Technology continues to make it easier for dental providers to engage digitally with their patients, and recent stressors are causing practices to adopt this technology faster than ever. Patients’ expectations for their provider experience have shifted along with the shift to consumerism. Additionally, as a response to the COVID-19 pandemic, practices are prioritizing staff and patient safety by making many changes, including eliminating paper processes, communicating with patients via multiple platforms, and incorporating electronic payments into their workflows.
Recently, Becker’s Dental + DSO Review, in conjunction with Rectangle Health, convened a group of executives from leading dental practices for an advisory call on the challenges and opportunities associated with the integration of digital tools into the dental practice.
Digital tools are transforming patient interactions, as well as delivery of dental services.
Many practices have embraced digital tools to support patient communication via email and text messages, in addition to marketing through social media. Most patients have responded positively.
Lerner & Lemongello Dentistry is using technology to create a paperless patient experience and reduce reliance on the telephone. “People are very busy and want the flexibility to contact you when it’s convenient for them. We email and text heavily with patients and have contacted more people in these ways. Our patients also love our digitized consent forms which are based on technologies from DocuSign and Google Docs,” said Daniela Borello, the patient relations and treatment coordinator for Lerner & Lemongello in Palm Beach Gardens, FL.
Since COVID-19 has made waiting rooms a thing of the past in many places, digital tools help practices notify patients when they can enter the building. “We engage in one-on-one texting with patients when they arrive and then invite them into the office when it’s safe for them to do so,” explained Todd Sewards, CIO at Wakefield, MA-based American Dental Partners.
Despite the widespread acceptance of digital solutions to support patient interactions, there is resistance from some dental practices to adopt contemporary tools. As practices concentrate on the quality and safety of dentistry during this time, some are focusing less on digital tools for patient care.
“Dentists may avoid using new digital tools due to the protective equipment they must wear and the protocols they must follow to keep patients safe. They need to move quickly and cautiously to deliver the best care possible. As a result, they are more likely to continue using the dentistry tools they know and have confidence in,” said Lisa Blair, COO of Amherst, NY-based Inspire Dental Group.
Some dental groups, however, have used telehealth consults to supplement in-person appointments in response to COVID-19. Capitol Dental Care in Portland, OR, for example, has created preventive teledentistry programs for Medicaid members. Capitol Dental hygienists recommend appropriate home care and preventive products through scheduled video consults, according to Manu Chaudhry, DDS, president and dental director.
Colorado Springs, CO-based Pacific Dental Services saw the pandemic as an opportunity to implement teledentistry services. The organization introduced online scheduling for patients who were afraid to come in when dentists were only offering emergency services. It also conducted some triage and pre-operative discussions over video.
“We sent patients instructions via email and text to help them get the most out of their teledentistry appointments. The most amazing part was that patients were extremely receptive and actually preferred this level of digital engagement. They absolutely engaged, wrapped their arms around it and put it into place,” said Stephanie Wootan, Pacific Dental’s regional director of operations.
When it comes to adoption of digital tools, dental practices face a variety of obstacles.
Today, dental office leaders are preoccupied with the challenges of managing the practice under the safety and social distancing precautions associated with COVID-19. Introducing a new or different dental payment solution might feel like a lower priority item or an unnecessary implementation for the administrators already juggling new demands requiring additional time, money, and effort. The irony is that digital payment solutions can be safe, secure, seamless, and simple ways to get the practice paid faster, freeing up the office administrator to focus more on getting patients scheduled in the new normal.
“Leaders are the ones who have to really decide that they want to move forward with digital technology,” Ms. Blair said. “I believe they should, especially when you look at the younger generation … Prior to the pandemic, 50 percent to 70 percent of our patients scheduled visits online or via text communication. It’s only increased amid COVID-19.”
Organizational culture plays a significant role in determining whether a dental practice is receptive or resistant to digital tools. Culture change starts with buy-in at the top. The leadership team must establish a vision for where the organization is going and how digital technology will enhance that vision.
“Everything comes down to culture. To lead change successfully, you need a strong culture and minimal attrition. We had a lot of retirements. This gave us the opportunity to change the culture and mindset of the executive team, as well as the providers and teams on the frontlines,” said Dr. Chaudhry.
Continuous communication is essential to managing change. “One of our biggest barriers to technology adoption has been geography. We have 300 practices across the country, and each has its own culture. It’s important to use consistent ‘drip’ messaging to reinforce why we’re making certain changes,” said Mr. Sewards.
Operational considerations can also pose obstacles to digital tool adoption. Staff training is critically important to utilization. People do not learn new things in a day. They need to continuously train on how to use new technologies to maximize the full feature sets of dental payment solutions.
“If you don’t have great support staff or a leadership team that will train employees to use digital platforms correctly, the implementation may struggle,” said Ms. Borello.
