Loc 001 ___ ___ ___ ___ ___ ___ ___ ___
Loc 002 ___ ___ ___ ___ ___ ___ ___ ___
... ... ... ... ... ... ... ... ...

Estimated time: 30–45 minutes per location for complete assessment

3.4 Rollout Sequence Recommendation Logic

☐ 🟣 Select Wave 1 pilot locations (executive decision with CDO/VP Ops input):

Wave 1 Selection Criteria:

  1. Tier 1 or high Tier 2 composite score (minimum 3.8)
  2. Geographic/regional diversity—select from different regions to identify regional variations
  3. PMS diversity—if you have multiple PMS systems, include at least one of each in Wave 1
  4. Provider archetype diversity—include at least one location with older/more skeptical providers
  5. Avoid highest-volume locations—protect revenue while learning
  6. Proximity to support—Wave 1 locations should be accessible for in-person support if needed

Recommended Wave 1 Size: 2–3 locations (regardless of total portfolio size)

☐ Map remaining locations to waves:

Wave Criteria Typical Size Timeline
Wave 1 Tier 1, diverse, accessible 2–3 locations Weeks 3–6
Wave 2 Tier 1–2, incorporate Wave 1 learnings 5–10 locations Weeks 7–12
Wave 3 Tier 2–3, templated deployment 10–20 locations Weeks 13–18
Wave 4+ Tier 3–4, remediated locations Remaining Weeks 19+

4. Rollout Strategy

4.1 Wave Structure Overview

                    PILOT                    SCALE                     COMPLETE
                  (Weeks 3-6)              (Weeks 7-18)               (Weeks 19+)
                      │                        │                          │
    ┌─────────────────┼────────────────────────┼──────────────────────────┼─────────┐
    │                 │                        │                          │         │
    │   Wave 1        │      Wave 2            │        Wave 3           │  Wave 4+│
    │   2-3 locs      │      5-10 locs         │        10-20 locs       │  Remain │
    │                 │                        │                          │         │
    │   Learn         │      Validate          │        Scale             │  Mop-up │
    │   Iterate       │      Template          │        Automate          │         │
    └─────────────────┴────────────────────────┴──────────────────────────┴─────────┘

4.2 Wave 1: Pilot Phase (Weeks 3–6)

Week 3: Pilot Preparation

☐ Finalize pilot location selection:

  • Confirm 2–3 locations meeting criteria above
  • Notify location office managers and providers
  • Estimated time: 2 hours for final selection and communication

☐ 🔵 Complete pre-deployment technical work:

  • Verify all hardware/software requirements met
  • Complete PMS integration configuration
  • Install Carestream imaging software updates if needed
  • Configure user credentials
  • Estimated time: 4–6 hours per location

☐ Champion preparation:

  • Conduct champion training (detailed in Section 6)
  • Provide implementation materials
  • Establish direct communication channel (Teams/Slack channel, phone)
  • Estimated time: 4 hours per champion

Week 4: Pilot Go-Live

☐ Execute go-live at pilot locations (see Section 8 for detailed runbook)

  • Stagger go-lives across pilot locations (not all same day)
  • Recommended: Tuesday–Thursday go-lives (avoid Mondays and Fridays)
  • Central team member on-site or immediately available for first 2 days
  • Estimated time: 2 full days per location

☐ Implement daily check-in protocol:

  • 15-minute call with each location champion, 8am daily
  • Standardized issue logging in shared tracker
  • Same-day escalation for critical issues
  • Estimated time: 30–45 minutes daily

Weeks 5–6: Pilot Stabilization & Learning

☐ Monitor pilot performance:

  • Daily usage reports (images analyzed, findings flagged)
  • Provider feedback collection (informal, via champion)
  • Technical issue tracking and resolution
  • Estimated time: 2–4 hours daily for monitoring

☐ Conduct pilot retrospective (end of Week 6):

  • What worked well?
  • What issues occurred and how were they resolved?
  • What would we do differently?
  • What should be standardized for Wave 2?
  • Estimated time: 2-hour meeting with all pilot champions + central team

☐ Document learnings and update playbook:

  • Update configuration templates
  • Revise training materials based on feedback
  • Create "FAQ" document from pilot issues
  • Estimated time: 4–8 hours

4.3 Go/No-Go Criteria for Wave Advancement

Wave 1 → Wave 2 Advancement Criteria

All "Must Have" criteria required; 3 of 5 "Should Have" criteria recommended:

Must Have (all required): ☐ All pilot locations actively using AI for ≥80% of applicable images ☐ No unresolved critical technical issues (system down, data loss, integration failure) ☐ Provider satisfaction ≥3/5 average across pilot locations ☐ Zero HIPAA incidents or security breaches ☐ Integration with PMS functioning correctly (findings documented in chart)

