The Group Dentistry Now Show: The Voice of the DSO Industry

🎧 Chris Scott, Chief Information Officer and Chief Information Security Officer of Dental Care Alliance, joins the GDN Show. Key podcast takeaways:

Utilizing technology to make practices more efficient
Modernizing communication processes & personalization
Call centers – Yes or No?
Patient intake and scheduling
Future DSO technologies

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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, Australia, Europe, and Asia. If you like our show, tell a friend or a colleague.

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Full Transcript:

Bill Neumann:

I’d like to welcome everybody to the Group Dentistry Now Show. I’m Bill Neumann, and as always thanks for listening in whether it’s on Apple, Spotify, Google, or any one of the other listening apps that are out there. Thank you. And you might be watching us on YouTube, so thanks for watching us. Without an audience, we wouldn’t have a show, and without great guests, we wouldn’t have an audience, so great to have Chris Scott from Dental Care Alliance. Chris, thanks for being on the Group Dentistry Now Show today.

Chris Scott:

Absolutely. Thanks for the invitation.

Bill Neumann:

This is going to be fun. We’ve had a couple folks from DCA on the podcast. We had Mitch Olan on a while back. We had David Pegg who was on the podcast a little while back, but nice to have you here, Chris. And I think you’ve got about little less than a year under your belt at Dental Care Alliance.

Chris Scott:

Yep. That’s correct, yeah. Started in July of last year.

Bill Neumann:

That sounds good. And we’ll have to get your perspective on the DSO space now that you’ve been involved for about a year, but Chris’s role is really interesting here. So he is the chief information officer at dental care Alliance. And he also has another role which I really want to find out about because I haven’t heard this one before. So it’s the CISO, which is the chief information security officer.

Chris Scott:

Security officer.

Bill Neumann:

Did I get that right?

Chris Scott:

That’s correct. Yes. So I play both roles at DCA.

Bill Neumann:

So let’s talk a little bit… First off, can we get at your background prior to DCA? What did you do? I saw that you were at Humana for a little while, General Electric, and a couple other organizations. We’d love to get your history, if you don’t mind, and how you arrived at DCA, and then we can kind of get into your role at DCA.

Chris Scott:

Absolutely. Yeah. So I’ve been in IT for a long time, since 1990 was my first job in IT. And I started out really in consulting. So I did a lot of networking and infrastructure, consulting for a multitude of different companies. It was mostly independent work from my perspective. And then, from my standpoint, my big change was getting hired by General Electric in 1999, and had a great run with them. Four different divisions of GE, multitude of different roles of everything from the Six Sigma roles to software engineering and app development and infrastructure. You name it, I’ve done it with GE. And then in 2008, I had the great fortune to go to work for Humana, which is, as you guys know, one of the leading health insurers in the United States and has grown tremendously through the years.

Chris Scott:

And so my role at Humana morphed from being a director in the EDW space, the enterprise data warehouse space, to owning the care delivery operations for IT. And so we started to buy primary care practices. And so, as you can imagine dental offices and medical offices are very similar in a lot of ways. And so I spent, gosh, almost six years of just acquiring and integrating different primary care practices. Of course, that meant lots of things and a lot of things that are very similar to what DCA does.

Chris Scott:

My last role with Humana was actually a company called Conviva, which was an offshoot of Humana. It was an independent company, about a $2 billion company. And it was, again, primary care practices, but we grew from 85 to 125 offices during the two years that I was there. And so then I had this great opportunity to come to DCA and kind of do it all over again. That’s the focus on affiliations, acquisitions, standardization, things like that, are all things I’m very used to.

Bill Neumann:

So Conviva was really the primary care version to a degree of what a DSO would look like.

Chris Scott:

That’s right.

Bill Neumann:

And the medicine.

Chris Scott:

Yeah. They were an MSO, medical services organization, so.

Bill Neumann:

Yep. And your role there is similar to what it is at DCA?

Chris Scott:

Yes. I was the CIO for Conviva from 2019 to 2021, and then came here to DCA in 2021.

Bill Neumann:

So when you started [inaudible 00:05:02], and really you have a couple of roles at DCA. So you’ve got the traditional CIO role, and then let’s talk about the chief information security officer, and what’s the difference there?

