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Two large DSOs and an award-winning dental AI company, Overjet, join our audio-only podcast to discuss how AI is revolutionizing dentistry and where it will take the DSO industry in the future. This fascinating and information-packed podcast dives into the clinical and nonclinical applications for AI and how it benefits payor, provider and patients alike. The data insights and diagnostic uses are beyond exciting as AI has the ability to propel dentists into becoming even better clinicians. If you want to understand how AI is transforming dentistry, this audio-only podcast is for you!
In recognition of Overjet’s achievements in pioneering AI-driven dentistry to improve oral health for everyone, CB Insights recently named Overjet on their List of 100 Most Innovative Artificial Intelligence Startups in the World that are redefining industries — the first time ever a company in dentistry was included on their annual AI 100.
It’s been a year of rapid growth for Overjet since the company came out of stealth in 2020 with the launch of powerful dental AI software and financing from VCs that included Crosslink Capital and the MIT-affiliated E14 Fund. Built upon multiple cutting-edge computational dentistry and AI techniques pioneered by Overjet over two years of extensive R&D, Overjet’s clinical and claim intelligence platforms are already being used by some of the largest dental customers in the nation.
Founded by PhDs and leading experts from MIT and the Harvard School of Dental Medicine, Overjet has assembled the largest and most seasoned team of technologists and domain experts with deep AI, dental and insurance experience. Overjet’s leadership team includes Dr. Wardah Inam, PhD, CEO and cofounder; Dr. Robert Faiella, DDS, chief dental officer and former president of the American Dental Association; Deepak Ramaswamy, PhD, CTO and former Amazon executive; Dr. Chris Balaban, DMD, clinical director; and Shaju Puthussery, COO and former chief analytics officer at DentaQuest, the largest Medicaid dental benefits provider.
Our podcast series brings you dental support and emerging dental group practice analysis, conversation, trends, news and events. Listen to leaders in the DSO and emerging dental group space talk about their challenges, successes, and the future of group dentistry.
The Group Dentistry Now Show: The Voice of the DSO Industry has listeners across North & South America, Africa, Australia, Europe, and Asia. If you like our show, click here to leave a ⭐⭐⭐⭐⭐ 5-star review.
Choose your favorite listening app below and subscribe today so you don’t miss an episode! Full transcript is also provided below.Choose your favorite listening app below and subscribe today so you don’t miss an episode! Full transcript is also provided below.
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Full Transcript:
Bill Neumann:
Hey, I’d like to welcome everybody to the Group Dentistry Now show. I’m Bill Neumann. And we appreciate you listening in on your favorite listening platforms, whether it’s Apple or Google or Spotify. Actually, you can listen to us on YouTube as well. And there’s probably another seven or eight platforms that we’re on. So anywhere you want to listen, you can listen to us.
Bill Neumann:
We’ve got three guests today. We’re going to have a panel discussion on all things dental AI, and how it relates the dental industry and DSOs. So I’d like to introduce first off, Dr. Wardah Inam. She is the CEO and Co-founder of Overjet AI. So, Wardah, thanks for being here today.
Dr. Wardah Inam:
Thank you, Bill.
Bill Neumann:
And next up, we have Mitch Olan. He is the Executive Chairman of DCA, Dental Care Alliance. Thanks, Mitch for being here.
Mitch Olan:
My pleasure. Thanks for having me.
Bill Neumann:
And we have Dr. Seth Gibree. He is the Senior Director of Clinical Advocacy for Heartland Dental. Welcome, Seth.
Dr. Seth Gibree:
Thanks for having me. Appreciate it, Bill.
Bill Neumann:
So let me just run through some quick bios here and then we’ll get into the panel discussion. So let’s start with Wardah. She is again, the CEO and also the Co-founder of Overjet, which is a technology company that has pioneered the use of dental artificial intelligence for payers and providers. Before founding Overjet, Wardah was a product lead at Q bio, a health technology company using AI to detect disease early.
Bill Neumann:
She completed her postdoctoral work at MIT’s Computer Science and Artificial Intelligence Lab and has her PhD from MIT in electrical engineering and computer science. Overjet, and we’ll talk about Overjet in more detail, was recently named one of the most innovative startups in the AI world that are redefining industries by CB Insights. So again, Wardah, thanks for being here. Next up is Mitch.
Bill Neumann:
Mitch has over 27 years experience in the DSO space. He is currently the Executive Chairman at Dental Care Alliance. Before becoming the Executive Chairman, Mitch was the CEO at DCA for six years. And then prior to that, he had 18 years as the COO.
Bill Neumann:
He joined Dr. Steve Matzkin in 1994 to form Dental Care Alliance, which has grown into one of the oldest and the largest DSOs in the country, with over 325 locations across 21 states. And prior to that, Mitch actually was on the manufacturing side in the orthodontic industry with Ormco. That’s something I didn’t know, Mitch.
