OrthoSelect / DIBS AI
Implementation PlaybookDSO · Group Practice

OrthoSelect / DIBS AI

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

OrthoSelect / DIBS AI — Implementation Playbook (DSO)

OrthoSelect DIBS AI Implementation Playbook

A Strategic Guide for DSO Deployment


1. Executive Summary

What DIBS AI Does

OrthoSelect's DIBS AI (Digital Intelligent Bracket Selection) is an artificial intelligence-powered orthodontic treatment planning platform that automates bracket prescription selection and wire sequencing by analyzing CBCT scans, intraoral scans, and patient records. The system generates optimized treatment plans with predicted outcomes, reducing doctor planning time from 45+ minutes to under 10 minutes per case while standardizing clinical protocols across providers.

Why DSOs Benefit from AI-Powered Treatment Planning at Scale

DSOs operating orthodontic or multi-specialty practices gain disproportionate advantages from centralized treatment planning AI:

  • Standardization Across Providers: Eliminates variability in treatment quality between new associates and experienced orthodontists—every patient receives protocol-driven care regardless of which location or provider they see
  • Data Aggregation Intelligence: DIBS AI improves its recommendations as it processes more cases; a 30-location DSO generates 50x the training data of a solo practice, accelerating model accuracy for your specific patient population
  • Operational Leverage: Centralized oversight of treatment plans enables quality assurance at scale without adding regional clinical directors
  • Predictable Case Economics: AI-generated treatment timelines improve case profitability forecasting and reduce refinement rates that erode margins
  • Associate Onboarding Acceleration: New orthodontists achieve clinical productivity parity 40% faster when supported by AI-guided treatment planning

Expected Timeline: Decision to Full Deployment

Phase Timeline Locations Covered
Pre-Implementation Weeks 1–2 Preparation across all locations
Wave 1 Pilot Weeks 3–6 2–3 locations
Wave 2 Expansion Weeks 7–12 5–8 locations
Wave 3 Full Rollout Weeks 13–20 Remaining locations
Optimization & Stabilization Weeks 21–26 Enterprise-wide

Total Timeline: 6 months from contract signature to full deployment with optimization complete.


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

Technical Requirements

Hardware (Per Location)

☐ Workstation with minimum Intel i7 (10th gen+) or AMD Ryzen 7, 32GB RAM, dedicated GPU (NVIDIA RTX 3060 or higher) for local processing ☐ 27"+ monitor with 4K resolution for treatment visualization (one per operatory running DIBS) ☐ CBCT scanner with DICOM export capability (compatible models: Carestream CS 9600, Planmeca ProMax 3D, i-CAT FLX) ☐ Intraoral scanner with open STL/PLY export (iTero Element 5D, 3Shape TRIOS, Medit i700)

Software

☐ Windows 10/11 Pro (64-bit) or macOS 12+ ☐ Latest Chrome or Edge browser for web interface ☐ .NET Framework 4.8+ (Windows installations) ☐ Current antivirus with exclusions configured for DIBS directories

Network

☐ Minimum 100 Mbps upload/download per location for cloud sync ☐ Static IP or DDNS configuration for remote access capabilities ☐ Firewall whitelist: *.orthoselect.com, *.dibsai.com (ports 443, 8443) ☐ ⚠️ VPN compatibility testing required if locations use site-to-site VPN—latency over 100ms degrades real-time rendering

Integrations

☐ Confirm PMS API access availability (see Section 5) ☐ Verify imaging software DICOM export paths ☐ Document current integration points between PMS ↔ imaging systems


Vendor Onboarding Steps (Est. Time: 4–6 hours)

Step Action Owner Time Est.
1 🔵 Schedule kickoff call with OrthoSelect implementation team Central IT + Vendor 1 hour
2 🔵 Complete enterprise customer intake form VP Operations 30 min
3 🔵 Receive dedicated Customer Success Manager (CSM) assignment Vendor
4 🔵 Execute Business Associate Agreement (BAA) Legal + Vendor 1–3 days
5 🔵 Obtain enterprise license keys and admin portal credentials Vendor → Central IT 1 hour
6 🔵 Schedule technical integration planning session Central IT + Vendor 2 hours