Should Have (3 of 5 required): ☐ Retake rate maintained or improved vs. baseline ☐ Training completion 100% at all pilot locations ☐ Champion confidence ≥4/5 to train next wave ☐ AI detection accuracy perceived as ≥80% by providers ☐ Patient flow impact neutral or positive

🟣 Go/No-Go Decision Process

Decision Criteria Action
GO All Must Have + ≥3 Should Have Proceed to Wave 2 on schedule
CONDITIONAL GO All Must Have + 2 Should Have Proceed with enhanced monitoring, additional support
DELAY Missing 1 Must Have OR <2 Should Have 2-week delay, remediation plan required
STOP Missing ≥2 Must Have Full project review, potential vendor escalation

Decision authority: Steering committee (CEO, CDO, VP Ops) Decision timing: End of Week 6

4.4 Wave 2: Validation Phase (Weeks 7–12)

Week 7: Wave 2 Preparation

☐ Finalize Wave 2 location list:

  • 5–10 locations (adjust based on Wave 1 learnings)
  • Apply updated selection criteria
  • Ensure regional manager buy-in for each location
  • Estimated time: 4 hours

☐ 🔵 Scale technical deployment:

  • Replicate Wave 1 configuration using standardized template
  • Leverage pilot champions for peer support
  • 🔵 Vendor provides additional training resources as needed
  • Estimated time: 2–3 hours per location (vs. 4–6 in Wave 1)

☐ Train Wave 2 champions:

  • Pilot champions assist in training (peer credibility)
  • Streamlined 2-hour training vs. 4-hour Wave 1 training
  • Estimated time: 2 hours per champion

Weeks 8–10: Wave 2 Go-Live

☐ Execute staggered go-lives:

  • 2–3 locations per week
  • Central team support distributed (not on-site for all)
  • Champions handle most first-day support
  • Estimated time: 4 hours central team per location

☐ Maintain check-in protocol:

  • Daily for first week, then twice weekly
  • Regional managers take more active role
  • Estimated time: 1–2 hours daily

Weeks 11–12: Wave 2 Stabilization

☐ Conduct Wave 2 retrospective ☐ Validate process improvements:

  • Did Wave 1 learnings improve Wave 2?
  • Are we ready to scale more aggressively?
  • Estimated time: 2-hour meeting

☐ Wave 2 → Wave 3 Go/No-Go decision (same criteria as above)

4.5 Wave 3: Scale Phase (Weeks 13–18)

☐ Deploy to 10–20 locations using templatized approach:

  • 3–5 locations per week
  • Champion training via recorded/standardized content
  • Regional managers own local execution
  • Central team focuses on exception handling only
  • Estimated time: 2 hours central team per location

☐ Maintain quality monitoring:

  • Automated usage dashboards (no manual tracking at this scale)
  • Exception-based escalation (only flagged issues escalate to central)
  • Weekly aggregate reporting to steering committee
  • Estimated time: 4–8 hours weekly for central team

4.6 Rollback Plan

⚠️ If a wave encounters critical issues requiring rollback:

Immediate Rollback Triggers (any one triggers rollback consideration):

  • System unavailable >4 hours during business hours
  • Data integrity issue (incorrect patient matching, missing data)
  • HIPAA incident
  • Provider refusal rate >25%
  • Patient safety concern

Rollback Procedure:

☐ Step 1: Contain (0–2 hours)

  • Disable AI overlay/analysis at affected location(s)
  • Revert to pre-AI workflow (imaging works without AI assist)
  • Document all issues in incident log

☐ Step 2: Communicate (2–4 hours)

  • Notify steering committee
  • Brief affected location champions
  • 🔵 Escalate to Carestream support

☐ Step 3: Investigate (4–24 hours)

  • Root cause analysis with vendor
  • Determine if issue is location-specific or systemic
  • Assess impact on other locations and waves

☐ Step 4: Decide (24–48 hours)

Scope Action
Single location issue Remediate location, continue wave
Wave-wide issue Pause wave, remediate, resume
Systemic issue Pause all deployment, vendor escalation

☐ Step 5: Remediate and Resume

  • Implement fix
  • Test at affected location(s)
  • Gradual resumption with enhanced monitoring

Key principle: Rollback preserves clinical workflow—imaging still works, just without AI assistance. This is inconvenient, not catastrophic.