Bill Neumann:
And we have Dr. Seth Gibree. Dr. Seth Gibree is the Senior Director of Clinical Advocacy for Heartland Dental. As the Clinical Advocacy Director, he has a daily focus on supporting doctors and their teams, primarily around strategic planning, AI, and machine learning. Prior to his time with Heartland Dental, Dr. Gibree started and owned multiple multidisciplinary dental practices.
Bill Neumann:
Seth’s values are deeply rooted in faith, family, and community. He is a key opinion leader and industry expert with 20 plus years of experience, with expertise in strategy, communication, emerging technology, leading change, and organizational development. He has also served on the Editorial Advisory Board of Dentaltown Magazine since 2009.
Bill Neumann:
Big resumes everybody has. So again, thanks, everybody for being here. I know that those are really, some well credentialed individuals in the DSO space and also the dental AI industry, but it’s important for everybody to get to know the team. So let’s get into the panel discussion here. We’re going to start off with Wardah.
Bill Neumann:
Can you set this stage a little bit? Let’s talk about dental AI, and then its impact in the DSO space. And Wardah and I were talking a little bit off before we started the record about just some of the impressions that the industry has and people have. But Wardah, the floor is yours.
Dr. Wardah Inam:
Thank you, Bill. And thank you, everyone, for listening. We’ll be talking about dental artificial intelligence here. And the first question of what is dental artificial intelligence, it’s software that encodes dentist level understanding of disease identification and progression into models. And these models are precise, bias-free and scalable.
Dr. Wardah Inam:
So these models interpret dental data similar to a dentist, but much faster. So for example, you can process all the data in a practice in minutes. Identifying bone loss, caries, infractions, calculus on every tooth for every patient in a practice. So this would have taken a dentist months to do.
Dr. Wardah Inam:
And that enables amazing abilities for DSOs to support their affiliated practices, and provide them abilities that you’ve not had before in processing data and analyzing data. Similar to dentists, but much faster, and being able to analyze vast amounts of data very, very quickly.
Bill Neumann:
Let’s talk a little bit about what you’re seeing in the DSO space. So, Wardah, I’d like to get your impressions. And then I’d love to talk to both Seth and Mitch a little bit about what they’re seeing, and the impact early on with dental AI.
Dr. Wardah Inam:
The great thing about DSOs is that they have been always at the forefront of adopting technology. And that has changed dentistry as well. Dentistry was known to be an industry which was slower to adopt technology. But when it comes to DSOs, there has been this adoption of technology at a level that we have not seen before, in order to support their affiliated practices, to perform better as well as in order to provide better care to the patients as well.
Dr. Wardah Inam:
So this is one of the technologies that we see that DSOs are adopting in order to support the practices. And here, we’re seeing four trends that we also mentioned in the article. And number one is practice analysis and affiliations. That means being able to affiliate practices, while looking at all the practice data in a way that has not been possible before. Basically, previously, we were looking at only the business data. Now, you have the ability to look at the clinical data as well.
Dr. Wardah Inam:
Second is looking at all the chart reviews. So not only are you utilizing a few number of charts from a particular patient or a provider, now you have this ability to look at every chart of every patient, and every radiograph that has been taken, and being able to identify trends that might be helpful. Third, looking at performance and performance enhancement, whether it is the diagnosis and how that has become more evidence-based. But also, having tools provided to the practices for better visualizations, so that you can actually communicate better with the patients as well.
Dr. Wardah Inam:
And lastly, which is an interesting topic that we didn’t look at early on, which is specialty referrals. So giving the ability to general dentists to not only look at treatments and procedures that they might have done in the past, but also look at more specialty procedures, whether they want to do it in-house or to outside as well. And giving them the ability, whether it’s ortho or anterior. And that is some of the things that are happening now.
Dr. Wardah Inam:
In the future, we’re excited about is being able to screen for medical conditions as well automatically. So these are some of the things that we’re excited about. We’re seeing some of the DSOs look into as well. And I’ll let the others add if they have something to add there.
Bill Neumann:
Dr. Inam, I believe that you and Dr. Gibree and Mitch Olin recently co-wrote an article in compendium with a number of other DSO leaders. You really talk about the impacts, so I’d love to … Maybe Seth, you can talk a little bit about that and what you wrote in the article. And I’d love to hear what you’re seeing right now and how you’re using dental AI.
Dr. Seth Gibree:
Well, I appreciate the question and the time. I think it’s important to remember that what we do, especially at Heartland as a DSO, our goal is to be a world-class company and the leader in dentistry is that we wake up every day trying to figure out how we can support doctors and their teams as they deliver high-quality dental care to their communities.
