The Group Dentistry Now Show: The Voice of the DSO Industry – Episode 35

Dan Larsen, Principal Product Manager at Henry Schein One, Bruce Lipsig, Vice President at RealCloud Imaging and Dr. Bruce Lieberthal, Vice President, Chief Innovation Officer at Henry Schein, Inc. discuss artificial intelligence (AI) and it’s impact and growing importance in the DSO industry.

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FULL TRANSCRIPT

Bill Neumann:

I’d like to welcome everyone to the Group Dentistry Now Show, I’m Bill Neumann. Today we’re going to talk AI, and practice management solutions, and probably a lot of other things. We have three experts here, really excited. I think AI is one of those things that we hear now all the time. I think most of us even see it in our daily lives, but trying to figure out how it all is going to impact DSOs and group practices, and dentistry. The three guests we have, we have Dr. Bruce Lieberthal. Bruce, thanks for being here. We have another Bruce. We have Bruce Lipsig, and then we have Dan Larson. Not three Bruce’s, just two. First off, welcome all to the Group Dentistry Now Show.

Bill Neumann:

We appreciate y’all being here. They’re actually representing different parts of Henry Schein. We’ll explain a little bit about what that means. We’ve got a Henry Schein, got a Henry Schein One, and then we have an OEM company to Henry Schein One, right Bruce?

Dr. Bruce Lieberthal:

That is correct.

Bill Neumann:

They’re going to explain that a lot better. Anyway, let me do a little bit of brief bio. The first Bruce, which is Bruce Lieberthal, Dr. Bruce Lieberthal. He is the chief innovation officer for Henry Schein, Inc. He’s an East coast guy. I’ll tell you a little bit about Dr. Lieberthal. He is really at the nexus of evaluating hundreds of cutting edge solutions and technologies, and he can really talk a little bit about what that all means. He advises the many medical and dental business units of Henry Schein, and right, they’re not just dental, you have medical as well and vet. There’s vet there also?

Dr. Bruce Lieberthal:

Not anymore.

Bill Neumann:

Oh, okay. Sorry, scratch that. There used to be. I remember that. He works with global sales, marketing, and distribution, and really trying to connect them with important new products that can help customers run better practices and deliver excellent patient care. Dr. Lieberthal welcome.

Dr. Bruce Lieberthal:

Thank you.

Bill Neumann:

I should say a couple more things about Dr. Lieberthal because, right now he is leading Henry Schein, also leading Henry Schein One’s DDX business. He can talk a little bit about what that is. Worked at Connect Dental for two years. These are all different parts of Henry Schein or Henry Schein One.

Dr. Bruce Lieberthal:

That’s right.

Bill Neumann:

I’m going to let you guys explain that because it is a little bit of a mystery to me. Let’s talk about the next Bruce that we have here. We have Bruce Lipsig. Bruce came to Henry Schein. You’ve been there, what, 20 years now it looks like he came in 2000, and that was with the acquisition of Integra medical in May of 2000. Yeah, it’s over 20 years, and worked with the Henry Schein team up until 2007 creating imaging products for Dentrix. You handled Dentrix Image, Dentrix Image ray and Image cam. You were on the equipment team from 2008 until this year.

Bruce Lipsig:

Correct.

Bill Neumann:

Now you are currently the vice-president of RealCloud imaging, which is an exclusive OEM provider of imaging software for Henry Schein One, and that’s where Dan Larson comes in. He’s with Henry Schein One, and has been in the dental industry for 15 years and is currently… Are you like the newbie here, 15 years only?

Dan Larsen:

Exactly. Yes.

Bill Neumann:

We have 20 years with Bruce Lipsig. Dr. Lieberthal, how many years have you been in the dental industry?

Dr. Bruce Lieberthal:

Actually, maybe I’m the newbie then, because I’m here 13 and a half.

Bill Neumann:

Okay. So at Henry Schein, but how long have you been at DMD?

Dr. Bruce Lieberthal:

You have to make me admit that, 1983.

Bill Neumann:

Okay. There we go. Yeah, well, so technically you’ve been in dentistry longer than any of us, but its not about that.

Dr. Bruce Lieberthal:

Yeah, unfortunately right.