5. Configuration & Integration (Weeks 2–3)

5.1 Practice Management System Integrations

Dentrix Integration

☐ 🔵 Verify Dentrix version compatibility:

  • Minimum version: Dentrix G7.4 or higher
  • eConnector license required for API integration
  • Estimated time: 30 minutes per location for verification

☐ Configure eConnector settings:

  1. Launch Dentrix Office Manager
  2. Navigate to Maintenance > Practice Setup > Preferences
  3. Enable "Third Party Integration"
  4. Configure eConnector API credentials
  5. Set up user mapping (Dentrix user → Carestream user)
  • Estimated time: 1 hour per location

☐ 🔵 Enable clinical findings integration:

  1. Work with Carestream to configure finding types
  2. Map Carestream AI findings to Dentrix clinical note templates
  3. Configure auto-population rules for treatment planning
  4. ⚠️ Test finding flow: AI detection → Dentrix chart note → Treatment plan
  • Estimated time: 2–3 hours per PMS template configuration

☐ Configure image bridge:

  1. Set Carestream as default imaging application in Dentrix
  2. Configure patient context passing (auto-open correct patient)
  3. Test bidirectional chart access
  • Estimated time: 30 minutes per workstation

Eaglesoft Integration

☐ 🔵 Verify Eaglesoft version compatibility:

  • Minimum version: Eaglesoft 21.10 or higher
  • Eaglesoft Integration API license required
  • Estimated time: 30 minutes per location

☐ Configure Patterson Imaging Bridge:

  1. Access Eaglesoft Setup > System > Integration
  2. Enable Carestream imaging integration
  3. Configure image type mappings (FMX, BWX, Pano, CBCT)
  4. Set up user authentication mapping
  • Estimated time: 1.5 hours per location

☐ 🔵 Enable clinical integration:

  1. Configure perio charting integration (if applicable)
  2. Map AI findings to Eaglesoft clinical alerts
  3. Set up treatment plan pre-population
  4. ⚠️ Test full workflow: image capture → AI analysis → clinical note → treatment plan
  • Estimated time: 2–3 hours per configuration

Open Dental Integration

☐ Verify Open Dental version:

  • Minimum version: Open Dental 22.1 or higher
  • API Module required (may require additional licensing)
  • Estimated time: 30 minutes per location

☐ Configure Open Dental API access:

  1. Navigate to Setup > Program Links > API
  2. Generate API key for Carestream integration
  3. Configure API permissions (patient read, image read, chart write)
  4. ⚠️ Limit API permissions to minimum necessary (security best practice)
  • Estimated time: 1 hour per location

☐ 🔵 Enable imaging bridge:

  1. Configure Open Dental Program Bridge for Carestream
  2. Set up image window auto-launch
  3. Configure patient context synchronization
  • Estimated time: 30 minutes per workstation

☐ Configure clinical documentation flow:

  1. Set up auto-population of procedure notes
  2. Map AI findings to Open Dental condition codes
  3. Configure treatment plan integration
  • Estimated time: 2 hours per configuration

5.2 Imaging System Integration

Carestream Sensors & Imaging Software

☐ Verify imaging software version:

  • Minimum: Carestream Dental Imaging Software 8.0
  • Recommended: Latest version for full AI feature set
  • Document current version at each location
  • Estimated time: 1 hour for enterprise-wide audit

☐ 🔵 Enable AI analysis module:

  1. Access Carestream Imaging Settings > AI Configuration
  2. Enter enterprise license key
  3. Configure analysis types (caries detection, perio analysis, pathology detection)
  4. Set confidence threshold display settings
  5. Configure annotation preferences
  • Estimated time: 30 minutes per location

☐ Configure capture workflow integration:

  1. Enable AI auto-analysis on image capture (recommended) or manual trigger
  2. Set up AI overlay display preferences
  3. Configure finding list panel location
  4. Set up one-click "Send to Chart" function
  • Estimated time: 20 minutes per workstation

Third-Party Imaging Systems (if applicable)

☐ 🔵 Verify compatibility and integration method:

  • Contact Carestream for compatibility matrix
  • Common compatible systems: Dexis, Apteryx, Schick, Planmeca
  • Integration method: TWAIN, DICOM, or proprietary bridge
  • ⚠️ Non-Carestream imaging systems may have reduced AI feature access
  • Estimated time: 2–4 hours per third-party system

☐ Configure DICOM integration (for CBCT):

  1. Set up DICOM send/receive nodes
  2. Configure PACS integration (if applicable)
  3. Verify 3D AI analysis compatibility
  4. Test CBCT workflow end-to-end
  • Estimated time: 4–8 hours for CBCT integration

5.3 Test Environment Setup

☐ 🔵 Establish enterprise test environment:

  • Carestream provides sandbox instance
  • Configure with representative PMS integration
  • Load anonymized test patient data
  • Estimated time: 8–16 hours (vendor-led)

☐ Create test scenarios:

Test Scenario Purpose Pass Criteria
New patient image capture Verify basic workflow Image captured, AI analysis displays, patient correctly identified
AI finding documentation Verify PMS integration Finding appears in patient chart within 30 seconds
Treatment plan creation Verify clinical workflow AI findings auto-populate suggested procedures
Multi-image series (FMX) Verify batch processing All images analyzed, aggregated findings view available
CBCT analysis Verify 3D workflow 3D rendering analyzed, findings marked in volume
Historical image analysis Verify archive integration AI analyzes previously captured images