Key Vendor Contacts to Establish

Role Purpose Expected Response Time
Customer Success Manager Strategic escalation, rollout planning Same business day
Technical Account Manager Integration issues, API troubleshooting 4 hours
Clinical Support Specialist Treatment planning questions, algorithm inquiries 2 hours
24/7 Support Line Critical system outages 15 minutes

Data/Access Prerequisites

☐ Admin credentials for each PMS instance (Dentrix Enterprise/Eaglesoft/Open Dental) ☐ 🔵 API keys from OrthoSelect (generated during onboarding) ☐ Imaging archive read/write access paths for all locations ☐ Patient consent template updates approved by compliance (DIBS AI disclosure language) ☐ Historical case data export (minimum 100 completed ortho cases per location for AI calibration) ☐ Provider NPI numbers and state license verification for user provisioning


Internal Stakeholder Alignment

🟣 Stakeholder Alignment Map

Stakeholder Level Role Involvement Type When to Engage
Board/Investors Oversight Informed of strategic AI investment Pre-contract, quarterly updates
C-Suite (CEO, COO, CDO) Decision-makers Approve budget, timeline, rollout strategy Weeks 1–2, wave transitions
Chief Dental Officer Clinical Champion Define clinical protocols, approve AI parameters Weeks 1–3, ongoing QA
VP of Operations Program Owner Own rollout execution, resource allocation Continuous
Regional Managers Cascade Leads Brief office managers, monitor location progress Weeks 2+, per-wave
Office Managers Location Leads Coordinate local logistics, staff scheduling Per-wave, 2 weeks before go-live
Providers (Orthodontists) End Users Training, workflow adoption Per-wave, 1 week before go-live
IT/Systems Technical Execution Installation, integration, troubleshooting Continuous

Approval Gates Required

🟣 Budget approval for enterprise license + implementation services 🟣 CDO sign-off on clinical protocol standardization 🟣 Legal approval on BAA and updated patient consent language 🟣 IT security approval on network/firewall changes 🟣 Board notification of AI adoption initiative (if material investment)


Baseline Metrics to Capture BEFORE Go-Live

⚠️ Critical: These metrics must be standardized across all locations to enable valid cross-location comparison and ROI measurement.

Clinical Efficiency Metrics

Metric Definition Measurement Method Target Source
Treatment Plan Creation Time Minutes from scan completion to finalized plan Time study (sample 20 cases/location) Stopwatch + log
Refinement Rate % of cases requiring mid-treatment bracket repositioning Chart audit (last 12 months) PMS
Average Treatment Duration Days from bond to deband Case completion report PMS
Provider Planning Time Hours/week spent on treatment planning per FTE orthodontist Provider self-report + schedule audit Survey + PMS

Financial Metrics

Metric Definition Measurement Method Target Source
Case Acceptance Rate % of presented ortho cases that start treatment Consult tracking PMS
Average Case Value Revenue per ortho case started Financial report PMS/Accounting
Lab Costs per Case Bracket, wire, and outsourced planning costs Expense tracking Accounting
Days to Treatment Start Calendar days from consult to bond appointment Case timeline audit PMS

Operational Metrics

Metric Definition Measurement Method Target Source
Staff Overtime (Ortho) Weekly overtime hours for ortho-related staff Payroll data HR/Payroll
Patient Chair Time per Visit Average minutes per ortho adjustment appointment Schedule analysis PMS
Case Documentation Time Minutes to complete clinical notes per visit Time study Observation

Standardization Protocol for DSO-Wide Measurement

☐ Create centralized data collection template (spreadsheet or BI tool) ☐ Assign one regional analyst or Office Manager per region to collect baseline data ☐ 🟣 Establish consistent definitions document—distribute to all locations ☐ Set 2-week data collection window across all locations simultaneously ☐ Central team aggregates and validates before proceeding to implementation


Enterprise-Level Requirements

Network Standards Across Locations

☐ Document current WAN architecture and bandwidth per location ☐ Identify locations below minimum bandwidth threshold (100 Mbps) ☐ ⚠️ Locations with satellite internet or cellular failover may require hybrid local/cloud configuration—flag for vendor consultation

Hosting Model Decision

🟣 Decision Required: Centralized vs. Location-Level Hosting

Option Pros Cons Recommended For
Centralized Cloud Easier updates, single backup, lower per-location IT burden Requires reliable WAN, single point of failure DSOs with robust network infrastructure
Hybrid (Cloud + Local Cache) Resilience during outages, faster rendering Higher setup complexity, more maintenance DSOs with variable connectivity
Location-Level Maximum resilience Update burden, inconsistent versions, higher TCO Not recommended for DSOs

OrthoSelect Recommendation: Centralized cloud with local caching for rendering-intensive operations.