Technology issues are a lower-priority concern than other factors for many organizations. A lot of technology, especially software, can be installed, implemented, and supported remotely. With cloud solutions, provisioning is as easy as pressing a button.
“It’s an exciting time; there are so many new market entrants from a technology perspective. It’s just a matter of picking one — but you still have to get the human factors out of the way. To introduce a different way of doing business, the workflow must be streamlined, and the technology must be easy to use,” noted Mr. Sewards.
Financial issues loom larger for some practices due to the pandemic. “A critical consideration is the cost of personal protective equipment. A disposable gown used to cost a few cents, now it costs a few dollars. Depending on the CDC and ADA guidelines, the cost of PPE could obliterate a practice’s ability to invest in anything else,” said Dr. Chaudhry.
The technologies that are accepted most easily are those that replace an existing cost structure, rather than imposing new, incremental costs for the organization. Dental payment solutions that supplant the current price point of a practice’s existing merchant services system represent an attractive proposition for practices. It is important to keep in mind that digital tools can also serve as a competitive differentiator for dental practices.
“The patient as a customer will go to the organization that provides them with the points of access that speak to them. It’s the organization’s job to provide those access points to the patient,” said Dr. Chaudhry.
Patient use of digital tools depends on clear communication.
Communication is the first step to patient usage of digital tools. “It’s all in how you communicate with patients. You have to know who your audience is and start the conversation based on what the audience is expecting. Often older generations have trouble adopting technology, but you may be surprised. Adoption sometimes has more to do with interest level and ability than age,” said Ms. Blair.
Consistent use of digital tools is also important for patient acceptance. Ideally, patients will come to expect digital tools as a part of every visit. “If you don’t have a technology policy in place and you don’t know how to use digital tools correctly, you can’t educate patients about how to use them,” said Ms. Borrero.
Organizations that have adopted the use of digital capabilities attest to the positive responses from their patients. Ms. Borello explained that their patients, “have really loved the fact that we’ve put all these consent forms digitally and then can text back and forth with us. We email heavily with patients. I think we’ve really been able to get in contact with more patients this way. There are a lot of people who are still extremely busy. They’re still working, and they want that flexibility to be able to contact you when they want to.”
Looking ahead, collecting patient payments may be a challenge for dental practices, but technology can help.
In an uncertain economic environment, the panel agreed that flexibility is a key factor to help overcome financial obstacles. Offering multiple payment methods is a benefit for both patients and providers. Ms. Wooten said offering options to the patient can offset impact to the productivity of the practitioner.
Patients want convenient, electronic ways to pay for dental care, as well as flexible payment options. At the same time, dental practices have recognized that payment rates drop significantly once people walk out the door. Patients are more likely to pay at the time of treatment if they know up front what their financial responsibility will be.
“Our job is to know our insurance contracts and reimbursement rates really well, so we can give patients accurate treatment plans and financial estimates. This gives patients confidence in both our clinical and financial care. When we handle things up front in the right way, people become long-term, happy patients,” said Ms. Blair.
Technology solutions such as Rectangle Health’s Practice Management Bridge® can help by capturing a card on file from patients, as well as enabling electronic payments and contactless payment solutions like Apple Pay and Google Pay. “We connect all the different points of payment between the provider and the patient, whether it’s pre-care, point of care or post-care. We can send texts to patients to enable payment through their mobile devices. We also create links so practices can collect payments online or embed links in e-statements,” said Matt McCammon, Rectangle Health’s Executive Vice President of Sales.
Unfortunately, many patients have been deferring dental care, either due to COVID-19 concerns or due to an inability to pay. “When patients delay care, they need more extensive care — especially in the pediatric population under age five and in older adults over 65,” said Dr. Chaudhry. For patients experiencing financial obstacles, dental practices may need to underscore the importance of care and identify payment plans that will work for them.
Digital tools enable dental practices to enhance the overall patient experience. While the coronavirus pandemic may have been the tipping point for many providers to embrace change, the dental industry recognizes the need to engage younger generations that are entering the workforce and are digital natives. The changes to the way dental practices communicate with patients, deliver care, and offer payment options will continue to evolve over time to meet market demands.
“Anything we can do from a digital perspective to elevate the patient care experience makes sense. We want to ensure they get the care they need and do it in ways that they feel good about,” said Mr. Sewards.
The connection between delivering a better patient experience and getting paid faster for services is not lost on providers. By offering dental payment tools, patients can feel even more in charge of their personal care, allowing dentists and their staff to focus on what they do best – providing a high level of dental care.
Innovation that drives patient payments
Rectangle Health is a leading healthcare technology company that provides a comprehensive suite of payment and patient engagement solutions to healthcare providers, insurance groups and billing services. Founded in 1992, the company is headquartered in Valhalla, NY. With best-in-class technology and customer service, Rectangle Health works with 60,000-plus healthcare providers in the U.S., reliably processing over $6 billion annually in payments.