☐ Execute test protocol:

  • Run all test scenarios
  • Document pass/fail for each
  • ⚠️ Do not proceed to pilot go-live until all scenarios pass
  • Estimated time: 4 hours per PMS/imaging combination

Per-Location Testing (Immediately Before Go-Live)

☐ Location-specific validation checklist:

  1. ☐ Workstation connects to Carestream cloud/server
  2. ☐ User credentials authenticate correctly
  3. ☐ PMS patient context passes to imaging correctly
  4. ☐ Test image capture triggers AI analysis
  5. ☐ AI findings display correctly
  6. ☐ "Send to Chart" function updates PMS
  7. ☐ All providers can log in with correct permissions
  • Estimated time: 30 minutes per location

5.4 Data Migration (Historical Images)

🟣 Decision: Historical Data Scope

Option Scope Pros Cons Recommendation
No historical Go-forward only Fastest, lowest risk Miss longitudinal tracking benefit Not recommended
12 months 1 year of images Balanced scope, meaningful baseline Moderate effort ✅ Recommended
24 months 2 years of images Better longitudinal data Higher effort, storage cost Consider for key locations
Full archive All historical Complete history Significant effort, diminishing returns Not recommended

☐ 🔵 Execute historical data ingestion:

  1. Export image archive from each location
  2. Carestream processes batch AI analysis
  3. Results imported back to patient records
  4. ⚠️ Historical analysis is batch processed—may take 1–2 weeks per location
  • Estimated time: Vendor-dependent (typically 3–5 business days per 10,000 images)

5.5 Standardized vs. Location-Specific Configuration

Standardize Centrally (Do Not Allow Location Variation)

Setting Standard Value Rationale
AI confidence threshold for display 70% Ensures consistent sensitivity across locations
Finding categories enabled All (caries, perio, pathology, restorations) Complete clinical picture
Auto-analysis trigger On image capture Consistent workflow
Chart documentation format Standardized template Enables cross-location comparison
Data retention policy Per enterprise policy Compliance consistency
User role permissions Per RBAC matrix Security consistency

Allow Location Discretion

Setting Location Choice Guidance
AI overlay color scheme Provider preference Some providers prefer different highlight colors
Finding panel position Left/right/bottom Depends on monitor setup
Annotation display density Minimal/standard/detailed Provider preference
Alert sound on finding On/off Office noise environment
CBCT analysis presets Per specialty mix Oral surgery vs. general locations may differ

☐ Create location configuration template:

  • Pre-fill all "Standardize Centrally" settings
  • Document decision points for "Allow Local Discretion"
  • Distribute to all location champions
  • Estimated time: 2 hours for template creation

5.6 Security and HIPAA Compliance

Enterprise-Level HIPAA Checklist

☐ Business Associate Agreement (BAA):

  • ☐ 🔵 BAA executed with Carestream Dental
  • ☐ BAA covers all locations and data types
  • ☐ Breach notification procedures documented
  • ☐ Subcontractor BAAs obtained (if Carestream uses subprocessors)
  • Estimated time: Legal review, typically 1–2 weeks

☐ Data Governance:

  • ☐ Data classification completed (all imaging data = PHI)
  • ☐ Data flow diagram documented (capture → analysis → storage → archive)
  • ☐ Data residency requirements met (US-based servers for US patients)
  • ☐ Data retention policy applied to AI analysis data
  • Estimated time: 4–8 hours

☐ Access Controls:

  • ☐ RBAC implemented per matrix in Section 2.4
  • ☐ Minimum necessary access principle applied
  • ☐ Access audit logging enabled
  • ☐ Automatic session timeout configured (15 minutes recommended)
  • ☐ Password complexity requirements enforced (or SSO used)
  • Estimated time: 2–4 hours

☐ Transmission Security:

  • ☐ TLS 1.2+ encryption for all data transmission
  • ☐ VPN required for on-premise server access (if applicable)
  • ☐ Secure API authentication (OAuth 2.0/API keys)
  • Estimated time: Included in technical setup

☐ Physical Security:

  • ☐ Workstations in secure areas (not public-facing)
  • ☐ Auto-lock screen timeout configured
  • ☐ No PHI on shared/public workstations
  • Estimated time: 1 hour per location audit

☐ Incident Response:

  • ☐ Carestream breach notification SLA documented (<24 hours)
  • ☐ Internal incident response plan includes AI system
  • ☐ Contact escalation for security incidents defined
  • Estimated time: 2 hours to update existing IR plan

6. Team Training Plan (Train-the-Trainer Model)

6.1 Champion Selection and Certification

Champion Selection Criteria

☐ Identify 1 champion per location meeting these criteria:

