CephX
Implementation PlaybookDSO · Group Practice

CephX

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

CephX — Implementation Playbook (DSO)

CephX Implementation Playbook for DSOs

AI-Powered Cephalometric Analysis & Treatment Planning at Scale


1. Executive Summary

What CephX Does

CephX is an AI-powered cephalometric analysis and treatment planning platform that automates landmark identification, generates instant diagnostic measurements, and produces predictive treatment visualizations from 2D and 3D imaging. The platform reduces cephalometric tracing time from 15-20 minutes to under 60 seconds while delivering consistent, reproducible analysis across all providers.

Why DSOs Benefit from AI-Powered Treatment Planning

Scale Advantage Impact
Standardization Every provider across 15-50 locations interprets cephalometric data using identical AI-derived measurements, eliminating inter-operator variability
Data Aggregation Centralized analytics enable comparison of treatment planning patterns, case acceptance rates, and outcomes across your entire portfolio
Provider Leverage Less experienced providers gain access to specialist-level diagnostic insights, reducing dependence on traveling orthodontists or specialists
Case Acceptance Patient-facing visualizations drive 15-30% improvements in case acceptance for complex treatment plans
Operational Efficiency Automated analysis recaptures 2-4 hours per provider per week previously spent on manual tracings

Expected Timeline: Decision to Full Deployment

Phase Duration Milestone
Pre-Implementation Weeks 1-2 Infrastructure audit complete, baseline metrics captured
Pilot Wave Weeks 3-6 2-3 locations fully operational, lessons learned documented
Wave 2 Expansion Weeks 7-10 5-8 additional locations deployed
Full Deployment Weeks 11-16 All remaining locations live
Optimization Weeks 17-24 ROI validated, workflows refined

Total timeline: 4-6 months for a 30-location DSO


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

Technical Requirements

Hardware

☐ Workstations with minimum 8GB RAM, Intel i5 or equivalent (2018 or newer) ☐ Dual monitors recommended for clinical operatories using CephX analysis ☐ Minimum 1920x1080 display resolution for accurate visualization ☐ Imaging sensors/scanners compatible with DICOM export (verify model compatibility with CephX)

Software

☐ Windows 10/11 or macOS 10.15+ on all clinical workstations ☐ Chrome, Edge, or Safari browser (latest 2 versions) ☐ PDF viewer for report generation ☐ Practice management system current on vendor-supported version

Network

☐ Minimum 25 Mbps upload/download per location (50 Mbps recommended for multi-provider practices) ☐ Firewall configured to allow HTTPS traffic to CephX cloud endpoints ☐ Wi-Fi infrastructure capable of supporting imaging upload from operatories

Enterprise-Level Requirements 🟣

Requirement Decision Needed
Hosting Model CephX is cloud-hosted; confirm compliance with your cloud security policy
Network Standards Establish minimum bandwidth and latency requirements across all locations
SSO Integration Determine if CephX will integrate with existing identity provider (Azure AD, Okta, etc.)
Centralized Credentialing Decide: central IT creates all accounts, or location-level admin rights
Data Residency Confirm CephX data center locations comply with any state-specific requirements

Vendor Onboarding Steps

Step Action Owner 🔵 Vendor Required
1 Execute enterprise BAA Legal/Compliance 🔵
2 Assign dedicated CephX Customer Success Manager Vendor 🔵
3 Schedule technical kickoff call IT Director 🔵
4 Obtain sandbox/test environment credentials IT Director 🔵
5 Establish support escalation contacts and SLAs Operations 🔵
6 Confirm enterprise pricing and per-location licensing model Finance 🔵

Key Contacts to Establish

Role Name/Contact Responsibility
CephX Customer Success Manager _____________ Strategic relationship, escalations
CephX Technical Implementation Lead _____________ Integration, configuration
CephX Support (Tier 1) _____________ Day-to-day troubleshooting
CephX Support (Tier 2/Engineering) _____________ Complex technical issues

Data/Access Prerequisites

☐ Complete inventory of imaging systems at each location (brand, model, software version) ☐ Identify image archive/storage system (local server, cloud, PMS-integrated) ☐ Obtain admin credentials or API access to imaging software 🔵 ☐ Determine DICOM export capabilities at each location ☐ Inventory existing cephalometric analysis tools being replaced ☐ Document current image naming conventions and filing structures

⚠️ Common Failure Point: Locations running outdated imaging software versions often cannot export DICOM files cleanly. Budget 1-2 weeks for imaging software upgrades at affected locations.