Chris Scott:

Yeah. So from the CIO perspective, it’s more our general IT footprint. So when you talk about networking and applications and any kind of practice management systems, or even telephone systems, all of that is kind of the purview of the CIO and the strategy behind where we’re going to go as an organization. And a lot of that is really around, from a CIO perspective is, what can I do that’s going to build business value and make things easier for the organization to function through technology? And then the other for me has always been, how do we support the organization better through standardization? Because, and I always like to say this, the CIO, we want as few applications as possible because we want to be able to support the organization as best as we can. So in the case of a dental services organization, if you have, let’s say, 15 practice management systems, you’re probably not going to do a great job at supporting all 15 of those. So if you have two or three, you can probably have subject matter expertise and be able to support them a lot better.

Chris Scott:

And then on the CISO side, the CISO side, for me, it’s all about protecting our data and our patient information. And so when you think about any kind of PHI or any kind of HIPAA compliance, all of that falls under the purview of the CISO. So that’s implementing practices and policies and tools to be able to make sure that not only are we protecting data, but we are also protecting our associates that are on our network and making sure that they’re not getting fished, or we’re watching the network movement, data movement on the network, and all those types of things as well.

Bill Neumann:

Yeah. And that seems to be, the security side, seems to be everywhere in the news nowadays with the what’s going on at all sorts and shapes and sizes of organizations, as far as people coming into systems and taking information. So that sounds like you have two full-time roles.

Chris Scott:

Yes.

Bill Neumann:

At least.

Chris Scott:

That’s right. Absolutely. And I would say that any CIO out there, if they’re not spending a good majority of their time thinking about IT security, they’re probably not doing the job the right way, because there’s so many bad actors out there. There’s so many threats out there that you constantly have to be thinking about, what is my security posture and how do I improve it?

Bill Neumann:

So let’s start off the conversation with just your thoughts on utilizing technology. That’s out there to make your practices more efficient. So how many locations does DCA have right now?

Chris Scott:

So right now we have a little over 370 locations, of individual offices, and they’re under a multitude of different brands. So at DCA, even though we’re the DSO, we don’t brand any offices DCA. They’re all the legacy names that they were before we affiliated with them.

Bill Neumann:

Gotcha. Okay. So you’re looking at technology across all 370 different locations.

Chris Scott:

That’s correct.

Bill Neumann:

And trying to take advantage of consistent how do you scale up technology? What technologies make sense? How does it help the organization and how does it help the patients?

Chris Scott:

Right. Absolutely. Yeah. And I say probably the biggest driver within the DSO space from a technology perspective is the practice management system, when you think about everything between how we keep track of patient appointments, how we track payments, and how we track insurance and claims, and all those types of things, that is the heart of the DSO is the practice management system.

Chris Scott:

At DCA, we have a strategy where we really want to get to just a handful of systems that we’re able to support across the organization. So the practice in the past has been, let’s affiliate with a certain brand, and then we just kind of leave them alone no matter what systems they have. But through my experience in the medical space, and also with Humana and Conviva, is that if you don’t standardize on systems, then you’re doing yourself a big disservice from a support perspective, because you just cannot support a multitude of different systems very well. You have to focus on one or two things. And then of course, the people on your team are constantly dealing with the same things over and over with those one or two platforms, so they get very good at being a subject matter expert in it, and so they can better support the organization.

Bill Neumann:

So is that something that you’re doing right now and as you acquire locations or groups, they may be on a different practice management system?

Chris Scott:

That’s correct.

Bill Neumann:

And there’s the transition over to one that your team’s more comfortable with?

Chris Scott:

That’s correct, yes. And so currently of our 370ish offices, we have 250 or so that are on the same platform. So we have 60 something percent on Denticon, which is a cloud-based practice management system. So for the most part, any of the offices that we affiliate with that are general practice, we want to eventually get them over to the Denticon platform. And so we have a roadmap between now and mid next year to where we are going through the organization and actively transitioning them to Denticon. And so, from a general practice perspective, that’s our strategy there. As you know, within dentistry, there are different specialties, like oral surgery or ortho, things like that that you really need a different platform for. So I think at the end of the day, when we look at where we’re going to be, it’ll probably be three platforms, but that’s much better than 15. So that’s where we’re going.

Bill Neumann:

That’s for sure. So let’s talk a little bit about the communication process that you have at Dental Care Alliance right now. So talking about the patient communication process, and as you modernize that, that becomes more of an IT function, right?