Bill Neumann:

Say a little bit about Dan Larson. Dan has been in the dental industry again for 15 years. He is a principal product manager for Henry Schein One, and really he’s focused on Dentrix Ascend, which we’re going to discuss in great detail. He’s been a member of the Ascend team since its inception, and enjoys working with customers and providing them a truly great experience. Dan lives in Utah with his wife Shandy, and their two sons. I know Bruce Lipsig is in California. Dr. Lieberthal, are you in New York?

Dr. Bruce Lieberthal:

I’m in Patriots country.

Bill Neumann:

Oh, you’re Boston. We’re outside of Philadelphia. We’re in Eagles country, and it’s been an interesting season already. COVID aside, it’s been an interesting season. Well, thanks gentlemen for being here. What we decided to do is since you’ve you really representing different parts of Henry Schein, I think what we’d like to do is have Dr. Lieberthal talk a little bit about Henry Schein, Inc. We can have Dan talk about Henry Schein One, and then Bruce, you can follow up and talk a little bit about RealCloud Imaging.

Dr. Bruce Lieberthal:

Okay, sure. I’ll start. Henry Schein is obviously a very large company. We’re a fortune 250 company. There are many hundreds of business units here at the company. As you mentioned, almost all of them having to do with medical and dental. We’re globally, and I think something like 33 countries, we have 19,000 employees around the world. Again, most of those employees are in the individual business units, but there are a number of people, I’m one of them, who are in corporate roles, and we serve or service the various business units around the company.

Dr. Bruce Lieberthal:

My group, which is the innovation group, we’re a little different then, let’s say an innovation at J and J, or Google. Our role really is mostly to capture edgy new technologies from young companies mostly, that are quickly being developed in healthcare or technologies that could be applied to health care and figure out which are those that are the best fit for Henry Schein and our customers.

Dr. Bruce Lieberthal:

The best way to understand what we do is, we’re a virtual accelerator. We help those young companies and those products get to a place and a maturity, where one or more of Henry Schein’s business units can represent them in terms of marketing, sales, distribution of those products. We also have, and you mentioned the DDX, so I’ll just quickly talk about that. We do have a very cool skunkworks group of developers, believe it or not in Nova Scotia, Canada, who develop some very cool software that we utilize for many different purposes inside and outside the company, including our clear liners software, software that integrates very deeply with Henry Schein One software, which Dan will talk about in a moment. Helps communication between doctors and labs, and equipment in the digital dentistry space and a whole bunch of other things that group does. That’s Henry Schein, that’s innovations. Bruce and Dan pass it to you.

Bill Neumann:

All right, Dan, you’re up?

Dan Larsen:

Yeah. Maybe I’ll talk for just a second about Henry Schein One. Some people may know that Henry Schein One is a joint venture between Henry Schein and Internet Brands. Henry Schein One is really a lot of the software components practice management. Products like Dentrix, Easy Dental, Dentrix Enterprise, Dentrix Ascend, as well as products that came in from the joint venture on the Internet Brand side. Things like Demandforce, Officite, Dental plans, I think I mentioned that, Sesame. Also, not part of the JV, but an Internet Brands owned company is web MD, which most people are familiar with which creates some cool opportunities for us.

Dan Larsen:

Again, Henry Schein One is a joint venture between Henry Schein and Internet Brands. Our headquarters is in American Fork, Utah. I think we’ve got something like 500 employees in American Fork, which is pre COVID is where I would go to work every day. Now I’m at home like a lot of people, but yeah, I think we’ve got… It’s a global business. We’ve got customers in New Zealand, Australia and the UK, but headquarters in, American Fork, Utah. That’s a little bit about Henry Schein One

Bill Neumann:

Henry Schein One is a relatively young organization. It was spawned by that Internet Brands acquisition, and almost to pull out the technology that Henry Schein had, and separated, and focus on it.

Dan Larsen:

Yeah, exactly. The JV is relatively new. I should know this exactly, but I think we’re somewhere to two or three years. In terms of the Henry Schein team that’s in American Fork, is pretty mature. Because Dentrix was founded in Utah, that’s why we have so many team members that are here in the headquarters here. That’s where it started from.

Bill Neumann:

Yeah. Excellent. There seems to be there a lot of dental talent in Utah, a lot of dental companies, aside from Henry Schein, that whole area there. Was it Silicon slopes, they call it now?

Dan Larsen:

Exactly. Yeah. Pretty interesting,

Bill Neumann:

Great part of the country. All right, Bruce, so tell us a little bit about… Well, your background. Sounds like you spend time at Henry Schein Inc, and the Henry Schein One, and now you’re at RealCloud imaging. Well talk a little bit about that.