Dr. Seth Gibree:
And so looking at technology, you have to look at it with an open mind on, how does this help doctors and their teams help their patients to achieve a higher level of clinical care and consistency? And so I think looking at the potential of what AI can bring, as Wardah was talking, the ability to analyze and to really dive into details that as a doctor, is really hard to stay focused on all those things.
Dr. Seth Gibree:
As a doctor, I need to be focused on that patient in front of me and making sure they have the care that they need, and the best thing that I can do. And so, how can we support them utilizing technology to do that better? And I think she hit on so many wonderful points. Even the last one she was talking about, specialty referrals, I think of ortho cases and how in my career as a practitioner, how the more cases I saw, then the more I learned. Okay.
Dr. Seth Gibree:
In this case, we need to do some interceptive ortho, or I need to refer this to an orthodontist. I’m not there. My skillset isn’t comfortable handling it as well as an orthodontist. And so being able to evaluate cases on an early basis in almost red light, yellow light, green light, so to speak, on what the difficulty of those cases are and say, “Okay, this case is a great case for aligners, fairly straightforward, there’s not a ton of movement, this case is a more complex case,” and having AI support.
Dr. Seth Gibree:
When you refer and when you don’t, depending on your practice level and where you’re at as a clinician, I think is so important. So, that’s just one example of numerous ones where the technology has the potential to help from a business tool case, but also from a clinical use case. Now, I think, as a dentist, you start freaking out a little bit in that it’s a Big Brother is going to watch. And I think it’s trying to flip that mindset and say, “Okay, how can we support doctors make the best decisions for their patients in a unbiased way,” as Wardah was talking about.
Bill Neumann:
That’s a great point about Big Brother, Seth. I’d love to maybe talk to you about that in a little bit more detail. But, Mitch, why don’t you talk a little bit about thoughts on artificial intelligence and how DCA is using it?
Mitch Olan:
Yeah, it’s something that can be used in so many different ways. From a business development standpoint, from a clinical management, mentoring, auditing standpoint, from an operational data standpoint, from a business development standpoint, every DSO has its own approach to assess the risk and value and potential for each practice affiliate. But one common objective is to understand prior treatment norms, trends, outliers, so on and so forth.
Mitch Olan:
Traditionally, during a prospective affiliation, most DSOs take a small sample of patient charts to understand the existing standard of care and the attributes of the patient population. What dental AI really provides is it unlocks the ability to complete this review in detail for every patient of the practice. This means that every radiograph, and actually every chart node can be analyzed. And it provides a detailed database to support clinical and business decisions on affiliation.
Mitch Olan:
Do we move forward? How do we move forward? So that you’re finding affiliates that blend basically, into your organization a lot smoother, a lot cleaner. Philosophically, they’re in the same ballpark. Culturally, they’re in the same ballpark. And it makes for a much better win-win for the affiliate, as well as the DSO. There’s other areas that I mentioned, in terms of clinical. And really, our affiliated clinical directors are very excited about the ability to use this tool for audits, for training, for mentoring. We currently have full-time auditors.
Mitch Olan:
And so when you talk about Big Brother watching, Big Brother in most DSOs is already watching to some degree. But they’re taking a very limited sample. And with artificial intelligence, what that provides us with is the ability to take a much broader sample of actually the entire database of patients that a doctor is working on, and show them how they’re comparing against hundreds of thousands of other patients and doctors and cases out there, to see where there might be an outlier, where they’re trending, how they stack up.
Mitch Olan:
It’s a tremendous learning tool, and something that doctors shouldn’t be afraid of, they shouldn’t be intimidated by. They should embrace this as a phenomenal learning tool. And from an operational standpoint, it helps us from the ability to work with our teams to help better support the doctors, with integration for new affiliations, with support with the existing docs and what they want to try to accomplish when they go through with their clinical directors, and how we can better support them to accomplish their goals.
Bill Neumann:
Excellent. Yeah, that’s a great point. That was one of my points, I guess, with Seth is the Big Brother aspect, or at least that perception. But Mitch, you touched on it. It shouldn’t be necessarily looked at, at that way. It can be looked at really as an opportunity, as a training tool, a mentorship tool. If somebody, a clinician maybe is struggling, that this can be used to really help engage them and find out where they’re struggling, and help them out.
Mitch Olan:
That’s right. It could also help them, too, when they see what they might be diagnosing quite a bit, but they’re not getting the type of treatment acceptance that their colleagues are getting, because they don’t have the same communication skills.
Mitch Olan:
And so what dental AI also helps with is a presentation tool for the doctors to use when presenting to the patients, and to give the patients greater confidence with the diagnosis. And the doctor has a much broader database to share with the patients as to what’s going on in the patient’s mouth, as compared to these 10,000, 100,000, 200,000 other cases that have been diagnosed in the system.