Chris Scott:

That’s right.

Bill Neumann:

Talk a little bit about that. And then, are there ways that you can personalize those communications to make it maybe not feel as automated?

Chris Scott:

Sure. Yeah. And actually I do have an example there where, so when I first came into DCA, we were faced with an expiring telephony system. So all the telephone systems that we had at DCA, we were up against a hard contract date. And so at that point, I kind of went out to the universe of telecom and started to figure out what we could potentially move to because in essence, what our legacy carrier was doing was saying, “Yeah, we’re going to put you in the cloud, but you’re still just going to have a phone.” And so at the end of the day, I was going to trade a phone for a phone, which to me isn’t moving us forward from a technology perspective.

Chris Scott:

And so one of the products that we did a pilot with was Weave. And so we actually started to implement Weave in January of this year, and we already have almost half of our 370 offices on Weave. And so when you talk about patient communication, you talk about productivity of the staff that are at the offices, you always have to look for ways to where you’re simplifying their lives and making patient communication, easier, making our associates lives easier to use the technology. And at the end of the day, it’s just going to be overall a better support process as well.

Bill Neumann:

So obviously one way you’re communicating with the patients is via the phone, right?

Chris Scott:

That’s right.

Bill Neumann:

We know that one.

Chris Scott:

Yeah.

Bill Neumann:

So what else are you doing as you start to modernize? What

Chris Scott:

Yeah, so definitely telephones. The other thing is texting, SMS messaging out to patient for patient reminders and things of that nature. We also text for reviews, like if you had a good experience, go online to Google or what have you, and rate us. Let us know how the office is doing, things like that. The thing that I like about the Weave platform that I just mentioned is you can personalize it based on your office. So it comes from that office. It’s not just a bland general text or email, or what have you. It comes from your dentist office, right? You recognize them and you know who’s there, and it’s a much more personal approach than just a standard text.

Bill Neumann:

Yeah. That’s interesting. So as you’re doing that, so who’s in control of that texting? Is it at the practice level? Is it at a higher level? Or does it…

Chris Scott:

Yeah, so it’s a little of both. So one of the great things about being in a DSO is you have a whole support organization behind you, right? Whether that’s IT or finance or marketing, what have you. And so with the Weave platform, not only do the local office folks have the opportunity to do the texting and emails through that system, but our marketing folks centrally can also do that as well. And so that’s just another way that we can provide benefit and value to our patients, is through our support services.

Bill Neumann:

And so at the support level, you’re able to almost benchmark, right? And look across your locations and see maybe somewhere that may be performing better than somewhere else, and maybe dig in a little bit, and figure out what they might be doing differently?

Chris Scott:

That’s right. Exactly. And besides the telephone pieces of this, or the Weave piece, we’ve also gotten very good at analytics when it comes to all of the productivity at all the offices. So our primary platform, we have a direct API to all of the data that’s within that cloud platform. And then all of the other ones, we have another process where every night we get out the data on patient visits and productivity and dollars and all that stuff. And so we have a way to roll up all of that information for all 370 offices every day to see how we’re performing down to the office level.

Bill Neumann:

Yeah. So talk about the analytics. Can you give us some examples of what it is that you’re actually measuring, looking at?

Chris Scott:

Yeah. So like when you think about the number of visits per day in the office,, how many hygiene appointments, how many regular appointments are there? Also when you think about the turnaround time per se, like how efficient are we being? What kind of productivity or income for the office are they having on that day? What’s their average for the day or for the week? And then we also take all of that information and look back a year and say, “Okay, on this day a year ago, were we better or worse than we are today? And are we making progress?”

Bill Neumann:

So moving from the analytics side to, you come back to the calls, the phone system that you have, a lot of DSOs seem to have centralized. They have a call center that they either run but it’s not done at the practice level, or in some cases they outsource to somebody else that’s doing that. What do you do at Dental Care Alliance?

Chris Scott:

Yeah, so we allow all of the offices to handle their own call volume. And so I think the implementation of Weave, of course, has helped that because when you think about the standard platform that is integrated with your practice management system and is the telephone as well, then it comes with more productivity, less time on calls, better answer rate, all those things. And so with the technology, we’re driving those efficiencies at the office so that we can allow them to continue to take those calls there locally, because I know every organization has tried a call center function at some point. And I think we always go back to having local familiar people answering the phones is always the best approach. And it’s definitely best for the patients because they get to know who Bill is or who the doctor is, and so they can call them directly and make an appointment or ask a question. And it’s just much more personalized and not so bland, if you will, as a call center approach.