Bruce Lipsig:

I appreciate that. I’m an inventor at heart. I was part of an acquisition. We made our own imaging software in the year 1995. We called it Viper soft, and it did very well in the market. In the year 2000 Henry Schein acquired our company, and rebranded our product, Dentrix Image. We became the imaging component to Dentrix, which was a great place to be because you saw a lot of great technology, and you were able to then translate that and communicate that technology and be able to integrate that into the practice management software. Now we have 35,000, 40,000 practice management software users, or more. It’s a great place to be able to focus the abilities, to connect those users to imaging devices, and give them a better workflow experience, the better we can automate and integrate those products.

Bruce Lipsig:

In the year 2000, with that acquisition, we were all brought together as one division. Over the years, we spun off a couple of different divisions. Now, in the year 2000, we’ve come full circle. Now I have left Henry Schein to join RealCloud Imaging, which is an OEM imaging provider for Henry Schein One, and now we’re bringing all of those imaging products much more closely together with Henry shine One to create better solutions for the dentist. It’s pretty exciting time.

Bill Neumann:

Yeah. Excellent. Let’s talk a little bit about, and maybe it’s important, Dan, because I think this is really geared towards you and the two Bruce’s, so please feel free to chime in, but so you have Dentrix, and then you have Dentrix Ascend, and Dentrix Enterprise. Am I missing anything else there? You talked about Easy Den. Maybe the important, especially because our audience being… We have a lot of emerging groups, so I’ve got two or three locations, and then we’ve got the 800 locations, the big guys. Talk a little bit about the different solutions you have, and maybe where the different inflection points are from a number of locations.

Dan Larsen:

Yeah, absolutely. Dentrix, obviously is the product that most customers are familiar with. It’s our flagship product where we have the most practices using. It’s been around for a long time. The Dentrix enterprise product really came out of Dentrix, and was really targeted towards the enterprises. The larger practices, but around, I want to say like 2011 timeframe, we wanted to reinvent ourselves and think about what’s the system that’s going to take us into the next 20 years. That’s where we had this idea for Dentrix Ascend. We really from the beginning, wanted Ascend to be a multi-site product. That was the concept from the beginning, but we wanted to throw out the playbook, and start from scratch.

Dan Larsen:

I remember in the very early days, we didn’t have any customers. It was an idea on a whiteboard. I would cold call dental practices, and ask them if we could come out and just talk to them about, what is the practice management system and to 2020 look like to you? What does next generation mean? We did hundreds of interviews, some Dentrix customers, but a lot of other practices on different systems, because we wanted to reinvent ourselves. We saw some themes about wanting a natural user interface, is what we call it, which is basically translation for, they want something really easy to use. They wanted to automate as much as possible. We took all of these themes and started building the product. It was fun to go from this idea on a whiteboard and no customers, to fast forward now, and we’ve got tens of thousands of users on the system. Anyway, so it’s pretty fun.

Dan Larsen:

Ascend is built for solo practices, and also for multi-site practices. The key things we want and make it easy to use, access it from anywhere, have a lot of the tools built in so it feels like one solution rather than a bunch of bolt-on stuff you try to make work together in dental practice. That’s a little bit about Ascend.

Bill Neumann:

Excellent. Okay. Any other feedback there, Bruce or Bruce?

Bruce Lipsig:

No, I think Ascend is a major paradigm shift when we went to a web-based solution, a cloud-based solution, which is really the best way to handle such technology. It’s a way that most people are used to nowadays. A cloud-based product is the best way to handle especially in these COVID days where you’d like to be able to access your data from multiple different potential areas.

Dan Larsen:

Yeah. Maybe I’ll add one thing to that. Bruce, what you reminded me of is, when we first started building Ascend, we built it from the ground up. It has the same name as Dentrix, but it was a full rewrite from the ground up. A lot of people questioned whether that was the right strategy. Why not just take the existing Dentrix product and host it, and call it cloud? We took the more expensive, longer term, ground up, build it the right way for the browser, which was at that time was an interesting decision. I think there were a lot of questions about whether that was the right way to go or not.

