While the principles of dentistry remain the same, digital technology has radically changed the profession to improve both patient care and practice management. John Cox, vice president of technology sales at Henry Schein, recently shared his insights about how innovation is transforming the way today’s dentists practice—and what tomorrow’s dentists can expect.
Q: What is the biggest technology challenge for dentists today?
A: The biggest challenge is understanding what technology they should consider incorporating. There are so many options, so many different things, whether it be upgrading existing technology to a digital format, maybe from analog to digital, or whether it be a completely new workflow within their practice, like CAD/CAM or digital impressions, changing the way they do things. So for the dentist, I think it’s, “Where do I start? What do I do first? And what’s going to give me the greatest return or deliver a great patient experience?” That’s probably the biggest challenge right now.
Q: What are some of the more significant technologies that dentists could or should be adopting right now?
A: First, it depends on the practice and what their needs are. We do a technology assessment and a practice assessment to understand what is important, what the opportunities are for the practice, and what direction the practice may be interested in. Some dentists want to get involved in implants. Some dentists want to get involved in ortho. Some dentists want to do same-visit crowns, or same-visit restorative dentistry. The interest level of the practice–and what the opportunity within the practice is—will dictate what the ideal technology will be.
One of the hot technologies certainly would be digital impression devices. Why? I think we can make a strong argument for most dentists to show them the savings they would have on their digital impression material, coupled with the typically lower cost they would get by sending their work to a laboratory. A laboratory tends to do a restoration from a digital file for lower costs than analog, so there’s savings there, in addition to the tax benefit they may get from purchasing equipment.
Typically, we can show them that really there’s no negative impact on their cashflow. You can incorporate something that provides a better patient experience, and there are studies that say 100% of patients prefer digital impressions over analog. They don’t like that tray of impression material that they gag on.
It also reduces the amount of time necessary for adjustments and remixes within the lab. The lab industry has done a lot of research into digital versus analog. They show a significant reduction in chair time to adjust crowns that are done from manual versus digital, as well as a significant reduction in remakes. Obviously, a dentist who has to remake a crown loses a revenue opportunity. They don’t get paid twice. So, those savings become positive cashflow for the dentist.
Plus, why would a dentist want to incorporate CAD/CAM? It’s not a matter of trying to save money on lab expenses. It’s more about the efficiency in doing things in their practice in a shorter period of time. Insurance has had a real impact in the dental industry over the last several years. Carriers say they are going to pay a dentist less for a procedure today than they did three or four or five years ago in a PPO environment.
So dentists have an option. How can they replace the 15% to 20% income they’ve lost because of the insurance situation? The only way they can do it today is by working longer hours, by opening Saturdays, or by doing dentistry in a shorter period of time. And technology allows them to deliver treatment in a shorter period of chair time.
At the same time, it’s good for the patient. Patients would rather be in the chair once versus twice—30 minutes versus 60 minutes. So if dentists can deliver the same treatment without compromising the quality of care, and deliver a better patient experience, it’s a win for the patient, it’s a win for the practice, and it’s a win for the profitability of the practice. They do more dentistry in that same eight-hour day, and they don’t have to be open Saturdays. They might for patient convenience, but they don’t have to.
Q: What about the learning curve for these new technologies, especially when you come from an analog background?
A: One of the things we pride ourselves in at Henry Schein is that we work hard to develop a recipe for success for practices when they do adopt technology. Oftentimes that includes pre-learning a technology, which could be online modules identifying which members of the staff would be engaged with this technology and providing an expectation of what that learning curve might look like. That way they don’t expect to go from zero to a hundred on day one and know that there might be a learning curve over the first 90 days.
We typically have in-office orientations where we have training experts that help practices onboard the equipment using the technology with patients to build up their competency and confidence in that technology. And then we have a 90-day window where we touch base on a biweekly basis with the clinicians and/or the staff using it and making sure they’re doing a good job. Anything challenging, anything they’re struggling with, we can revisit and do more training if necessary to get them through that learning gap. We’re confident that we put recipes in place that help get a clinician to the point where not only is it doing the work that it’s supposed to do, but it’s a great patient experience and the staff are fully engaged and excited to use the technology as well.
Q: So the company is proactive in providing those educational opportunities?
A: Very much so. It’s part of our high-touch, high-value offering that we bring into a dental practice. The educational component of it is not only learning. It’s learning new workflows to implement in a practice. It’s learning new technologies and how to use them. And then further from that is that these technologies are collecting information about the patient. They will be used for more things tomorrow than they are today.
For example, I can take a digital impression of every patient every time they come into the practice. Three years from now, I’ll have a baseline of three years that I can look at and compare, and the software would show me that this patient has had some tooth wear in the posterior right quadrant. So let’s educate the patient. We need to stop the continued erosion. We’re going to get a night guard. We’re going to figure out what’s going on.
On things like that that, we’re going to use the data more in the future than we are today. The continual development of how we use information is just part of the machine learning and whole big data phenomenon that’s going on in our world, not just in dentistry.
Q: What else does Henry Schein offer in terms of big data, practice management, and case management, aside from the practical tools of diagnosing and treating a patient?
A: I think it’s part of our complete story. When you look at how you run an efficient dental practice, or run it more efficiently tomorrow than you do today, it’s the practice management software where all the patient information sits. It sits on a network of hardware that’s got to be robust enough. So, we try and do a technology assessment in the practice to establish that it has good hardware that can support the software and all the diagnostic tools that will allow them to run a great business.