  • Employment tenure ≥1 year (stability)
  • Comfort with technology (uses smartphone apps, digital tools comfortably)
  • Respected by peers (informal leadership)
  • Available for training time commitment (8–12 hours total)
  • Willing to be the "go-to" person for AI questions

Preferred roles for champions:

  1. Tech-savvy provider (ideal—clinical credibility + can train other providers)
  2. Lead hygienist (strong alternative—workflow integration knowledge)
  3. Office manager (acceptable—organizational influence)

☐ Champion commitment confirmation:

  • Review role expectations with candidate
  • Obtain commitment from candidate and their manager
  • Allocate protected time for training and support duties
  • Estimated time: 30 minutes per champion for onboarding conversation

Champion Certification Process

☐ 🔵 Champion training curriculum (8 hours total):

Module 1: Technical Foundation (2 hours)

  • How the AI works (high-level explanation suitable for relay to staff)
  • What the AI detects and doesn't detect
  • Accuracy expectations and limitations
  • Hands-on: Analyze 20 practice images, compare AI findings to known diagnoses

Module 2: Clinical Workflow (2 hours)

  • Capture → Analysis → Review → Documentation workflow
  • PMS integration: How findings flow into the chart
  • Provider override and disagreement handling
  • Hands-on: Complete 10 end-to-end simulated patient workflows

Module 3: Troubleshooting & Support (1 hour)

  • Common technical issues and fixes
  • When to escalate vs. resolve locally
  • How to submit support tickets
  • Hands-on: Resolve 5 simulated technical issues

Module 4: Training Delivery Skills (2 hours)

  • How to train each role (provider, hygienist, front desk)
  • Managing resistance and skepticism
  • Day 1 support strategies
  • Hands-on: Deliver practice training session to peers

Module 5: Certification Assessment (1 hour)

  • Written quiz (20 questions, 80% pass required)
  • Practical demonstration (train a mock staff member)
  • Signed certification confirmation

☐ Champion certification tracking:

  • Maintain roster of certified champions
  • Certification valid for 12 months (annual recertification required)
  • Decertification trigger: location performance issues attributable to training gaps
  • Estimated time: 8 hours per champion for full certification

6.2 Role-Specific Training Outlines

Training for Dentists/Providers

Delivered by: Certified champion (preferably a provider-champion from pilot location) Duration: 2 hours

Content:

  1. Why we're implementing this (15 min)

    • Organizational rationale (quality, consistency, patient outcomes)
    • What's in it for the provider (diagnostic support, efficiency, documentation)

  2. How the AI works—clinical perspective (20 min)

    • Detection categories (caries, bone loss, calculus, periapical pathology)
    • Confidence scoring and what it means
    • What the AI does NOT detect (soft tissue, some pathology types)
    • Accuracy data (sensitivity/specificity by finding type)

  3. Workflow changes (30 min)

    • Where AI findings appear in your workflow
    • How to review and confirm/modify findings
    • One-click documentation to chart
    • Treatment plan integration
    • Hands-on: Review 10 patient images with AI assist

  4. Clinical override and disagreement (20 min)

    • When to override AI findings
    • How to document disagreement
    • AI as assistant, not decision-maker—clinical judgment remains paramount
    • Medicolegal considerations

  5. FAQ and concerns (20 min)

    • Address specific provider questions
    • Common concerns: accuracy, liability, workflow disruption
    • Success stories from pilot locations

  6. Day 1 expectations (15 min)

    • What their first AI-assisted day will look like
    • Where to get help
    • Feedback mechanism

Common Resistance Points and Responses:

Resistance Response
"I don't need AI to diagnose" "The AI is a second set of eyes, not a replacement. It helps ensure nothing is missed, especially on busy days."
"This will slow me down" "After 1 week, most providers report neutral or faster workflow. Let's track your experience."
"I don't trust the accuracy" "The AI is designed to flag potential findings for your review. You make all final clinical decisions. Let's look at the accuracy data together."
"Patients will lose trust if they see AI" "Studies show patients appreciate additional diagnostic tools. We'll discuss how to communicate this positively."

Provider Day 1 Cheat Sheet:

┌─────────────────────────────────────────────────────────────────────────┐
│  CARESTREAM AI - PROVIDER QUICK REFERENCE                              │
├─────────────────────────────────────────────────────────────────────────┤
│  1. AI analysis runs AUTOMATICALLY when image is captured              │
│  2. Look for colored overlays indicating findings:                     │
│     🔴 Red = Caries   🟡 Yellow = Calculus   🔵 Blue = Bone loss       │
│  3. Click any overlay to see details and confidence score              │
│  4. To CONFIRM a finding: Click ✓ (adds to chart automatically)        │
│  5. To DISMISS a finding: Click ✗ (logs your override)                 │
│  6. To ADD a finding AI missed: Use standard annotation tools          │
│  7. All confirmed findings flow to treatment plan screen               │
│                                                                         │
│  NEED HELP? → Contact [Champion Name] or call support: XXX-XXX-XXXX    │
└─────────────────────────────────────────────────────────────────────────┘