Internal Stakeholder Alignment Map 🟣

Stakeholder Level Who Communication Need Approval Required
Board/Investors Board members, PE partners Strategic rationale, expected ROI, timeline Investment approval if CapEx >$X
C-Suite CEO, CFO, CDO, COO Business case, resource allocation, success metrics Budget, staffing, go-live authority
Regional Managers Regional Directors, Area Managers Rollout timeline, location selection, staff implications Location readiness sign-off
Location Office Managers Office Managers Training plan, workflow changes, go-live date Staff scheduling for training
Providers Dentists, Orthodontists, Specialists Clinical workflow impact, AI interpretation guidance None (but engagement critical)
Clinical Staff Hygienists, Assistants Touchpoint training, process changes None
IT Central IT, MSP contacts Technical requirements, security review Security/compliance sign-off

Stakeholder Alignment Actions

☐ 🟣 Present business case to C-suite for formal approval (Week 1) ☐ 🟣 Brief board/investors on AI adoption initiative (if required by governance) ☐ Conduct regional manager alignment call to explain location selection process ☐ Distribute location manager FAQ document ☐ Identify executive sponsor (recommend: Chief Dental Officer or VP Operations) ☐ Establish project governance: Steering committee (monthly), Working group (weekly)


Baseline Metrics Capture ⚠️

Critical: Capturing baseline metrics BEFORE go-live is the only way to prove ROI later. Standardize measurement across all locations.

Metric Category Specific Metric How to Measure Baseline Target
Efficiency Time to complete cephalometric analysis Time study: start of tracing to final output Average per provider
Efficiency Provider time spent on treatment planning per case Self-reported or time study Average per case type
Case Acceptance Case acceptance rate for ortho/complex cases # accepted ÷ # presented (last 90 days) By location
Case Acceptance Average case value for accepted ortho cases Total revenue ÷ # accepted cases By location
Clinical Volume Cephalometric analyses performed per month Count from imaging system or manual log Per location
Referral Patterns % of ortho cases referred out vs. treated in-house Referral log or estimate Per location
Staff Time Hours per week spent on manual tracing/analysis Staff survey or time study Per provider

Standardizing Baseline Measurement Across Locations

☐ Create standardized data collection template (spreadsheet or form) ☐ Assign one person per location responsible for data collection ☐ Define measurement period (recommend: trailing 90 days) ☐ Establish deadline for baseline data submission (end of Week 2) ☐ Central operations team validates data completeness and flags outliers ☐ Store baseline data in central repository for post-launch comparison

⚠️ Common Failure Point: Locations underreport or use inconsistent definitions. Provide explicit instructions and examples with the data collection template.


3. Location Readiness Assessment

Scoring Framework

Score each location on the following factors. Use 1-5 scale where 1 = significant gaps, 5 = fully ready.

Factor 1: IT Infrastructure Maturity

Score Criteria
5 Network >50 Mbps, all workstations <3 years old, PMS current version, DICOM export functional
4 Network 25-50 Mbps, most workstations current, PMS within 1 version of current
3 Network meets minimum, some workstations need upgrades, PMS slightly outdated
2 Network inconsistent, multiple workstations need replacement, PMS significantly outdated
1 Network unreliable, hardware end-of-life, imaging system incompatible

Factor 2: Staff Tenure and Adaptability

Score Criteria
5 Low turnover (<15%), team has adopted new tech in past 12 months, positive feedback on technology
4 Moderate turnover, some tech adoption history, generally receptive
3 Average turnover (~25%), limited recent tech changes, neutral reception expected
2 Higher turnover (>30%), resistance to recent changes, training retention concerns
1 High turnover, active resistance to technology, significant retraining burden expected

Factor 3: Patient Volume

Score Criteria
5 High volume (>15 ortho-eligible patients/week) with stable scheduling
4 Moderate-high volume (10-15/week), room for growth
3 Moderate volume (5-10/week), representative of typical location
2 Lower volume (<5/week), limited opportunity to demonstrate ROI quickly
1 Very low volume or highly seasonal, poor pilot candidate

Note on Volume Scoring: High volume is desirable for demonstrating impact but increases implementation risk. Balance this factor accordingly.