For the software layer, we try some of the new developments from Henry Schein One, which is our joint venture with Internet Brands. It’s best-in-class on the marketing side, the patient engagement side, and the practice management side. So not only do we help practices attract and get more patients through the door and into the funnel, we also help provide tools that maintain and help get patients into the office at the right time, so practices have fewer cancellations and fewer gaps in the schedule. Anytime there’s a gap in the schedule and a patient doesn’t show up, that might be a one-hour block of time that you never get back. We’ve got tools that help practices keep that from happening and really optimize efficiency.
The other thing we do is from an insurance standpoint—revenue cycle management. It helps practices maintain and automate an insurance claim so less falls through the cracks. A good example of that is our new Smart Image technology. In the past, if a digital image was taken of a patient, it couldn’t be submitted for a claim. The ADA suggests that upwards of 15% of claims may not be submitted because practices just don’t get to it or people forget to do it. They’re too busy running around.
With the new Smart Image, when you take the image, it’s attached to the patient’s file. It also attaches an automatic CDT insurance code. And, it sends it through submission for claim. It takes out the chance that you miss submitting a claim and recaptures revenue that otherwise would have been left out. It also takes the job that a staff member would have done in the past and automates it. Now, that staff member can do other things that will be more productive for the practice.
All this adds up to how we’re really helping practices optimize their resources on the personal side—how they use the data more effectively to get more cases accepted and to get more patients through the door. That’s part of the value-add from a higher-level view of some of the things we’re pulling together.
Q: Can you tell us about the launch of Henry Schein One?
A: Prior to the Henry Schein One joint venture, Henry Schein Practice Solutions always had fabulous market share in practice management, and we did a great job of managing the patient database within a practice on the revenue piece, on insurance submission. But we realized there were some other opportunities where we could do better on the marketing side—getting new patients, marketing to existing patients the services we provide, and marketing to existing patients to make sure they come in the times they’re scheduled to.
We then realized that there were best-in-class products that weren’t in our portfolio, so the merger of Internet Brands with Henry Schein Practice Solutions provided a synergy in those two things. We brought the strength and power of their marketing piece and their insurance plan and merged it in with our practice management piece to end up where we are today, which we feel provides us a lot more opportunity to bring a lot more value to dentists today.
Internet Brands gave us the piece that was missing, which included initiatives with online media and the opportunity to attract patients from a digital aspect. Now, we’re bringing powerful online solutions to our practices to attract new patients. So that’s been an exciting piece of it, for sure.
Q: What can you tell us about the SOI Equals ROI program?
A: SOI is sleep, ortho, and implants, and ROI is return on investment. When we look at the average general practice, if they’re not involved in sleep, ortho, or implants, they’re missing an opportunity. They’re some of the fastest growing areas in dentistry.
There’s information that suggests 25% to 50% of the adult population over the age of 50 has some form of sleep obstruction, and it’s undiagnosed, for the most part. Dentists are in a great seat to help diagnose those situations, ask the right questions, and then provide treatment solutions that give patients relief—relief being more oxygen when they sleep. They feel better when they wake up rested versus tired. They think better, they think straighter, and they become more productive, all of which are things they would benefit from. So, sleep is a tremendous opportunity.
The middle, the O, represents ortho. The explosion in tooth aligners, in teen treatment and adult treatment, allows dentists to get involved. If they don’t want to get involved in bonding brackets and wires, they can certainly get involved with aligners. Henry Schein Orthodontics recently launched its own aligner called the SLX. The ability for a dentist to deliver levelling alignment with aligners is a tremendous opportunity.
And, the 40 million edentulous arches and the 100 million-plus missing teeth in this country give dentists the opportunity to provide dental implant treatment within their practice. How do you do that? You do that with great education. You do that by leveraging technology. Dentists will be able to treat patients where they have the skill set to deliver high-quality care by leveraging technology, such as guided surgery.
We’ve got 3-D analysis of the airway for sleep dentistry. We’ve got 3-D analysis of the patient for ortho treatment. We combine technology with great CE. We have continuing education programs through our dental implant partners BioHorizons and CAMLOG and the same thing with Henry Schein Ortho. We’ve got alignment with sleep providers to educate general dentists on what they need to know to deliver treatment. And, of course, the technology enables them to do it safely and in a predictable way and deliver great outcomes for a convenient and great patient experience.
Q: Do you see this trend of general practitioners adopting more work in these specialties continuing?
A: A hundred percent. We provide great education and technology. Dentists can then establish a good workflow in the office so treatment is predictable, safe, and profitable for the practice while staying within their guardrails. We’re not suggesting that they’re going to do complex cases. Such cases would still be referred to a specialist. But those simpler cases, where patients would be treated by a dentist they already know and have a relationship with? It’s good for the patient, and it’s good for the practice.
Q: Do you have any other advice for dentists who are hesitant to explore new technology?
A: The only thing I would add would be for the clinician who’s thinking, “Well, maybe I could do something new tomorrow.” There’s always going to be something new tomorrow. The important thing is to get a baseline of your digital information today, because it’s that data that you’re going to be able to use to do things tomorrow. And if you don’t have the data, you can’t do it, such as the tooth monitoring that I talked about, and the ability to show tooth wear and deliver a night guard to a patient for relief. It’s a great solution, and it’s also a revenue generator for the practice. So the sooner they get started with digital acquisition and capturing digital information, the more it will return to them in the coming years. You can’t wait on technology.