Bill Neumann:
Great points. Wardah, this is really talking about some key opportunities within AI, right? So there’s a lot of different ways it can be used. What are you finding the majority when a DSO or an emerging group decides they want to get involved with AI and work with Overjet? Is there a first step? Is there an area of focus right away? What are you seeing?
Dr. Wardah Inam:
For us, depending on the size of the practice or the DSO, so if it’s 50 and above, we see them adopting the chart review first. If it’s 50 or below, we see them adopting the practice tools first. So it depends on what their objectives are and what they’re trying to achieve. As Mitch mentioned, if you have a large practice, being able to ensure quality compliance across the practice is hard.
Dr. Wardah Inam:
That means you’ll have a significant amount of people looking at the data and trying to ensure that the right care is getting delivered, as well as supporting the dentists in any other way that they might need as well. So not only is it just to look at things that might be going wrong, but actually what we find is the other way around. Now, you can actually finally see what in your practice is actually going right, and being able to learn from the learnings.
Dr. Wardah Inam:
And a lot of the dentists are very surprised when we tell them that on these metrics, you’re actually doing so much better than 80% of the other practices. And for them, they’ve never seen that before, compared against other practices as well. And it’s a way for them to not only have areas of improvement, but also know where they’re really shining as well. And have that kind of complete comprehensive view of their performances, as well as all the practices that are in the network as well.
Dr. Wardah Inam:
So from our point of view, when we look at a chart review, not only are we looking at what has been completed, but also what has been treatment-planned and what has actually been treated. And that way, we can highlight things that are not being done, or should be looked into. And those things are something that at the managerial level, you can look at all your practices and help identify and drill down on what areas of improvement that need to be there. And help us for the dentist as well.
Dr. Wardah Inam:
And on the other side, on the practice level, that is more to what Mitch mentioned regarding communication. So better patient experience, better communication with the patient. So the patients are more informed to make the right decision for themselves by looking at better visualizations. So when a dentist points at a green, white or black image, the patients don’t see a lot. Apart from say, them recognizing a tooth, there’s not a lot that they can recognize in that image.
Dr. Wardah Inam:
And on top of that, if you add periodontal disease and carious, lesions, and calculus, that’s a lot of information that is being provided to the patient. And having the presentation layer or the output visualizations really help the dentist to point to that X-ray and especially to those visualizations, and that brings the condition to life for the patient, and make them better understand. So those are the two areas that we’re seeing, depending on the size of the practice of what’s being adopted first. But in both cases, it is going from one to the other.
Dr. Wardah Inam:
And the more that then just utilize the technology, the more they see how useful it is. And I think all the fears, et cetera that they might have, go away very quickly. So for us, it is about showing the technology, and I think that’s what helps people understand it. And then when they utilize it in their practices, I think we’ve not had a single practice that’s not been shocked at their numbers, the good and the bad, and being able to say, “Okay, how can I do better? And how can I take pride in what I’m doing really good as well?”
Bill Neumann:
Thanks, Wardah. Dr. Gibree, I’d love to get a little perspective, clinically. Maybe talk a little bit about Heartland and how you started things off with dental AI, and maybe how you’re using it right now.
Dr. Seth Gibree:
As a clinician, what excites me is the stuff that Wardah and Mitch were just talking about. How can I help my patient receive the care that I believe that they need? Because I’m not diagnosing this if I don’t think it’s in their best interest to get it done. And so having a third party support that basically, somewhat, you have an independent variable that’s there to help communicate to the patient and help them understand it at a higher level. It’s funny how many times as a doctor, we tend to want to draw pictures and over explain.
Dr. Seth Gibree:
And we know so much about dentistry, and I think sometimes we get so excited to share it, and we overwhelm people. And so I think having that access to almost like a third party validation, and to be able to help people make the best decision for their healthcare is so important. And even taking it a step further, before I dive into the Heartland question, because I’ll make sure I get that for you, even taking it a step further, having the ability to compare, say, I’m 46 years old, my 46 year-old mouth with the medicines I’m on, to other people that fit my same demographics of healthcare.
Dr. Seth Gibree:
And so, what’s the best decision for the longterm health of my mouth? Is it going down a preventive nature based on what scene is it? Is it maybe some interceptive stuff early? That there’s actually the ability to take so much information and dial it down into predictable care is what is super exciting for me. And the other thing is reducing liability. We’re talking about chart audits earlier and I think part of it, too, is helping the doctor say, “Okay, we don’t have a medical history update for this patient.”