Bill Neumann:

So this is a great point here, and so I’m trying to think this through. So you’ve got people at the local, at the office, handling the calls and in a lot of cases handling beyond the calls, the patient communication with the texting and some other things, and the follow ups and for reviews. Are you able to have consistency while doing things like that at the practice level?

Chris Scott:

Yes. And in fact, I think that the standardizing on the platforms, that really helps to drive the experience that they’re going to have because we’ve optimized, like for example, in our Denticon offices, we’ve optimized the workflows. We’ve optimized the way they use the system. We’ve optimized the reporting out of the system. We’ve optimized all these things, and so I think those are cases where the technology is really driving the efficiencies, making things better, not only for the patients, but for the associates that are using the technology.

Bill Neumann:

Yeah. That’s some great points. On the admin side of things. So we’re still talking patient communication in a lot of cases, but on the patient intake and the scheduling, and how do you handle those things?

Chris Scott:

Yeah. So of course, again, still back at the local office level, in a lot of cases, there are some things that we do with other systems that are kind of bolted on right now to facilitate some of that stuff. But for the most part, scheduling or rescheduling, or even last minute appointments, all of that stuff is still done at the local office level from a DCA perspective.

Bill Neumann:

Okay. And are you able to… So there are times when people aren’t in the office, right? So does, in that case, if somebody calls after hours, how do you handle things like that?

Chris Scott:

Yeah. So we have a process where it would go to either someone that is on call per se for the office, or it would go to a voicemail with the appropriate information on there about the hours and when they’re available, or, “If you need something, press this, press this number or call this number.” One of the things that we’ve noticed on the weave side is they do have an app so that you can actually use the platform, even if you’re not at the office. Of for some reason that there’s a… I’ll just use an example, there was a winter weather event in the Northeast, right? And so some folks that were on Weave could actually do this from home on their mobile app, but they could start to reschedule appointments through their mobile app versus having to go in and do everything there manually. So things like that, again, it’s convenient, it’s standard, it’s standardized, it’s integrated with the practice management system. It offers a lot of different functionality.

Bill Neumann:

Are you finding that patients are getting more comfortable with using online platforms? And I would think maybe in some cases actually demanding it? That might be a strong word, but expecting it maybe is a better one.

Chris Scott:

Yes. Yes. Especially we’ve noticed from the texting perspective, a lot of people, it’s just so convenient to get a text, appointment reminder, or even a text to pay, or, “Hey you can pay your bill. Click this link,” blah, blah, blah. And I think people definitely are demanding of that technology these days. And so you really have to find a way to have those integrated systems to be able to provide that, because if you’re not, you’re behind the times. I know that years ago in the medical world, it was all about patient portals and how do we get people to log in and get their own medical records or make appointments and stuff like that? And it was always a big challenge, but fast forward 10 years from then, it’s just expected. It’s the cost of doing business.

Bill Neumann:

And I think COVID really in a lot of cases sped up that adoption where there was fear of being in the office or people wanted to do as as little in person as they had to do.

Chris Scott:

That’s right.

Bill Neumann:

So do you feel like that there was some adoption that came after? COVID’s now become a little bit… Well, not going to say it’s over yet, but-

Chris Scott:

Right.

Bill Neumann:

It’s changed. We’ve become more comfortable with it, I guess.

Chris Scott:

Yeah, absolutely. And I think that’s across the board. When you look at just us and our daily lives, we expect to get things electronically that we used to find no issue in going to an office or some other building to get the information, but now everybody wants it digitally and everybody wants it at their fingertips. So I think that’s another case where I think COVID has helped to spawn some of this technology and some of the advancements that have been made over the last few years.

Bill Neumann:

So let me just kind of go back because I want to make sure we didn’t miss anything. So on the calling side, everything is done at the practice level. As far as technology goes, patients can, either they’re getting text reminders as far as when their appointment is. They get a text, if they had a great experience, to do a Google review.

Chris Scott:

Mm-hmm.

Bill Neumann:

You also talked a little bit about they can text to pay, right? That’s another.