Training for Hygienists

Delivered by: Certified champion Duration: 1 hour

Content:

  1. Overview and why this matters (10 min)

    • How AI imaging assists the clinical team
    • Hygienist's role in the AI workflow

  2. Workflow integration (25 min)

    • When AI runs (during image capture)
    • What you'll see on screen (if hygienists view images)
    • How this affects patient conversation (can reference findings during education)
    • Perio-specific AI features (bone loss detection, calculus identification)
    • Hands-on: Review 5 patient images with AI overlays

  3. Patient communication (15 min)

    • How to explain AI to curious patients
    • Talking points: "Our imaging system includes advanced analysis that helps us identify potential areas of concern"
    • What NOT to say: Avoid implying AI replaces the dentist's judgment

  4. Day 1 expectations (10 min)

    • What changes and what doesn't
    • Where to get help

Hygienist Day 1 Cheat Sheet:

┌─────────────────────────────────────────────────────────────────────────┐
│  CARESTREAM AI - HYGIENIST QUICK REFERENCE                             │
├─────────────────────────────────────────────────────────────────────────┤
│  • AI analysis is AUTOMATIC - no extra steps for image capture         │
│  • You may see colored overlays on images (caries, calculus, bone loss)│
│  • PROVIDERS confirm/dismiss findings - you do NOT need to act on them │
│  • For patient education: "Our advanced imaging can highlight areas    │
│    for Dr. [Name] to review"                                           │
│  • DO NOT diagnose based on AI findings (provider's role)              │
│                                                                         │
│  NEED HELP? → Contact [Champion Name]                                  │
└─────────────────────────────────────────────────────────────────────────┘

Training for Front Desk / Office Manager

Delivered by: Certified champion Duration: 45 minutes

Content:

  1. Overview (10 min)

    • What the AI system does (high-level, non-clinical)
    • Why we're implementing it (quality, efficiency)

  2. Administrative functions (20 min)

    • User access management (adding/removing users, password resets)
    • Basic system status monitoring
    • Report generation (usage reports, if applicable)
    • Hands-on: Navigate admin functions

  3. Patient communication (10 min)

    • Answering patient questions about AI
    • Script: "Yes, our imaging system includes advanced analysis tools that help our doctors ensure nothing is missed."
    • When to defer to clinical staff

  4. Day 1 expectations (5 min)

    • Minimal workflow change expected
    • Support role for providers experiencing issues

Front Desk Day 1 Cheat Sheet:

┌─────────────────────────────────────────────────────────────────────────┐
│  CARESTREAM AI - FRONT DESK QUICK REFERENCE                            │
├─────────────────────────────────────────────────────────────────────────┤
│  • PATIENT QUESTION: "What's this about AI?"                            │
│    RESPONSE: "Our imaging system includes advanced analysis that        │
│    helps ensure nothing is overlooked. Dr. [Name] reviews all findings."│
│  • YOUR WORKFLOW: Minimal change - system runs in background           │
│  • USER ISSUES: For login problems, try password reset first           │
│  • SYSTEM DOWN: Escalate to [Champion], then regional support          │
└─────────────────────────────────────────────────────────────────────────┘

Training for Billing/Insurance Staff

Delivered by: Certified champion Duration: 30 minutes

Content:

  1. Coding impact (15 min)

    • AI does NOT change diagnostic imaging codes (D0210, D0220, D0230, D0270, D0330, etc.)
    • AI findings may support medical necessity documentation
    • No new codes required for AI-assisted diagnosis

  2. Documentation changes (10 min)

    • AI findings appear in clinical notes
    • Documentation is typically MORE complete (supports claims)
    • No specific AI disclosure required on claims

  3. Day 1 expectations (5 min)

    • Minimal change to billing workflow
    • Monitor for any unusual denials (none expected, but track)

Billing Day 1 Cheat Sheet:

┌─────────────────────────────────────────────────────────────────────────┐
│  CARESTREAM AI - BILLING QUICK REFERENCE                               │
├─────────────────────────────────────────────────────────────────────────┤
│  • CODING: No change - use same diagnostic imaging codes               │
│  • CLAIMS: No AI-specific disclosure required                          │
│  • DOCUMENTATION: May be more detailed - supports medical necessity    │
│  • DENIALS: Track as usual - no increase expected                      │
│  • QUESTIONS: Contact [Champion] or regional billing lead              │
└─────────────────────────────────────────────────────────────────────────┘

6.3 Training Completion Tracking

☐ Implement training completion tracking system:

Location Champion Certified Providers Trained (n/total) Hygienists Trained Front Desk Trained Billing Trained Ready for Go-Live
Loc 001 ☐ / ☐ ☐ ☐ ☐
Loc 002 ☐ / ☐ ☐ ☐ ☐
... ... ... ... ... ... ...