Factor 4: Existing Tech Stack Compatibility

Score Criteria
5 PMS and imaging system on CephX certified integration list, proven at other CephX customers
4 PMS integrated, imaging system compatible with standard DICOM workflow
3 PMS integration available but not yet tested, imaging system requires manual export
2 PMS requires workaround, imaging system partially compatible
1 PMS not supported, imaging system requires replacement or major upgrade

Factor 5: Local Champion Availability

Score Criteria
5 Identified provider or office manager who is tech-forward, respected by team, committed to champion role
4 Strong candidate identified, needs confirmation of availability and interest
3 Potential champion exists but limited capacity or moderate enthusiasm
2 No clear champion, will need to develop someone during pilot
1 No viable champion candidate, leadership gaps at location

Composite Readiness Score Calculation

Factor Weight Location A Score Location B Score Location C Score
IT Infrastructure 25% ___ × 0.25 = ___ × 0.25 = ___ × 0.25 =
Staff Adaptability 20% ___ × 0.20 = ___ × 0.20 = ___ × 0.20 =
Patient Volume 20% ___ × 0.20 = ___ × 0.20 = ___ × 0.20 =
Tech Stack Compatibility 20% ___ × 0.20 = ___ × 0.20 = ___ × 0.20 =
Local Champion 15% ___ × 0.15 = ___ × 0.15 = ___ × 0.15 =
Composite Score 100% ___ ___ ___

Readiness Tiers

Composite Score Tier Rollout Wave Recommendation
4.0 - 5.0 Tier 1: Pilot Ready Wave 1 candidates
3.0 - 3.9 Tier 2: Ready with Prep Wave 2 candidates
2.0 - 2.9 Tier 3: Needs Remediation Wave 3 after infrastructure upgrades
Below 2.0 Tier 4: Not Ready Defer until remediation complete

  1. Sort locations by composite score (highest to lowest)
  2. Apply strategic filters to top-scoring locations:
    • Geographic diversity (don't put all pilots in one region)
    • Specialty mix representation (include GP, ortho-heavy, pediatric if applicable)
    • Political considerations (include a "flagship" location if leadership visibility important)
  3. Select 2-3 Wave 1 pilot locations from filtered top tier
  4. Assign remaining Tier 1 and Tier 2 locations to Waves 2 and 3
  5. Create remediation plans for Tier 3 and 4 locations with target dates for readiness

4. Rollout Strategy

Wave Structure

Wave Locations Duration Purpose
Wave 1: Pilot 2-3 locations Weeks 3-6 Validate integration, refine training, identify issues
Wave 2: Expansion 5-8 locations Weeks 7-10 Scale validated playbook, stress-test support model
Wave 3: Broad Rollout Next 10-15 locations Weeks 11-14 Deploy at scale with refined processes
Wave 4: Complete Remaining locations Weeks 15-20 Full deployment, address stragglers

Wave 1 Pilot Location Selection Criteria 🟣

Select 2-3 locations that meet ALL of the following:

☐ Composite readiness score of 4.0 or higher ☐ Strong local champion identified and confirmed ☐ Imaging system already on CephX certified list (reduces integration risk) ☐ Patient volume sufficient to generate meaningful usage data (>8 eligible cases/week) ☐ Office manager tenure >12 months and supportive of initiative ☐ Geographic accessibility for potential on-site support during pilot ☐ Representative of broader portfolio (not your most or least typical location)

⚠️ Common Failure Point: Selecting a "showcase" location that's not representative of the portfolio. Lessons learned won't transfer to average locations.