Dr. Seth Gibree:
And being able to make sure that stuff is done. Or thinking about how much over the years, how much time my team has spent on chart preps in the morning for our morning huddles and saying, “Well, this patient has this, they don’t have a future hygiene appointment for their family member,” all that stuff can be automated. Even to say, how much having AI be able to review X-rays and say, “Oh, there was actually a class II lesion on number 14 that we didn’t really talk about last time.”
Dr. Seth Gibree:
So being able to analyze what edentulous spaces are there, and is it potential for implants based on their bone levels, based on their medical history? Is it the proportion of class II and class II carious lesions that haven’t been treated that need to be treated? What’s the periodontal health and predictability of the population? What percentage of teeth are posterior teeth that contain amalgam that are huge?
Dr. Seth Gibree:
And so how old are those? Is that something we need to really look at, to make sure these teeth aren’t starting to crack and split? Especially because people are more stressed during COVID times. I get excited when I think about the ability of this in the diagnostic patient communication, patient treatment realm. It makes me super excited. Within Heartland, I’ll go back to what I even said before, is we wake up every day figuring out how we can better support doctors and their teams to help them deliver care to their patients.
Dr. Seth Gibree:
And so that clinical relationship is so important that that lies at the local level between the doctor and the patient. And that’s why we’re a dental support organization. We’re supporting them however we can for the non-clinical stuff. And part of AI that’s exciting is it can help them as they desire they want to use it, to be able to clinically help their patients at a higher level. And so with us, with the adoption, yes, we talk about AI and a lot of people think about certain specifics. But AI covers a wide, wide spectrum of business tools, clinical tools.
Dr. Seth Gibree:
And there are some really exciting things coming down the road that I think will help those even better, being developed by companies like Overjet and others in the marketplace currently. So I think it’s a matter of adopting, but it’s adopting it in a strategic manner that makes sense for the practices that we’re supporting. So it’s evaluating what works in the workflow, because part of adoption of something is it’s easier, when I own a practice or two, it’s easier for me to adopt that into my philosophy when I believe in it and I get my team on board with it.
Dr. Seth Gibree:
When you talk about change management in a company that supports over 1,100 practices, we have to really, really think deeply on how that affects practice flow and patient flow, and in my ability and one practice to adapt. And if I make a mistake here and it’s not a big deal, but it could be a big deal. So we want to make sure that as we roll out things, we’re rolling it out in a strategic manner that makes the most sense in the workflow for our support clinicians.
Bill Neumann:
So it sounds like you’re really looking at a significant amount of data and insights. I think I’d pose this to Mitch. Whether it’s existing practices, or possibly from a business development perspective, are you using dental AI at all to look at some of these potential practices to acquire? Are you able to do a practice analysis that way?
Mitch Olan:
We have not used it to that extent yet, but we have every intention to do that. It’s something that we got to first get our team comfortable with. We’re in the beta stages of trying this out and everything. It looks very positive thus far.
Mitch Olan:
Right now, it’s within what we call our Innovation Committee’s world, which is a combination of our IT team and our clinical team, and our operations team, and how they roll this out, where they’re going to test it, how they’re going to test it.
Mitch Olan:
But ultimately, we see it very much a tool for the business development team, to better assess a prospective candidate to join the organization, and if they’re a good fit or not.
Bill Neumann:
Wardah, this is for you. So as Mitch talked about, it’s getting clinicians comfortable with this and other team members comfortable with AI. What is it Overjet is doing really to onboard and help educate? Because I’m curious, is there a big learning curve? What does that look like?
Dr. Wardah Inam:
So the way we see it is, not only is the technology being developed by clinicians. So if you think about it, where does the data come in from, which we use to train our models? It actually comes from dentists. So dentists are actually creating these models. We’re just architecting them. And then second is actually, utilizing that in the practice as well.
Dr. Wardah Inam:
So the clinicians on the team on board the clinicians in the practices themselves as well. And such that they feel comfortable in utilizing the technology, as well as their staff as well, which might be hygienists and office managers, et cetera. And in terms of making them feel comfortable, a lot of it is the outputs, being able to see, first time they notice something that they missed or had ignored, and it’s brought to them.
Dr. Wardah Inam:
Or if something is brought in front of them, and that makes them look a little deeper, those are the times when we get an email back saying, “Oh, wow, I didn’t imagine it would work this way.” So far for us, we’ve been very lucky that the dentists, the practices we’ve worked with, have been excited to use the technology, as well as see the potential of it in terms of better patient experience, better patient care, and want to utilize it in this way.
Dr. Wardah Inam:
And as both Mitch and Seth mentioned, there’s a lot to be done right now. It isn’t a fully completed technology that is similar to say, something that has existed for 20 or 30 years. This is a new technology. And with any new technology, there’s a lot of potential. But there’s also understanding of risk, et cetera, that you need to look at. So the good thing is DSOs have teams to evaluate both aspects. But also, especially clinicians are for us, the biggest champions have always been clinicians.