☐ 🟣 Establish training completion policy:

  • No location goes live until 100% training completion
  • New hires must complete training within 5 business days of start
  • Annual refresher training required (1 hour, delivered by champion)

☐ Create training completion verification:

  • Training sign-off sheet (signatures from all trained staff)
  • Brief quiz for provider training (80% pass required)
  • Central training completion dashboard
  • Estimated time: 30 minutes per location for administrative tracking

7. Change Management

7.1 Executive Sponsor Communication Plan

Board/Investor Updates

☐ 🟣 Initial investment communication:

  • Include AI implementation in strategic technology investment narrative
  • Position as competitive differentiation and quality improvement
  • Present ROI projections and timeline
  • Estimated time: Include in regular board materials

☐ Ongoing board update cadence:

Timing Content Format
Pre-implementation Investment rationale, expected ROI, risk mitigation 2-page memo + 5-minute verbal
End of Wave 1 Pilot results, provider feedback, preliminary metrics 1-page update + dashboard
End of Wave 2 Scaled results, refined ROI projections 2-page memo + dashboard
Full deployment Complete metrics, ROI vs. projections, next steps 5-page report + presentation
Quarterly (ongoing) Optimization updates, AI advancement updates 1-page dashboard

Executive Sponsor Responsibilities

☐ Identify executive sponsor (typically CDO or VP Ops):

  • Accountable for implementation success
  • Visible champion of the initiative
  • Decision authority for cross-functional issues
  • Time commitment: 2–4 hours per week during implementation

☐ Executive sponsor communication activities:

  • Kick-off video message to all staff
  • Presence at Wave 1 go-live (at least one location)
  • Monthly all-hands update during implementation
  • Celebration communication at full deployment
  • Estimated time: 4–6 hours per month during implementation

7.2 Regional Manager Briefing Guide

☐ Conduct regional manager briefings before Wave 1:

Briefing Agenda (1.5 hours per region):

  1. Strategic context (15 min)

    • Why diagnostic imaging AI, why now
    • DSO competitive landscape and differentiation opportunity
    • Quality and consistency improvement goals

  2. Implementation plan overview (20 min)

    • Wave structure and timeline
    • Which of their locations are in which wave
    • Their role in the rollout

  3. Regional manager responsibilities (30 min)

    • Champion selection support
    • Location preparation oversight
    • Go-live week support expectations
    • Escalation and support role
    • Performance monitoring ownership

  4. Cascade communication expectations (15 min)

    • How to brief office managers
    • Key messages to convey
    • What NOT to promise (timeline flexibility, exception requests)

  5. Q&A and concerns (10 min)

    • Address regional-specific concerns
    • Document concerns for central team follow-up

☐ Provide regional manager toolkit:

  • One-page project summary
  • Location-specific timeline
  • Champion selection guide
  • Office manager briefing script
  • Escalation contact card
  • Estimated time: 1.5 hours per region + 2 hours for toolkit creation

7.3 Staff Resistance Framework for Multi-Location Dynamics

Anticipated Resistance Patterns

Source Pattern Impact Mitigation
Senior providers "I've diagnosed fine for 20 years" Credibility challenge, slow adoption Peer testimonials, emphasize second-opinion framing, highlight cases where AI caught something
Busy locations "We don't have time for new systems" Delayed training, superficial adoption Emphasize time-neutral workflow, schedule protected training time
Tech-skeptical staff "I'm not good with technology" Training anxiety, avoidance Extra hands-on support, patient progression, celebrate small wins
Competitive dynamics "Why did location X get it first?" Perceived favoritism Transparent selection criteria communication, emphasize "preparation = priority"
Union locations (if applicable) Concern about job replacement Formal grievance risk Early union communication, emphasize augmentation not replacement

Resistance Response Escalation Path

☐ Implement escalation framework:

Level Scope Owner Action
1 Individual staff member Champion 1:1 conversation, extra support, address specific concerns
2 Multiple staff at location Office Manager + Champion Team meeting, identify root cause, escalate to regional if unresolved
3 Provider refusal Regional Manager + CDO Provider-to-provider conversation, clinical rationale, performance expectation
4 Location-wide resistance Regional Manager + VP Ops Site visit, systemic issue assessment, potential wave delay
5 Pattern across locations VP Ops + CDO Project-level assessment, communication strategy revision

7.4 Internal Marketing

Initiative Naming and Branding

☐ 🟣 Name the initiative (executive decision):

Example names:

  • "Imaging Intelligence Initiative"
  • "AI-Assist Rollout"
  • "[Company Name] Smart Imaging"
  • "Next-Gen Diagnostics"

Select a name that:

  • Is memorable and easy to reference
  • Conveys advancement without threatening
  • Can be used consistently across all communications