Identity & Access Management

☐ Confirm SSO provider (Okta, Azure AD, Google Workspace) ☐ 🔵 Request SAML/OIDC integration specs from OrthoSelect ☐ Define role-based access levels:

  • Enterprise Admin (Central IT)
  • Regional Admin (Regional Managers)
  • Location Admin (Office Managers)
  • Provider (Full clinical access)
  • Staff (View-only/limited functions)

Centralized Credentialing

☐ Create provider roster with NPI, license state, DEA (if applicable) ☐ Establish process for adding/removing providers across locations ☐ Define credential verification workflow (who approves new provider access?)


3. Location Readiness Assessment

Scoring Framework

Score each factor 1–5 per location. Higher scores indicate greater readiness.

Factor 1: IT Infrastructure Maturity

Score Criteria
5 Gigabit internet, workstations <2 years old, PMS on latest version, dedicated IT support
4 200+ Mbps internet, workstations <3 years old, PMS within 1 version of current
3 100 Mbps internet, workstations 3–4 years old, PMS 2 versions behind
2 50–100 Mbps internet, workstations 4–5 years old, PMS significantly outdated
1 <50 Mbps internet, workstations >5 years old, PMS no longer supported

Factor 2: Staff Tenure & Adaptability

Score Criteria
5 <15% annual turnover, team trained on 2+ tech tools in past year, documented tech enthusiasm
4 15–25% turnover, trained on 1 tech tool in past year, generally positive toward change
3 25–35% turnover, mixed training history, neutral toward change
2 35–50% turnover, minimal recent training, resistance to past changes noted
1 >50% turnover, no recent tech training, documented change management failures

Factor 3: Patient Volume

Score Criteria Risk/Impact Balance
5 80–120 ortho starts/month High impact, manageable complexity
4 60–80 or 120–150 ortho starts/month Solid impact, slightly higher/lower risk
3 40–60 ortho starts/month Moderate impact and risk
2 150–200 ortho starts/month High risk, may overwhelm during transition
1 <40 or >200 ortho starts/month Too low ROI or too high risk for pilot

Factor 4: Existing Tech Stack Compatibility

Score Criteria
5 PMS and imaging fully compatible, existing integrations documented, APIs active
4 PMS compatible, imaging requires minor configuration, some API work needed
3 PMS compatible with workarounds, imaging partially compatible, integration effort moderate
2 PMS marginally compatible, imaging requires upgrade or replacement, significant integration work
1 PMS or imaging not compatible, major infrastructure changes required

Factor 5: Local Champion Availability

Score Criteria
5 Tech-forward orthodontist + engaged office manager, both express enthusiasm for AI
4 Either strong provider champion OR strong admin champion with other's support
3 Willing participants but no strong advocate, passive support
2 Provider skeptical but office manager supportive (or vice versa)
1 No identified champion, known resistance from key staff

Composite Readiness Score Calculation

Formula: (IT Infrastructure × 1.5) + (Staff Adaptability × 1.5) + (Patient Volume × 1.0) + (Tech Stack × 1.5) + (Local Champion × 1.5)

Maximum Score: 35 points

Score Range Readiness Tier Rollout Recommendation
28–35 Tier 1: High Readiness Wave 1 candidate
21–27 Tier 2: Moderate Readiness Wave 2 candidate
14–20 Tier 3: Conditional Readiness Wave 3, address gaps first
<14 Tier 4: Not Ready Defer until prerequisites met

Location Readiness Assessment Template

Location IT Infra (×1.5) Staff (×1.5) Volume (×1.0) Tech Stack (×1.5) Champion (×1.5) Total Tier
[Location A]
[Location B]
[Location C]

Rollout Sequence Recommendations

Wave 1 Pilot Selection Criteria

Select 2–3 locations that meet ALL of the following: ☐ Tier 1 readiness score (28+) ☐ Geographic/demographic diversity (represent different regions or patient populations) ☐ Identified champion orthodontist willing to provide feedback ☐ Not currently undergoing other major system changes ☐ Office manager with bandwidth to participate in daily check-ins for 4 weeks

⚠️ Common Mistake

Do NOT select your highest-volume location or flagship location for Wave 1. These locations face disproportionate risk if issues arise and create outsized negative perception if the pilot stumbles. Choose representative but lower-profile locations.