Dr. Wardah Inam:
Because once they see it, for them, it’s like okay, I totally get it. And after that, it is about seeing in your practice what works. How would you roll it out? And it varies DSO to DSO, and even smaller groups as well. And we work with the groups, making sure that they’re comfortable with the rollout, they’re comfortable with the adoptions as well. But also, making sure that all the protocols are being followed in such a way that the patient care and experience is being kept in mind. And making sure that that’s the best quality ever.
Bill Neumann:
I’d like to ask Seth this question, and then maybe we can bring Mitch in a little bit and get some perspective on how chart auditing is typically being done today at Heartland and then at DCA. And then Wardah can maybe talk a little bit about how she sees AI really changing that. But Seth, if you want to start?
Dr. Seth Gibree:
In short, I would say that there’s a checklist that you would go through as you look through a chart to make sure it has the right signatures, the right medical histories are reviewed. Do they have an FMX, or do they have some sort of full radiographic experience in there? Has the patient been seen for a comprehensive review? So it’s pretty random, truthfully. And I think that’s one of the things that’s hard to do, because you’re pulling … And they’re time-consuming.
Dr. Seth Gibree:
I think Mitch said, when he was talking earlier, they have a full-time team that does that because of just some of the detail. Usually, it’s an administrator and a doctor who will look through some of those items, too. Is there perio charting? Are the radiographs up to date? What are the past diagnosis, treatment plans? Does something need to be followed up on? And so it’s about trying to improve the standard of care, but making sure also that you’re doing the right thing from a liability standpoint.
Dr. Seth Gibree:
So I would say there’s a process to that, that’s a continual ongoing process that’s managed. But I think the future ability to automate that brings excitement. And I think that’s one of the key things that we have to think about in developing technologies, is as we look about new things out there, and this is emerging technology, and I think that’s one thing Wardah was just trying to share is that these are things that are being developed and are growing. So it’s exciting.
Dr. Seth Gibree:
To me, it’s exciting because the potential that I see to automate processes that are manual currently, allows us to focus at a higher level on our patients. So, how do we utilize AI with like chart reviews, or chart audits to make the process which is a manual process currently, and it’s very time-consuming and not truly comprehensive, how do we automate that into something that’s less time-consuming and gives us greater insight into a liability of a practice, or help a clinician to reduce their liability and make sure the systems are where they need to be?
Dr. Seth Gibree:
And then on the other side of that, from an AI standpoint, being able to help with business tools and making sure that the business team can work in a more efficient manner related to the patient. So there’s a lot of excitement in the development of it and there’s a ton of potential. And I think within the dental space, especially, the floor is open for, I think, players to come in and try to figure out solutions to problems that we’ve just been addressing at the office level for years and years, and years, even as as DSOs working toward providing systems to help those be as efficient as possible, if that makes sense.
Bill Neumann:
Mitch, do you have anything to add as far as the chart audits at DCA and what you’re currently doing?
Mitch Olan:
Yeah, our process is very similar, it sounds like. We’ve got a couple of committed docs that are former clinicians with us that have retired from the chair. Also, have clinical directors in the field that do chart audits. More importantly, they look closely with the newer docs, the younger docs. It’s an opportunity to help counsel and poach them, mentor them. We have a system that every doctor has to have X number of audit or charts audited per quarter, so that they are …
Mitch Olan:
But if that’s 10 or a dozen, or 20 charts, it’s nothing like what we can accomplish with AI. So with so many doctors to audit them, and we have over 750 affiliated doctors, Heartland has got probably three times that number, it’s tough to get out there and audit more than a dozen, 15, 20 charts per quarter per doctor, because they are time-consuming to make sure that that’s being done right. That’s the exciting aspect. From us, it’s what AI can bring to that process and make it a lot more efficient, make it a lot more comprehensive, make it a lot more educational.
Bill Neumann:
Thanks, Mitch. Wardah, do you have any input? And you talk really about how AI can reinvent chart audits. Where do you see AI right now? Are we like in the second inning? What’s the future look like there?
Dr. Wardah Inam:
What we did was when we started on chart audit or chart review, we basically got our best dentists and we said, “Here’s the practice. Look at the charts and let us know, where do you see any issues?” It was a big DSO. They started, they picked a dentist, they started looking at their charts. Five or six charts in they said, “Oh, I think there’s some issue with what’s happening here.” We took that data, we processed the entire dataset: every patient’s record, every appointment, every note that they had taken.
Dr. Wardah Inam:
And we actually found that it was actually not statistically significant what they had found. So the fact that looking at five or 10 charts, it might say yeah, there were a few things here and there, but it isn’t statistically significant to actually say that it needs more review even. And that is the challenge here, which is it’s just not humanly possible to review every chart and be able to even do it at a statistically significant level by being able to see, okay, how many procedures have they done? Et cetera.