Timeline Per Wave with Learning Buffer

Wave 1 Detailed Timeline (Weeks 3-6)

Week Activities
Week 3 Configuration, integration testing, champion training
Week 4 Staff training, parallel run begins
Week 5 Go-live, intensive support, daily check-ins
Week 6 Stabilization, lessons learned documentation
Buffer (3-5 days) Incorporate lessons into Wave 2 playbook

Wave 2+ Timeline

Week Activities
Week 1 Pre-configuration, champion training at all Wave 2 locations
Week 2 Staff training, parallel run
Week 3 Staggered go-live (2-3 locations per day)
Week 4 Stabilization, address issues
Buffer (3-5 days) Update playbook, go/no-go decision for next wave

Go/No-Go Criteria to Advance Waves 🟣

Before advancing from one wave to the next, verify:

Criteria Threshold Status
Technical Stability <3 critical issues open, no data loss incidents ☐ Met
Integration Functioning Images flowing correctly in >95% of cases ☐ Met
Staff Adoption >80% of trained staff using tool as intended ☐ Met
Champion Confidence Champions rate readiness to support next wave ≥4/5 ☐ Met
Patient Impact No patient complaints attributable to CephX ☐ Met
Support Capacity Vendor and internal support have bandwidth for next wave ☐ Met

Decision Rule: All criteria must be met. Any criterion not met requires remediation plan with timeline before wave advancement.


Rollback Plan ⚠️

If a wave fails (defined as: critical integration failure, >5 unresolved critical issues, or staff safety concern):

Immediate Actions (Hour 0-4)

  1. Notify executive sponsor and vendor Customer Success Manager
  2. Instruct affected locations to revert to pre-CephX workflow
  3. Disable CephX access at affected locations to prevent confusion
  4. Document all open issues with screenshots and reproduction steps

Short-Term Actions (Day 1-3)

  1. Conduct root cause analysis with vendor 🔵
  2. Determine if failure is location-specific or systemic
  3. If location-specific: remediate that location, continue wave for others
  4. If systemic: pause all wave activity until resolution

Communication Protocol

  1. Within 2 hours: Email to regional managers and affected office managers
  2. Within 24 hours: Written incident report to C-suite
  3. Within 72 hours: Remediation plan with revised timeline

Critical: Rollback at one location should NOT automatically halt deployment at unaffected locations. Isolate the problem.


5. Configuration & Integration (Weeks 2-3)

Practice Management System Integration

Dentrix Enterprise Integration 🔵

Step Action Owner Time Est.
1 Confirm Dentrix Enterprise version (18.0+ required) IT 30 min
2 Request CephX integration credentials from vendor Vendor 1-2 days
3 Install CephX bridge application on Dentrix server IT + Vendor 2 hours
4 Configure patient data sync (demographics, chart number) IT 1 hour
5 Test patient lookup from CephX interface IT 30 min
6 Configure treatment plan export back to Dentrix IT 1 hour
7 Validate round-trip: patient lookup → analysis → plan saved IT + Provider 1 hour

Eaglesoft Integration 🔵

Step Action Owner Time Est.
1 Confirm Eaglesoft version (21.0+ required) IT 30 min
2 Enable Eaglesoft API access (may require Patterson support) IT 1-3 days
3 Provide API credentials to CephX implementation team IT 30 min
4 CephX configures integration in backend Vendor 1-2 days
5 Test patient data sync in sandbox IT 1 hour
6 Validate bi-directional data flow IT + Provider 1 hour

Open Dental Integration 🔵

Step Action Owner Time Est.
1 Confirm Open Dental version (current stable required) IT 30 min
2 Generate API key in Open Dental (Setup → Program Links) IT 30 min
3 Provide API key and database connection details to CephX IT 30 min
4 CephX enables integration Vendor 1-2 days
5 Configure which data fields sync IT 1 hour
6 Test in sandbox environment IT 1 hour

⚠️ Common Failure Point: Open Dental self-hosted instances often have firewall rules blocking API access. Work with your IT team or MSP to whitelist CephX IP ranges.