4. Rollout Strategy

Wave Structure

Wave Locations Duration Purpose
Wave 1: Pilot 2–3 locations 4 weeks Prove technology, refine workflows, identify issues
Buffer Period 2 weeks Document learnings, adjust training, fix bugs
Wave 2: Expansion 5–8 locations 4 weeks Scale with improved playbook, test regional variation
Buffer Period 2 weeks Aggregate feedback, prepare for final push
Wave 3: Full Rollout Remaining locations 4–6 weeks Complete deployment with mature process
Stabilization All locations 4 weeks Optimize, troubleshoot stragglers, begin ROI measurement

Wave 1: Pilot Phase (Weeks 3–6)

Selection Criteria for Pilot Locations

Criterion Weight Rationale
High readiness score 40% Reduces implementation friction
Manageable patient volume 25% Allows staff learning curve without overwhelming
Representative of portfolio 20% Learnings transfer to other locations
Accessible for in-person support 15% Enables hands-on troubleshooting

Pilot Timeline

Week Activities
Week 3 Installation, integration, test environment validation
Week 4 Staff training, parallel run begins (AI + manual planning side-by-side)
Week 5 Primary reliance on DIBS AI, manual verification of outputs
Week 6 Full AI adoption, daily feedback collection, go/no-go assessment

Daily/Weekly Check-In Cadence

Frequency Participants Agenda
Daily (Week 4–5) Location champion + Central team Issues log review, workflow observations, quick wins
Daily (Week 6) Location champion + Regional manager Performance metrics, user feedback, go/no-go inputs
Weekly VP Operations + CDO + Vendor CSM Pilot status, escalated issues, decision points

Go/No-Go Criteria: Wave 1 → Wave 2

🟣 Must pass ALL criteria to proceed:

Category Go Criteria No-Go Criteria
Technical Stability System uptime >99% during pilot; <3 critical bugs System outages >4 hours cumulative; unresolved critical bugs
Clinical Accuracy Provider override rate <15%; no patient safety events Provider override rate >30%; any patient safety event
Workflow Integration Treatment planning time reduced ≥30% Treatment planning time unchanged or increased
User Adoption All trained staff using system daily by Week 6 >20% of staff avoiding system use
Vendor Support Issues resolved within SLA; responsive communication Multiple SLA breaches; communication breakdown

Wave 2: Expansion Phase (Weeks 7–12)

Location Selection for Wave 2

☐ Select 5–8 locations from Tier 1 and high Tier 2 readiness scores ☐ Ensure at least one location in each region if geographically distributed ☐ Include at least one high-volume location to stress-test scalability ☐ Include one location with previously identified integration challenges (to validate fixes)

Adjusted Protocol Based on Wave 1 Learnings

Area Potential Adjustments
Training duration Extend or shorten based on pilot feedback
Parallel run period Adjust length based on pilot confidence curve
Configuration defaults Update based on pilot provider preferences
Escalation path Refine based on actual issue patterns

Go/No-Go Criteria: Wave 2 → Wave 3

Same criteria as Wave 1, with additional requirements: ☐ 80% of pilot + Wave 2 locations meeting performance targets ☐ Scalability confirmed (central systems handling increased load) ☐ Regional managers fully briefed and confident in cascade model


Wave 3: Full Rollout (Weeks 13–20)

Approach for Remaining Locations

☐ Group locations into sub-waves of 5–10 based on regional manager capacity ☐ Tier 3 (conditional readiness) locations receive additional pre-rollout preparation ☐ Tier 4 locations deferred until prerequisites addressed