Chris Scott:

That’s right. That’s right. And you know what I’ve seen too? And I think we talked about this a little bit in the intro, is where is the DSO space going? And I think the DSO space and the applications and platforms are starting to integrate together. So when you look at where we were a few years ago, you had to have this application to do this and this application to do that. And you needed a different one for revenue cycle management, and you needed a different one for your practice management. And now all those things are being built into one system so that you have full life cycle of the dental office all at your fingertips. And so I think that’s where we continue to go, is you’re much better off to implement something where you get all of those in one, versus having a point solution for every single process.

Bill Neumann:

So that makes it easier on the IT side, for sure. No but you’re not building bridges. Right? So you don’t have to necessarily worry about that.

Chris Scott:

Yeah.

Bill Neumann:

It’s probably better for on the admin side, the office manager at the practice level. And then I would think that would translate to better patient satisfaction too, because everything works together.

Chris Scott:

That’s right. Exactly. Yeah. And the other point there is our primary practice management system, the imaging is also integrated into that as well. So when you think about a person at the office looking at the patient record, they just click on another tab, and then they have all of the imaging there. So instead of going to yet another system to do imaging, it’s all right there together in one pane of glass.

Bill Neumann:

That’s great. Talk to me about, as we start to kind of wind down this podcast, I’m curious what you’re seeing out there as CIO, what’s exciting as far as technologies that you see that are maybe out there that haven’t advanced completely, or some things maybe, you mentioned Weave a couple of times, that they may be working on, or some things that they’ve done recently that have really just been helpful for the group.

Chris Scott:

Yeah. I think a couple of things. One, I think we’re seeing a lot more of I guess the Weave type of companies where they’re saying, “Hey, not only can we be your telephone, but we can integrate with your practice management system. And then we can do all these cool things with texting and emails and surveys and all of that stuff.” I think that general platform is getting better and better, and I think that there are a lot of players out there that are trying to buy for how much of the office can they consume with one platform.

Chris Scott:

And then there are also things that are on the horizon that we’re actually piloting right now, which is artificial intelligence. So looking at dental images and things that the naked eye can’t see, artificial intelligence can see it, and can flag it, and can at least provide another sense of, “Hey, is there something else wrong here that we didn’t find that we could go in and look at?”

Chris Scott:

And so I think between platform consolidations and artificial intelligence, and then of course, all of the analytics and everything around, how is my office performing? I think all of those are definitely things that are going to be hot over the next few years.

Bill Neumann:

Some good stuff. Chris, is there anything that we missed before we end the podcast? This is a great conversation. I think it’s important to… A couple of takeaways here. Not everything has to be centralized, nor should it, but there are ways to still gain efficiencies and be able to benchmark and measure what’s going on at each location in order to take best practices and share those across the brands that you’re managing. So I think that’s super important. It’s not all about one system doing everything exactly the same way, taking that administrative from the practice level and having holding that somewhere else. There are really good ways to do that where you’re making sure that you still have those patient relationships which are so important-

Chris Scott:

That’s right.

Bill Neumann:

-nowadays. So I think that’s the lesson that I’ve learned today.

Chris Scott:

Yeah. And for me, it’s all about standardization being able to support the organization, the patients and the associates as good as we can. And I think lastly, one thing I would say is that nothing is ever perfect. There’s no perfect technology system, but at the end of the day, pick one. I always say I’m from Kentucky and we say, pick a horse and ride it. Pick a horse and ride it. It may not be perfect. And you may not come in first, but you’ll come in second. Or you’ll be there right at the end. And at the end of the day, you’ll be on one platform or one process, and it just makes things a lot easier for the enterprise.

Bill Neumann:

Yeah. Great stuff. So thank, thank you, Chris Scott. We really appreciate it. It’s been eyeopening for sure. Again, and I was thinking everything’s centralized now, and that’s not the case, nor should it be. Also, we mentioned Weave a couple of times there. They sponsor this podcast. So just wanted to make sure that anybody that’s interested in finding out more, we will drop a link to Weave and some of their information in the show notes. So if you want to reach out and find out more, you can do that. But thanks to Dental Care Alliance and Weave and Chris Scott for being part of the Group Dentistry Now Show. And again, thanks everybody for listening in or watching today. I’m Bill Neumann. Until next time, we thank you.