☐ Create visual identity:

  • Branded slide template for all communications
  • Initiative logo/icon for emails and materials
  • Consistent color scheme
  • Estimated time: 2–4 hours (marketing/creative team)

Momentum Building

☐ Launch communications sequence:

Timing Communication Audience Channel
Week 1 Initiative announcement All staff Email from CEO + regional meetings
Week 2 Provider FAQ Providers Dedicated email + CDO video
Pre-Wave 1 Pilot location spotlight All staff Intranet article
Post-Wave 1 Success stories All staff Video testimonials
Monthly Progress updates All staff Newsletter section

☐ Milestone celebrations:

  • Wave completion acknowledgments
  • Location go-live announcements
  • "AI Champion of the Month" recognition
  • 1,000th/10,000th image milestone
  • Estimated time: 1–2 hours per month for recognition activities

☐ Success story capture:

  • Identify positive cases (AI caught something provider appreciated)
  • Record brief video testimonials (30 seconds)
  • Share across organization with permission
  • Estimated time: 30 minutes per story capture

8. Go-Live Day Runbook

8.1 Standardized Go-Live Checklist

T-7 Days: One Week Before Go-Live

☐ Technical readiness confirmation:

  • ☐ All workstations configured and tested
  • ☐ All user credentials created and tested
  • ☐ PMS integration validated
  • ☐ Network connectivity confirmed
  • ☐ Test images analyzed successfully

☐ Staff readiness confirmation:

  • ☐ All staff training complete (100%)
  • ☐ Champion prepared for support role
  • ☐ Day 1 cheat sheets distributed
  • ☐ Schedule adjusted for potential first-day delays

☐ Communication:

  • ☐ Final reminder sent to all location staff
  • ☐ Patient notification posted (if applicable)
  • ☐ Support contacts distributed

T-1 Day: Day Before Go-Live

☐ Final technical check:

  • ☐ Run 3 test images through full workflow
  • ☐ Verify PMS documentation flow
  • ☐ Confirm support contacts are correct
  • ☐ Check backup workflows documented

☐ Champion briefing:

  • ☐ 15-minute call with champion
  • ☐ Review day 1 schedule
  • ☐ Confirm champion availability all day
  • ☐ Review escalation path

8.2 Hour-by-Hour Go-Live Schedule

Day: Go-Live (Recommended: Tuesday, Wednesday, or Thursday)

Time Activity Owner Notes
7:00 AM Central team online, system health check Central IT Confirm cloud services operational
7:15 AM Champion arrives early, system validation Champion Run 1 test image, confirm working
7:30 AM Brief team huddle (5 min) Champion "Today's the day, I'm here to help"
8:00 AM First patients, AI goes live Providers Champion available in operatory area
8:30 AM Check-in call with central team Champion Brief status: working/issues
10:00 AM Mid-morning check-in Champion → Central Document any issues encountered
12:00 PM Lunch check-in Champion → Central Status update, any escalations
2:00 PM Afternoon check-in Champion → Central Capture early user feedback
4:30 PM End of day debrief (15 min) Champion + staff What worked? Issues? Concerns?
5:00 PM Day 1 summary report Champion → Central Submitted via standard template

Who Needs to Be On-Call

Role Availability Contact Method
Location Champion On-site all day In-person
Regional Manager Available by phone Phone/text
Central Implementation Lead Available immediately Teams/Slack/phone
🔵 Carestream Tier 2 Support On-call Dedicated support line
PMS vendor support (if needed) Standard support channels Phone/portal

8.3 Common First-Day Issues and Troubleshooting

Issue Symptoms First Response Escalation Trigger
AI not running No overlays on captured images Restart imaging software, verify cloud connection Issue persists after restart
Login failures User cannot authenticate Verify credentials, try password reset Multiple users affected
Slow analysis >10 seconds for AI overlay Check network speed, verify no bandwidth bottleneck >30 seconds consistently
PMS not receiving findings Findings don't appear in chart Verify integration settings, restart both systems Issue persists after restart
AI findings inaccurate Provider disagrees with majority of findings Use override function, document for calibration Pattern of inaccuracy (>50%)
Workstation freeze System unresponsive Standard restart, capture error message Repeated freezes (>2 per day)

⚠️ Known Day 1 Gotchas:

  1. First image delay: First AI analysis of the day may take 30–60 seconds as system initializes. This is normal.
  2. Credential sync lag: If new users were added recently, credentials may take up to 15 minutes to propagate.
  3. Browser caching: If web components look wrong, clear browser cache and refresh.
  4. VPN disconnection: If using VPN, any disconnection will interrupt AI analysis until reconnected.

8.4 Patient Communication Script (If Patient Sees AI Overlays)

**

AI-generated implementation guide based on public vendor information. Verify specifics directly with Carestream Dental.