Imaging System Integration 🔵

CBCT/Cephalometric Imaging Integration

Imaging System Integration Method Configuration Notes
Carestream (CS series) DICOM export to CephX folder watch Configure auto-export on image acquisition
Planmeca Romexis Direct integration via API Requires Romexis 6.0+
Sirona/Dentsply (Sidexis) DICOM export Manual or scheduled export to shared folder
Vatech DICOM export Configure in EzDent-i software
i-CAT DICOM export Export from Vision software
KaVo Direct integration available Contact CephX for specific configuration

Step-by-Step Imaging Integration

Step Action Owner Time Est.
1 Inventory imaging software version at each location IT 2 hours (total)
2 Verify DICOM export capability IT 1 hour/location
3 Create CephX import folder (local or network share) IT 30 min/location
4 Configure imaging software to export to CephX folder IT 1 hour/location
5 Test export with sample image (non-PHI if possible) IT 30 min
6 CephX ingests test image, confirms format compatibility Vendor 1-2 hours
7 Test with actual patient image (with consent documentation) Provider 30 min
8 Validate automatic patient matching (image → patient record) IT + Provider 1 hour

Test Environment Setup and Validation Checklist

☐ 🔵 Request dedicated CephX sandbox instance for enterprise ☐ Configure sandbox with connections to test/training PMS database ☐ Populate sandbox with de-identified test patient data ☐ Create test user accounts for each role (provider, staff, admin) ☐ Import sample cephalometric images representing common scenarios ☐ Document sandbox access credentials and distribute to training team

Validation Checklist (Per Location)

Test Case Expected Result Pass/Fail
User login with SSO (if configured) Successful authentication
Patient search by name Correct patient record returned
Patient search by ID Correct patient record returned
Image upload from imaging system Image appears in CephX within 60 seconds
Automatic landmark detection Landmarks identified, analysis generated
Measurement accuracy check Compare CephX measurements to known values
Treatment plan generation Plan generated with visualization
Export treatment plan to PMS Plan appears in patient chart
Report generation (PDF) Report generates, opens correctly
User access controls Non-admin users cannot access admin functions

Data Migration / Historical Data Ingestion

Decision Point 🟣

Option Pros Cons Recommendation
No historical import Faster deployment, lower cost No baseline for comparison, can't review prior cases Acceptable for most DSOs
Selective import Preserves recent case history (12-24 months) Requires image export, validation effort Recommended if using CephX for longitudinal tracking
Full archive import Complete patient history Significant time/cost, diminishing value for old images Rarely justified

If Importing Historical Images

☐ Define date range for import (recommend: 12-24 months) ☐ Identify storage location of historical images at each location ☐ Verify image format compatibility with CephX ☐ 🔵 Coordinate bulk upload timeline with CephX (may require extended processing) ☐ Plan for validation: spot-check imported images match correct patients ☐ Budget 1-2 weeks per location for import + validation


Security and HIPAA Compliance Verification

Enterprise-Level HIPAA Checklist 🟣

Requirement Evidence Required Status
Business Associate Agreement Signed BAA on file ☐ Complete
Encryption in Transit Confirm TLS 1.2+ for all data transmission ☐ Verified
Encryption at Rest Confirm AES-256 or equivalent for stored data ☐ Verified
Access Controls Role-based access, unique user credentials ☐ Configured
Audit Logging CephX logs all access to PHI, logs available on request ☐ Confirmed
Data Backup Vendor backup procedures documented ☐ Documented
Breach Notification BAA includes breach notification terms ☐ In BAA
Minimum Necessary Access limited to users who need PHI for job function ☐ Configured
Data Retention Retention and deletion policies align with state requirements ☐ Confirmed

Data Governance Decisions 🟣

☐ Define data ownership: CephX stores but DSO owns all PHI ☐ Establish data export rights: DSO can export all data on request ☐ Document data deletion procedures: What happens if you terminate CephX? ☐ Review CephX's SOC 2 Type II report (request from vendor) 🔵 ☐ Confirm data center locations and any cross-border data flow implications


Standardized Configuration Template (Enterprise)