Timeline per Sub-Wave

Day/Week Activity
Week -2 Pre-installation verification, staff scheduling for training
Week -1 Installation, integration testing
Go-live week Training + parallel run + cutover (compressed based on matured process)
Week +1 Daily check-ins, rapid issue resolution
Week +2 Transition to standard support model

Rollback Plan

⚠️ If a Wave Fails Go/No-Go Criteria

Immediate Actions (within 24 hours of no-go decision):

  1. 🟣 VP Operations convenes incident review with CDO, IT, and Vendor CSM
  2. Document specific failure points and root causes
  3. Communicate pause decision to affected locations and regions

Rollback Protocol: ☐ Locations in current wave revert to manual treatment planning workflow ☐ Disable DIBS AI integration but maintain installation (faster restart) ☐ Preserve all data and configuration for analysis ☐ Set 2-week remediation timeline with vendor ☐ Locations in previous waves continue operations (unless systemic issue identified)

Restart Criteria: ☐ Root cause identified and remediated ☐ Fix validated in test environment ☐ 🔵 Vendor provides written confirmation of resolution ☐ 🟣 CDO approves restart based on clinical safety review


5. Configuration & Integration (Weeks 2–3)

Practice Management System Integration

🔵 Dentrix Enterprise Integration

Step Action Time Est. Owner
1 Request API credentials from Henry Schein (Dentrix Enterprise Administrator Console) 1–3 days IT Admin
2 🔵 Provide credentials to OrthoSelect technical team 15 min IT Admin
3 🔵 OrthoSelect configures HL7/FHIR bridge 2–4 hours Vendor
4 Test patient demographic sync (20 sample records) 1 hour IT + Vendor
5 Test appointment data bi-directional sync 1 hour IT + Vendor
6 Test treatment plan and ledger integration 2 hours IT + Vendor
7 ⚠️ Validate procedure code mapping (DIBS AI codes → Dentrix CDT codes) 2 hours Billing + Vendor
8 Document custom field mappings 30 min IT
9 User acceptance testing with sample workflows 2 hours Office Manager + Provider

🔵 Eaglesoft Integration

Step Action Time Est. Owner
1 Verify Eaglesoft version 21.x or higher (required for API access) 15 min IT Admin
2 Enable Patterson API Services in Eaglesoft Administrator 30 min IT Admin
3 🔵 Submit integration request to Patterson (co-signed by OrthoSelect) 3–5 days IT Admin + Vendor
4 🔵 OrthoSelect receives and configures API credentials 2–4 hours Vendor
5 Test patient search and record retrieval 1 hour IT + Vendor
6 Test image association (link DIBS treatment plans to patient records) 1 hour IT + Vendor
7 ⚠️ Validate insurance eligibility pass-through 1 hour Billing + IT
8 User acceptance testing 2 hours Office Manager + Provider

🔵 Open Dental Integration

Step Action Time Est. Owner
1 Confirm Open Dental version 22.x or higher 15 min IT Admin
2 Enable API module in Open Dental (Module Setup → API) 30 min IT Admin
3 Generate API key with read/write permissions 15 min IT Admin
4 🔵 Provide API key and database connection string to OrthoSelect 15 min IT Admin
5 🔵 OrthoSelect configures direct database integration 2–4 hours Vendor
6 Test full patient record sync 1 hour IT + Vendor
7 Test treatment plan write-back 1 hour IT + Vendor
8 ⚠️ Validate eServices integration (if patient portal used) 1 hour IT
9 User acceptance testing 2 hours Office Manager + Provider

Imaging System Integration

CBCT Integration (DICOM)

Step Action Time Est. Owner
1 Document CBCT model and current DICOM viewer/server 30 min IT
2 Configure DICOM export path from CBCT software to DIBS AI watched folder 1 hour IT
3 🔵 Provide DIBS AI DICOM listener address to CBCT software 30 min IT + Vendor
4 Test automatic DICOM import with 5 sample scans 1 hour IT + Vendor
5 Verify metadata preservation (patient ID, scan date, acquisition parameters) 30 min IT
6 ⚠️ Test large file transfer (high-resolution scans) for timeout issues 30 min IT
7 Document final DICOM workflow 30 min IT