Dr. Bruce Lieberthal:

It’s interesting you say that because, and I’m showing my age here, of course, but years and years ago, when the Dentrix, what we call Dentrix core now, which is the product that most people have, the Windows product. When that was brand new, Windows was brand new. This was mid 90s or maybe even earlier. Many of the products that were more implanted in the marketplace, and the dental software marketplace at the time, had been DaaS products, including product that I wrote. The path that most of them took was to port, or move over the exact functionality they had in DaaS into windows. That turned out to be a very bad strategy for a lot of reasons, but mostly because if you run a DaaS program inside of Windows, you can’t take advantage of what Windows was great at, all the new capabilities of Windows.

Dr. Bruce Lieberthal:

I won’t get too technical about that. Those companies, and those products are really not players anymore at all. In a sense, when you built Ascend with that same mindset of, if we really want to take advantage of what the cloud is great at, we can’t just pour it over a Windows product. It is the very much more difficult way of going. It took longer, it costs more. It’s all of that, but the reality is it produced a way better product. I think it pays dividends in the end.

Bruce Lipsig:

Yeah. The challenges were incredible. I remember the challenges of trying to acquire images in a browser when you need to talk to local drivers on local machines, and be able to talk to devices, having these challenges seemed almost insurmountable and took new thinking and new technology. I think Ascend, as Dan would probably agree, was also a good trial and testing ground for us because it was brand new. You could work on new ideas for workflows. At RealCloud Imaging, we actually had a breakthrough that we patented in conjunction with Dentrix Ascend. What we did, was we came up with an idea to automate the interaction between practice management and imaging, rather than just integrate the two. We automate them so that they work together better than they would work separately.

Bruce Lipsig:

One of the things we did was we created a way of acquiring images via CDT codes, right Dan? So that we have the ability to then know why we’re taking an x-ray, and as soon as the x-ray is taken, we can bi-directionally communicate to Dentrix Ascend and say, “That procedure has been completed. You can go ahead and the practice management software now and close that procedure, and update the ledger, and update re care and automatically attach those images to claims.”

Bruce Lipsig:

All of that bi-directional communication was all something we could start and look at freshly. We actually have some patents and some ideas surrounding the ability to bi-directionally communicate between the practice management and the imaging. It really created some great automation, and time-saving for the practice. Would you agree Dan?

Dan Larsen:

Yeah. Absolutely. I think we talked earlier a little bit about how we wanted everything to be included, and I think imaging solutions are in a lot of cases standalone and separate from practice management. But to your point, Bruce, with Ascend, one of the key things that I think we’ve really delivered on, is a reason customers like the product is, it’s all one solution. It functions as a single experience.

Bruce Lipsig:

Yeah, by having two separate programs, you can only be so close. By embedding things, you can really start to communicate better and automate the interaction between those two. That really does eliminate clicks, make things happen faster, make things happen in a more intuitive way. It was a great opportunity to reinvent all of this. I’ve seen a lot of major reinventions. I got involved in 1992, and we were doing intraoral cameras. At the same time we were doing cameras, I watched practice management software throw up from a pen and paper to a computer program. We watched intraoral cameras replaced mountaineers. Then from there we saw film get replaced by sensors. Today we’re watching impression material being replaced by intraoral scanners, and two dimensional imaging being replaced by three-dimensional imaging. Boy, we’re about to talk some great AI potential solution that Dentrix Ascend is currently piloting. I’ll let you talk about that. Maybe Bill you’d like to chew that up.

Bill Neumann:

Yeah. That was a good lead, and for sure that’s the next thing on the list is really to talk about AI, and I know it’s a buzz word that we all hear whether it’s inside a dentistry or just in everyday life now. It may be a little bit of a fear factor surrounding it when it comes to automating somebody’s job and to oblivion, but let’s focus on how it can help make practices, and whether it’s multi-site or solo is more efficient, create better outcomes for the patients. What does AI mean really to Henry Schein, and Henry Schein One, and then inside of Dentrix Ascend?

Dr. Bruce Lieberthal:

Yeah. Let me start us off. First of all you mentioned something really quick, and I won’t dwell on it, but AI is not the least bit new. In fact, I was researching a presentation about a year ago on AI, and was surprised that the time to learn that the concept of AI was actually created in a conference at Dartmouth university in 1956. The concept of computers thinking, having almost independent thought or doing things independent of the operator, which is essentially maybe one of the ways you can describe it, has been something that’s been around for quite some time. In fact, those who were old enough, again, we’ll remember, I think it was in 1968, there was this breakthrough film, 2001 A Space Odyssey where the Hal 9,000, that red blinking eyes took over the spaceship, and ejected the astronauts. The guy named Dave, if you recall.