Settings to Standardize Centrally 🟣

Setting Category Standardize? Rationale
Analysis types enabled ✓ Yes Ensure consistent service offering
Measurement standards (Steiner, Ricketts, etc.) ✓ Yes Provider training based on standard set
Report templates ✓ Yes Consistent patient communication
User role definitions ✓ Yes Uniform access controls
Image export format ✓ Yes Consistent for referrals and records
Alert thresholds ✓ Yes Standard of care consistency
Branding (logo, colors) ✓ Yes Unified patient experience

Settings to Allow Local Discretion

Setting Category Local Control Rationale
Provider-specific measurement preferences ✓ Yes Respect clinical autonomy
Specialty-specific analysis workflows ✓ Yes Ortho vs. GP different needs
Patient communication language ✓ Yes Demographics vary by location
Integration scheduling (sync frequency) ✓ Yes Based on local IT capacity
Notification preferences ✓ Yes Provider workflow preferences

6. Team Training Plan

Train-the-Trainer Model

Champion Selection Criteria

Each location requires one designated champion who will:

  • Complete advanced training directly from CephX 🔵
  • Train and support all staff at their location
  • Serve as first-line support for questions and issues
  • Communicate feedback to central implementation team

Ideal Champion Profile: ☐ Provider (dentist, orthodontist) OR experienced office manager ☐ Tenure at location >12 months ☐ History of adopting new technology successfully ☐ Respected by peers, able to influence behavior ☐ Available for 4-6 hours of training + ongoing support responsibilities

Champion Responsibilities

Phase Responsibility Time Commitment
Pre-Go-Live Complete certification training 4 hours
Pre-Go-Live Train all staff at location 2-4 hours
Go-Live Week On-site support during all operating hours Full availability
Post-Go-Live Answer questions, troubleshoot basic issues 30 min/day
Ongoing Train new hires within 1 week of start 30 min/hire
Monthly Participate in champion community call 30 min

Champion Certification Training 🔵

Module Duration Format Delivered By
CephX Platform Overview 30 min Video + Live Q&A CephX
Technical Setup & Troubleshooting 45 min Live demo CephX
Clinical Workflow Integration 60 min Live training with cases CephX
Training Delivery Skills 30 min Live workshop DSO Operations or CephX
Support Escalation Procedures 15 min Documentation review DSO Operations
Certification Assessment 30 min Practical test CephX

Certification Requirement: Champions must score 90%+ on practical assessment before training their teams.


Standardized Training Materials (Developed Centrally)

CephX Quick Start Guide (1 page per role) ☐ Workflow cheat sheets (task-based, laminate-ready) ☐ Training slide deck (champions customize for local context) ☐ Video library (short clips for each major function) ☐ FAQ document (updated after each wave) ☐ Troubleshooting guide (common issues + solutions)


Role-Specific Training Outlines

Dentists/Providers

Training Duration: 60-90 minutes Format: Live demo with hands-on practice (champion-led, supported by video)

Topic Time Key Learning
CephX value proposition and AI capabilities 10 min Why this improves your practice
Accessing CephX from your workflow 10 min Where it fits in your day
Reviewing AI-generated analysis 20 min How to interpret landmarks, measurements
Understanding AI confidence indicators 10 min When to trust vs. verify
Manual adjustment/override procedures 15 min How to correct AI if needed
Treatment visualization for patients 15 min Using visuals to explain treatment
Documentation and export 10 min Getting analysis into patient record

Common Provider Resistance Points:

Objection Response
"I've been doing this manually for 20 years" "CephX handles the tedious tracing; your expertise interprets the results and plans treatment"
"I don't trust AI to get it right" "You always review and can override. 97%+ accuracy matches trained specialists"
"This will take more time" "Initial learning curve, then you save 10-15 min per case"
"My patients don't need fancy visualizations" "Data shows 15-30% improvement in case acceptance with visual treatment plans"

Day 1 Cheat Sheet: Providers

CephX QUICK REFERENCE - PROVIDERS

1. ACCESS: Click CephX icon or navigate to [URL]
2. FIND PATIENT: Search by name or ID
3. SELECT IMAGE: Choose ceph image for analysis
4. RUN ANALYSIS: Click "Analyze" - results in <60 seconds
5. REVIEW: Check

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