Dr. Wardah Inam:
And that’s where I think by being able to automatically review it now, you not only give the benefit of the doubt and have statistically significant results here, but also, nobody is perfect. There’s something, a few things that might be going wrong, et cetera. You’re able to see whether that is, the person is an outlier, or there might be a few charts that X things might be off.
Dr. Wardah Inam:
So I think there is an opportunity here to make this process more quantitative, make it more accurate, such that you can actually rely on the results of these reviews to a point, to make a decision, whether it is that a particular provider needs a C course that they should be taking, or whether it is that they’re doing such a great job that they should be mentoring some of the other younger dentists in the practices.
Dr. Wardah Inam:
Or whatever the decision might be, but being able to collect enough information that you can actually make a very good decision is what we feel the use of this technology is, as well as completely changes how we look at chart views, rather than just it being a tick mark for making sure that compliance is happening. But really, a tool to ensure that the dentists are being supported in such a way that they are not. They’re getting feedback, they’re improving, they’re achieving the goals that they want to achieve. And DSOs are supporting them in doing so.
Bill Neumann:
Thanks. Thank you, Dr. Inam. So as we start to wrap this up a little bit, I’d like to ask Dr. Gibree, just from a perspective of … We’ll get a little, maybe a futuristic viewpoint here. So as a clinician, where would you like to see AI go? And then we can ask Mitch, as somebody who was a COO for quite a while and then a CEO, where do you think this really, AI can excel in the DSO space? But Seth, I’ll let you start.
Dr. Seth Gibree:
Wow, I think where would I like to see it go is-
Bill Neumann:
Or where do you think it will go? Maybe that.
Dr. Seth Gibree:
I think I get excited when I’ve seen what I’ve seen as potential. I think that’s one of the cool things that I get to do on a daily basis is have conversations with a company like Wardah’s and others that exist out there, both in the clinical realm and in the business realm of the AI space. And I get to see what they’re trying to develop, and the problems that they’re trying to solve for, and the business use cases they’re trying to make.
Dr. Seth Gibree:
And those things are exciting. If they can figure out the computer science side of the data programming and the machine learning, the capabilities that exist, too, that will open up the door to allow us as clinicians, like Wardah was talking about, even with chart reviews, to have a true vision of saying, “Okay, this is what’s going on. How can we help? Or how can we support this doctor or this team at a higher level?”
Dr. Seth Gibree:
And I think that’s what excites me, both from a dental support organization side, but also from a clinical advocate side, because that’s what I do is say, “Okay, how can we help doctors and their teams?” And so I think it’s super exciting, one, from a business tool use to help … Business team members that answer the phone, that are the first really contact, human contact that a patient might have with an office, their jobs are hard. And dentistry is a hard, hard thing to do day in and day out.
Dr. Seth Gibree:
And so I think anything that can be created that helps streamline the ability to care for their patients is what excites me. So from a clinical standpoint, we talked about it earlier, having the ability to have third party validation for a diagnosis, or even have something that if I just came out of doing a crown prep and two fillings on a patient that could barely open and won’t lean back and gags every time you put a drill in their mouth, it’s a hard situation.
Dr. Seth Gibree:
And then I go in to do a hygiene check on a new patient, and I’ve got to be on my best. And I think AI helps give a second set of eyes, or has the potential to give a second set of eyes of looking at that patient as a unique experience. That that patient can get the best of you even when you’re tired and you’re worn down. And it gives you insights into highlighting things that maybe, again, Wardah said none of us are perfect. And that’s, I think, a great thing to remember.
Dr. Seth Gibree:
And then on the flip side of that, I get excited when I think about the mentorship possibilities that AI brings to the table, because we are really big as a DSO, on our mentor network and our ability to mentor doctors in our clinical network. And I think the ability to help each other do better and be the best clinicians that we desire to be is super exciting. There are so many possibilities on that side of things. And I can go on for ages and ages, and ages about this. And so I think I will shut up now, but I appreciate the question.
Bill Neumann:
No, that’s great input from a clinician, and then also from a clinical management standpoint. So we appreciate that. Mitch, from an operations standpoint, can you give us a little feedback on what would you like to see things headed?
Mitch Olan:
We’ve been talking about AI as it applies to radiographs and patient data in the practice. There’s also AI that’s being developed that is being applied towards your call centers, telephone and answering the phones. They support the operations to make for a more efficient process for patient management, a better patient experience. The AI that we’re talking about, it supports compliance.