Dr. Bruce Lieberthal:

The fear of AI, and the promise of AI are not new. What’s different now I think is what people ask all the time. Why do we actually see AI happening? It is all around us, anybody who has an Alexa or Google home device in their house, or uses smart home stuff, knows that AI is definitely here to stay. The difference today is that technology is caught up with the dream. That’s why AI is having an impact today. For healthcare, there’s enormous potential. We’re going to talk about, I think one of them, especially today, which is this pilot that actually that just lifted off, but the whole aspect of what in medicine is called clinical decision support, or the use of AI enabled software to assist healthcare professionals make better decisions.

Dr. Bruce Lieberthal:

It’s not making the decisions, it’s helping them make decisions in terms of diagnostics and treatment plan design and the actual in certain cases, in terms of robotics, the execution of those treatment plans is really here right now. We think it’s an amazing opportunity for our company, and more importantly for our customers, doctors and dental professionals, and their patients to open up the vista of that world right now, and we see enormous potential. I wonder, Bruce or Dan, or both of you, if you may want to just sort of describe what are we doing?

Bruce Lipsig:

Well, Dan, I pick a little guess at that first to try to describe best how this pilot is rolling out and what we’re trying to accomplish, and what it could lead to for the future as we move forward. Maybe Dan will outline the actual details of the Dentrix Ascend AI pilot, that we just started. When we got together and we started looking at AI, we looked at different companies that were developing AI engines. One of the first things that became clear, especially to Dr. Lieberthal was that it doesn’t seem like there will be any one particular company that will be able to do everything. There are so many different opportunities with AI that some companies were focusing in one direction and doing a great job. Other companies were focusing in another direction and still doing a great job.

Bruce Lipsig:

All of these things could be connected to our incredible wealth of data through the plumbing that we’re currently building through Henry Schein One. What we’re doing is we’re giving ourselves the ability to tap into the data that is held in Henry Schein One. The imaging data and the demographic data, as far as the patient information. If you can put that together, it can be so much more powerful knowing if it’s a man or a woman when you look at that x-ray. Knowing that they live near the river or near the Lake. Knowing the demographic information. Knowing only how old they are, how young they are, all of that can then correlate into the images and the viewing of those images to help us look forward and do something I like to look at called predictive dentistry. To be able to look forward and see things that are starting to progress, and then help to identify them, and then point them out and hopefully strategically work with them so that we can have the best outcomes.

Bruce Lipsig:

That is the multiple different directions that AI could go. The amount of data that we have in our cloud-based solution, we’re capturing 10 million images a month, and putting all that data in a big old data vault that we can then mine and learn from. With that, we created the plumbing and we’ve created all of the architecture needed to start plugging in these different AI engines. I’ll probably turn that over to Dan to tell a little bit more about how Dentrix Ascend will make use of this pilot and be able to judge these different technologies, Dan.

Dan Larsen:

Yeah. I think that’s exactly right. To me, what’s exciting, earlier, we talked about wanting to have a single user experience. Pulling in this technology into Dentrix Ascend so it just feels like one solution, I think is big as our long-term goal. Bruce mentioned learning, which I think is the part I’m most excited about with this whole thing. I wanted to share a story. When I was in college, I had a public speaking class. We were supposed to speak on a topic, whatever we wanted to talk about. I talked about this technology. This has maybe like 2009, and there was a technology called Google Wave. Do you guys remember? Do you remember Google wave? It was a product that, Google used to do these long betas, like Gmail was in beta for like 10 years or something.

Dan Larsen:

They would do these long betas, and they had this product called Wave. Again, I think it came out around 2009. I gave this presentation in college about how Google Wave is going to be the next thing. In five years, everyone will be using it, and I was dead wrong because no one’s heard of Google Wave. But what was interesting about that, the underlying technology was the ability for two people in a web browser to collaborate on a document at the same time. If you think about Google Sheets and Docs, and all of this capabilities to work on one thing at the same time. That’s survived, and that was incredibly valuable. I think for me, what’s exciting is I don’t know exactly what form the AI technology and imaging, exactly what it’s going to look like.

