Practice management software vendors will install on whatever you give them. That is the problem — the decisions that determine whether your practice IT works for the next decade get made in the weeks before their install date, usually by nobody in particular.
1. Size the server for your operatories, not the demo
The specification a PMS vendor quotes is frequently a minimum, benchmarked against a small practice. Imaging changes everything — digital sensors, pan units and 3D imaging generate storage and throughput demands that a minimum-spec server handles poorly by year two.
Size for your actual operatory count, your imaging equipment, and reasonable growth. The cost difference between a minimum server and an appropriate one is small compared to replacing it early or watching staff wait on it daily.
2. Choose the backup target before patient records exist
The easiest moment to establish clean backup practice is before there is anything to lose. Decide: where backups go, how often, how long they are retained, whether there is an offsite copy an attacker cannot reach, and — the part everyone skips — when restores get tested.
A backup that has never been restored is a hypothesis. Test it before you depend on it, and put a recurring test on the calendar.
3. Turn audit logging on from day one
HIPAA expects you to be able to review who accessed what. Enabling audit logging on day one costs nothing; enabling it after an incident tells you nothing about the period that matters. Turn it on before the first patient record exists, and know how to produce a report from it.
4. Get the BAA chain right before go-live
Every vendor that touches protected health information needs a Business Associate Agreement — your PMS vendor, your IT provider, your backup provider, your imaging vendor, and increasingly any AI or communication tool handling patient information. Missing BAAs are a common audit finding and they are trivially avoidable if you collect them as you sign each vendor rather than reconstructing the chain later.
5. Two drops per operatory, while the walls are open
Cable is cheap during construction and expensive after. Two network drops per operatory covers the chair-side workstation and the imaging sensor, with capacity for whatever gets added later. Add drops at the front desk, the sterilization area, the doctor’s office, and every planned wireless access point location.
This is the single decision that is most painful to reverse. Cored walls in a finished operatory cost multiples of a cable pulled during the buildout, and the disruption lands on a practice that is already seeing patients.
The physical side people forget
HIPAA’s physical safeguards apply to the practice too — controlled and documented access to the server room, records storage and medication areas. Getting door hardware prepped during construction is the same economics as cabling: cheap now, expensive later. We cover it in access control for dental and medical practices and the broader physical safeguards checklist.
The sequencing that saves the most money
Network infrastructure before PMS install. PMS install before staff training. Staff training before opening. Practices that compress this sequence end up doing infrastructure work around patients, which costs more and works less well.
Opening or relocating a practice? See dental IT support or call (833) 306-3168 — earlier is genuinely cheaper here.