Intraoral Scanner Integration

Step Action Time Est. Owner
1 Document IOS model and current export format (STL, PLY, OBJ) 15 min IT
2 Enable open export in IOS software (disable proprietary-only export) 30 min IT
3 Configure export path to DIBS AI watched folder 30 min IT
4 🔵 Validate mesh file compatibility with DIBS AI 1 hour IT + Vendor
5 Test automatic import and case matching (scan → patient record) 1 hour IT + Vendor
6 Document final IOS workflow 30 min IT

Test Environment Setup

☐ 🔵 Request OrthoSelect sandbox instance (separate from production) ☐ Clone PMS configuration from one representative production location ☐ Load synthetic patient data (provided by vendor or generated) ☐ Mirror imaging integration to test DICOM/STL import ☐ Provision test user accounts for QA team

Validation Checklist

Test Category Test Case Pass Criteria
Authentication User login via SSO Successful login within 5 seconds
Patient Sync Create patient in PMS, verify in DIBS AI Patient appears within 2 minutes
Imaging Import Export CBCT from scanner, verify in DIBS AI Scan appears and renders within 5 minutes
Treatment Plan Generation Run AI analysis on test case Plan generated within 10 minutes
Plan Write-Back Approve treatment plan, verify in PMS Plan and codes appear in patient ledger
Error Handling Submit incomplete data Clear error message, no system crash
Performance Generate 10 treatment plans simultaneously No degradation >20% in generation time

Data Migration / Historical Data Ingestion

Purpose

DIBS AI improves recommendation accuracy when trained on your historical case data. Ingesting completed orthodontic cases allows the system to learn patterns specific to your patient demographics, provider preferences, and treatment protocols.

🔵 Migration Steps

Step Action Time Est. Owner
1 Identify last 12–24 months of completed ortho cases per location 2 hours Office Manager
2 Export case data: demographics, diagnosis codes, treatment plans, pre/post imaging 4–8 hours IT
3 🔵 Submit data package to OrthoSelect via secure transfer 1 hour IT
4 🔵 OrthoSelect processes historical data ingestion 3–5 days Vendor
5 🔵 Receive confirmation of successful ingestion and baseline model calibration Vendor

⚠️ Data Quality Requirements

  • De-identification NOT required (data processed under BAA)
  • Minimum 100 completed cases per location for meaningful calibration
  • Include cases with complications/refinements (helps AI learn edge cases)
  • Exclude cases with incomplete records or missing imaging

Security and HIPAA Compliance Verification

Enterprise-Level HIPAA Checklist

Item Verification Method Responsible Party
☐ Executed BAA with OrthoSelect Legal file review Legal/Compliance
☐ Data encryption at rest (AES-256) 🔵 Vendor attestation Vendor
☐ Data encryption in transit (TLS 1.3) 🔵 Vendor attestation Vendor
☐ SOC 2 Type II certification 🔵 Request current report Vendor
☐ HIPAA compliance attestation 🔵 Request current attestation Vendor
☐ Penetration test results (within last 12 months) 🔵 Request summary Vendor
☐ Data residency (US-only servers) 🔵 Vendor confirmation Vendor
☐ Audit logging enabled Configuration review IT + Vendor
☐ Access controls per role Configuration review IT
☐ Automatic session timeout (15 min) Configuration review IT
☐ Patient consent language updated Legal review Legal/Compliance
☐ Notice of Privacy Practices updated Legal review Legal/Compliance

DSO-Specific Configuration

Standardized Configuration Template

🟣 These settings must be identical across all locations:

Setting Recommended Value Rationale
Treatment planning protocol CDO-approved defaults Clinical consistency
AI confidence threshold for auto-approval 85% Balance automation + oversight
Procedure code mappings Enterprise CDT standard Billing consistency
Report templates Branded enterprise templates Patient experience consistency
Audit log retention 7 years Compliance requirement
User timeout 15 minutes Security standard
Notification preferences Email + in-app Workflow consistency

Location-Specific Configuration

Setting Allowed Variation Approval Required
Provider treatment preferences Within CDO-defined parameters No (provider discretion)
Operatory-specific workflows Based on equipment differences No (Office Manager)
Appointment scheduling rules Based on local capacity No (Office Manager)
Lab vendor integration If multiple approved vendors Regional Manager

AI-generated implementation guide based on public vendor information. Verify specifics directly with OrthoSelect / DIBS AI.