Dan Larsen:

But I think we have a good idea about the areas where it’s going to be valuable, and the use cases exactly how it ends up working is I think what’s in front of us. In the grand scheme of things, Bruce mentioned that this concept of AI has been around since the 50s. It’s took a long time to come to fruition, I think in some cases, but now I think, what is the exciting part where we get to learn, how can this technology that’s now real, how does that actually get applied in dentistry and in other verticals? I’m excited about… These next few years are going to be fun.

Bill Neumann:

What is AI like currently, what is being used in dentistry? First of what’s the learning curve? If I’m a provider, is this something that is relatively easy to understand, or if I’m an office manager working with Ascend or whoever’s… Tell me a little bit about that. It’ll just be interesting to see what’s really applicable now. Maybe we talk a little bit about how that affects multi-sites. Maybe let’s say what’s going on now with solos? Is there a way that maybe there’s different AI that can even be more impactful for somebody that has 10, 20, 100 locations?

Dr. Bruce Lieberthal:

Well, I think first of all, AI shouldn’t scare anybody. There aren’t computers that are suddenly going to take over the world. It’s also any software that’s too difficult to use AI or otherwise is really poorly formed software, in my opinion. Software should be a tool and it should be an assistant. It shouldn’t be a chore or work. I wonder if we might want to, guys, talk about what we’re doing specifically as a great example of how AI can have really practical importance in dental care. The three of us, and obviously many other people in the dental world, have been talking about AI for many years. What’s exciting now I think with this project that we’ll describe for you is, this is a project that I think we won’t have a hard time explaining to people what the benefit and the value is.

Dr. Bruce Lieberthal:

It should be, I think, pretty obvious and straightforward what the value is. This is where AI has great potential. Maybe I’ll just kick it off, and then the guys will join in with me. What we’ve done is, we’ve found a really brilliant software companies, four or five of them actually, who have been able to create a branch of AI software often called Computer Vision. This is the concept of using software to look at, read if you will, images. In this particular case, these images are largely radiographic images. What it does when it reads those images is very quickly, it can look for and find pathology.

Dr. Bruce Lieberthal:

This can be caries, it can be periodontal disease, it could be periapical lesions, it could be other types of pathology. We can certainly talk, guys, if we have time and we want, about how AI software gets smart in this particular example, because some of that is actually fairly mundane about how you teach the software in a sense, what it knows and what it can do.

Dr. Bruce Lieberthal:

I think Bruce and Dan can describe that, that’s largely experiential. Essentially, the software is able to look at a radiograph and very quickly find where the lesions are. This all kinds of practical use to that software. The fact that it can assist the dental professional in locating that, and help the patient see better as the dental professional is trying to explain that pathology to the patient, is really pretty wonderful. What Bruce and Dan were talking about in terms of the cloud, it fits here exactly as well, because without the cloud, you can’t do this. Why can’t you do it? Because the smarts in the AI software that’s reading that radiograph is actually not local to the user. It’s a server with the software somewhere else.

Dr. Bruce Lieberthal:

What’s happening is, data from these images, and by the way, this is very secure, all HIPAA compliant. Data from those images is being almost instantly pushed up to the cloud, analyzed and brought back down. What the user will see is, little circles and indications of here’s some caries, here’s a periapical lesion, and so on and so forth. But this is a truly wonderful advance in software, and only available in the very recent past. This is brand new stuff. Maybe have Bruce or Dan describe, since we’re not the creators of this particular software, what have we done to provide real value to this software?

Bill Neumann:

Dan, you want to start there?

Dan Larsen:

Yeah, I’ll take that one. I think it’s similar to what we talked about with 2D imaging. We’re bringing the technology closer to where the user is spending most of their time. Bruce Lipsig mentioned, we have all these images that can be helpful in the learning and the teaching of the algorithm. But I think where we bring the value is, we have a lot of practice management software users. Bringing that technology to them, to a place where it’s convenient, is where we can add a ton of value for the practices. If you were to try to run these today, standalone, there’s a lot of steps between the dentist and getting those results.

Dan Larsen:

But I think what we can do with integrations and partnerships is bring that closer to them. Bruce mentioned that a tool that’s difficult to use is not well created. I think that ease of use is a key part and where we can really add a lot of value. What do you think Bruce?