Mitch Olan:
From a DSO’s perspective, one of the things that you want to make sure that you have is a good compliance program. And if you get rogue operators, they can tarnish the reputation of the entire organization. So you want to make sure that you have a good compliance program, and AI really helps with that. And looking at it from a CEO standpoint, having something that allows us to use that as a tool to continue to polish our reputation and our systems, is a tremendous tool to have.
Mitch Olan:
We talked about the ability for it to support affiliations. Affiliation assessment, affiliation integration, those are all very powerful tools for artificial intelligence to help in the way that they can bring data to the table that currently is very tough to get to. And finally, I think that … well, not finally, but my last thought on it right now is it supports training, which, again, from a DSO’s perspective, the more you train your people.
Mitch Olan:
The better they become, the more committed they are to the organization, the more they feel like you’re investing in them, the better the outcomes are from those employees. And I’m not talking just about clinicians being trained by clinicians. I’m talking about the non-clinicians being trained as well, and AI really helps in that process.
Bill Neumann:
Thanks, Mitch. Wardah, I’ll let you finish this off. So, as far as you’re working with a number of DSOs on the application of dental AI, and as you look across the industry, emerging groups, larger DSOs like Heartland and DCA, where else do you see the technology leading?
Dr. Wardah Inam:
Great question. I think I missed a little piece of your last question, which is, where is AI right now? And then I’ll address, where is it leading us as well? And here, the great thing is, at this time when it comes to clinical diagnosis or clinician decision support tools, the AI models are at a point that are either exceeding or meeting dentist level accuracy in determining pathologies on extras, on determining treatment planning as well.
Dr. Wardah Inam:
The question here is how it gets adopted. That’s where doing it in such a fashion that is non-disruptive to the practices, as well as the patient’s themselves, and supports the dentist in doing so. We’re already working with some of the largest peers. A lot of the utilization review or claims review is now going through AI in determining whether a claim should be paid out or not based on medical necessity. That is already happening in the dental industry.
Dr. Wardah Inam:
And that was we went into production last year. That’s something that peers have adopted very, very quickly, in order to ensure efficiencies in their operations, as well as make sure that accurate decisions are made, which providers were not quite happy with previously. And now we’re seeing improvement in appeals, as well as making sure that the right decisions are being made when it comes to determining whether a claim will be paid out or not.
Dr. Wardah Inam:
So there’s already AI being utilized in the dental industry, and a lot of the things that we mentioned that are helping DSOs as well as practices, do better. But what we’re very excited about and we’re laying the groundwork for is also improving that patient experience even further. And they’re especially making decisions on claims while the patient is in the chair. So predetermination or pre-authorization of claims while the patient is in the chair. And that way, they know there is no financial uncertainty.
Dr. Wardah Inam:
They’re not waiting weeks for determining whether the claim will be paid out or not. And then they are able to make that decision while in the chair, whether they would like the treatment, especially if the insurance companies will pay for that as well. That’s something that we believe that DSOs, as well as the insurance companies, have a major role to play in order to ensure the right care for the patient. As well as it’s a win for the DSO as well, with better revenue cycle management, and for the insurance companies, in a way that they can see that the right treatments are being performed, too.
Dr. Wardah Inam:
So this technology, we believe is a win-win, which usually doesn’t happen for the payer or provider and the patient. And that’s why it’s being adopted this quickly across the ecosystem, and why there’s so much excitement about it. And no pushback really, from one side strongly against it, which will really help this technology even achieve a lot. And the second thing that we’re very excited about is medical dental integration.
Dr. Wardah Inam:
We’ve started research work with Harvard School of Dental Medicine, and their Initiative of Oral and Overall Health and other groups where we’re working on, how do you screen for medical conditions in the dental practice? How do you ensure that the risk is being taken care of? We’re looking at outcomes, and you’re able to measure progression of disease and outcomes to improve the care. While you’re not just looking at oral health, you’re utilizing oral health data and the practice to really improve the overall health of the patient as well.
Dr. Wardah Inam:
So those are things that we’re very excited about, and where we feel that this technology is going to have a huge impact, not only in improving care for the patients when it comes to oral health, but in overall health as well.
Bill Neumann:
Thank you, Wardah. A great way to finish things off. I really would like to thank the panelists for being here today and really clearing some things up regarding dental AI, talking a little bit about how they’re using it currently in their DSOs and then what the future holds for DSOs using dental AI in the industry, the providers and the patients as well.
Bill Neumann:
So just a quick shout out. Thank you, Dr. Seth Gibree of Heartland Dental, thank you to Mitch Olan of Dental Care Alliance, and thank you to Dr. Wardah Inam of Overjet. We really appreciate your input today on the Group Dentistry Now show.
Bill Neumann:
And until next time, I’m Bill Neumann. We appreciate you listening in. And I’ll have links to Heartland, Dental Care Alliance and of course, Overjet in the show notes. Thanks again for listening, until next time.