Bruce Lipsig:

Dan, you actually put that really well. Bringing the information to where the doctor really needs to see it. If you have an imaging product and you have a couple of marks on it, that’s really great, but then you need to be able to bring that information into your treatment planning software and plan what you’re going to do with it. If it’s available on the dashboard right there in your practice management, that’s where those decisions can help to be made and then can be executed from there. I think that is probably the first step. People have looked at that like a bit of a second opinion, a bit of an assistance software, or helping them to focus on little areas. But I look at it one step further with the practice management in that, if we can not analyze the image on the screen, but analyze the images in the doctor’s database. We can see things a couple of years ago, a couple of months ago, a couple of days ago, that maybe the doctor wasn’t looking for at that time.

Bruce Lipsig:

Patient comes in complaining about sensitivity in one area, doctor takes an x-ray and looks at that area. Maybe there are other things going on in a new patient that he hasn’t even had a chance to look for yet, or could have some assistance as far as something screening the rest of the mouth to be able to then treatment plan and create other potential treatments that could be done for that patient to help them have better oral care, that maybe weren’t seen on a first visit or on a first evaluation.

Bruce Lipsig:

I know we’ve actually discussed looking at x-rays, and then populating a chart with the original dentition of how that case comes in the door at that point, so you know a starting point. But you can also use that same technology to look through all of the images that currently exist, and find certain pathologies or certain things that are starting to progress, and then put together a small dashboard in the practice management, as Dan said, where that information is most important. Have a customer be alerted to the fact that your new patient has a slight watch that we put on number six, because we see a potential loss there, potential Caries developing.

Bruce Lipsig:

Now it’s in the practice management software, not just in the imaging software, it comes up on the patient’s chart on their next visit, and we can discuss and proactively look at these things. That’s why it’s so important to have that interaction with the practice management software, which is really what’s running the practice. I think Dan, you and I talked about this practice management without imaging really doesn’t run your practice. The things you can do when you tie them together, really need to be brought back into the practice management because that’s where those things are seen and executed, and planned.

Dan Larsen:

I wonder if I could just build on that on what you just said a little bit, which is if we open our minds a little bit, one of the values of having this inside the practice management software, is that’s where all the images are resident. We can build workflows between the practice software and this AI imaging software. For instance, we can ask the imaging software to look through the entire library of images in a practice quickly, and determine where are the untreated planned, unscheduled work and find that, and then maybe deliver that information to outgoing patient marketing tools that are also part of the practice software so that we can help the practice take this amazing amount of data which is great because this is treatment productivity that’s sitting in your patient database, and get that information to outbound marketing tools that are in the practice software to reach out to the patients and try to get them scheduled, and track that information in an automated fashion. This is real power for the practice that we just never were able to deliver previously.

Dr. Bruce Lieberthal:

Yeah, I think maybe one last thing I’ll add to that is, with the multi-site practices in particular, as we’ve been talking about this technology. One of the things that I’ve heard over and over is, as a multi-site practice wanting to compare your doctors, because I think that at the end of the day, this is all about the patient. You don’t want to have doctors who are under diagnosing. You also don’t want to have doctors over-diagnosing. As a multi-site or a DSO, having this tool that’s unbiased, that’s able to benchmark and understand dentists diagnosis of different conditions compared to each other based on data is really, also I think, an interesting use case that refer to a lot about from DSO practices.

Bill Neumann:

Yeah. That’s a good point Dan. It’s like a neutral third party that’s just giving an opinion from a computer’s point of view.

Dr. Bruce Lieberthal:

Yeah.

Bill Neumann:

You get a baseline. Very good point.

Dan Larsen:

I think, and again, this is just so many different use cases to this technology. Another one would be the potential to adjudicate claims much faster in certain cases than we were able to do today. As every dental professional knows, certain types of treatment, let’s say endo for instance often is accompanied by in these days, a digital radiograph. But very often there are people, some of the times dentists, who are looking at those one by one and determining if the claim can be adjudicated. This takes time. If however, the AI software were engineered to look at those radiographs, and adjudicate them pretty much instantaneously in real time, then it’s really possible that we get to a place that we’d been looking to get to for many years, decades actually, which is adjudicating claims pretty much in real time. This also closes the revenue loop for the doctor in a really substantial way.

Bill Neumann:

Just to come back to the point earlier I think about, Dr. Lieberthal you mentioned it, but I thought I’d get through this podcast without mentioning COVID, but as we lost at least a couple of months of production. I think to your point about a lot of this undiagnosed treatment that’s there, that you can actually look at. The fact that it’s there, the AI is in the practice management software, and then can connect and actually throughout bound marketing, communicate with the patients. I think that could be invaluable now, especially when everybody’s trying to get back to where they were or where they thought they’d be. They’re going to need to be creative. Getting new patients isn’t the answer, it’s what can you do with what you already have?

Dr. Bruce Lieberthal:

One interesting statistic that Dan, Bruce and I have heard over and again from people who study this stuff, is that 30% of the caries that are in radiographs, somewhere 30% or North of that, guys, you can correct me, it goes undiagnosed. I think if we go back again to this use case of looking through the whole library of images, that is a product production in the bank, if you will, for the practice, and very important. Also, important obviously from a patient health perspective. It’s really all upside for this technology. Again, it’s not making decisions, it’s helping the doctor make better decisions, and maybe more quickly and more easily.

Bill Neumann:

Good. I’ve got one last thing here to ask you all, and this is always gets your crystal ball out and give us an idea of where do you think AI is headed? I’m sure Dr. Lieberthal, you’re talking to a lot of different people, and working with a lot of different companies, maybe even outside of Henry Schein. You might have some insights, but I’m going to ask Bruce Lipsig first, and then we’ll go to Dan, and then Dr. Lieberthal you can finish up if that’s okay?

Dr. Bruce Lieberthal:

Of course.

Bruce Lipsig:

That sounds great. I’m a bit of a dreamer. I’m a bit of a visionary, and I like to see the potential for AI to create better patient care. I think better patient care can come back to better health, as well as lowering healthcare costs. Imagine if we can predictably see things that are changing in the mouth, and address them earlier rather than later, so that they have less costs and better healthcare for the patient. I’m a dreamer. I see better patient care as the future. I see a lot of revenue recognition opportunities. I think that they’re important, and I’m sure that the revenue recognition will be great, but the actual better patient care is where I see things going, and that’s where I’d like to help them get.

Bill Neumann:

Excellent. Thanks Bruce. Dan?

Dan Larsen:

Yeah. I agree with Bruce. I think that, maybe going back to something that was mentioned earlier about some team members maybe being concerned about their jobs, and things being automated way. I’ve heard that in other industries as well. Is that a concern longterm? I don’t see it that way. I see really, that there are so many inefficiencies today that can be solved that will allow the dental practice team members to focus on the relationship with a patient, and to put their time there. At the end of the day, it’s that relationship, it’s the patient care that is the reason that they come back. I think the technology is just going to help facilitate that, and improve that. That’s where I see it heading.

Dan Larsen:

I think there are other applications of AI, and machine learning automation, things like chatbots on websites and helping patients get booked online, and patient communication tools. We see examples of those things already say. I see those continuing to improve. But like Bruce said, I think at the end of the day, it’s better experience for the patient more efficiency for the practice.

Bill Neumann:

Excellent. Dr. Lieberthal I’ll let you have that final word.

Dr. Bruce Lieberthal:

It’s completely unfair that I had to go last because these two geniuses said everything. The only thing I would add maybe, it’s just one more a use case that I would stick in there and that’s for implants. The ability for AI software like this to look at a set of records, including radiographs, but not limited to those obviously, and be able to determine which patients in your database would be great candidates for it, and of those who would be great candidates. Here are maybe two or three different case designs that you can look at. If you go to this particular case design, maybe the patient needs a sinus lift or something. It might be best if you use this particular type of implant, and this length of implant, the vistas out here in terms of what this technology can do, again, as an aid to the practice are enormous.

Dr. Bruce Lieberthal:

I agree completely with my colleagues that this doesn’t make the dentist less valuable, through automation, it makes you infinitely more valuable. We’re catching treatment that’s needed to happen earlier, and more often. We are opening up new types of procedures that never would be able to be done before. We’re improving people’s health care and reducing costs, and fraud and all the rest of these things. It’s really all upside, and this is just great news that we’re excited to bring.

Bill Neumann:

Excellent. Well, thanks gentlemen. I really appreciate the education. We’ve got an education, not just on AI and Dentrix Ascend, but also Henry Schein, Henry Schein One and RealCloud Imaging and how you all work together. I’d like to thank Dr. Bruce Lieberthal, Bruce Lipsig, and Dan Larson for being on the Group Dentistry Now Show. I’m Bill Neumann until next time. Thanks everyone.