by DSOs work to separate true innovation from the ho-hum
Choosing the dental supplies, equipment and services your doctors and staff will enjoy using is no easy task. Are the vendor’s claims for a new technology well-documented? Will its benefits outweigh its cost? Will you be using this on patients five years from now, or will it be collecting dust in a closet? Is it truly innovative, or just another (expensive) me-too product?
“In our 33 years of evaluating products and equipment, we see many great products,” says Mary Yakas, The Dental Advisor. “But they’re not necessarily all innovations. ‘Innovation’ means different things to different people.” The Ann Arbor, Mich.-based company provides the dental profession with evidence-based and clinically relevant information on dental restorative products, infection control products and dental equipment.
Adds Ken Strohschein, chief information officer, Great Expressions Dental Centers, “‘Innovation’ is a buzzword commonly used in IT, so we hear it used in the majority of our conversations. However, it is actually rare for something to be truly innovative. Oftentimes, the solution is helpful or has the potential to be helpful, but not many solutions are truly new, advanced and original.”
Definition of terms
“Innovative is when a new or significantly improved solution is provided to an existing problem,” says Strohschein. “In many cases, innovation isn’t using a new technology or device, but rather, just using existing technologies in a more effective way.
“Uber is a perfect example of this,” he continues. “Everyone knows that GPS and online payments have been available on smartphones for a long time. It just took someone to come up with a different way of using the existing technology to come up with a truly innovative solution.”
Great Expressions itself has found ways to use existing technologies in more effective ways, adds Strohschein. “Our marketing team launched ‘Expressions TV,’ a lobby television system that educates patients on medical topics and services offered in our offices, while at the same time playing entertainment segments, such as local news, sports and weather. This is not necessarily ‘innovative,’ but it is a great way to use an existing technology to better meet the needs of our patients, to educate, and to create a more comfortable and enjoyable experience.”
Says Yakas, “I see innovation as simple as something that changes a technique, viewpoint, or story of anything that is being presented. At The Dental Advisor, we are considered trusted experts. Readers want us to cut through claims and help them identify things that will help them in practice.
“When we really see innovation, we like to explain how it works, why it works, what it improves, and why people should consider it. Each year, we have the opportunity to give an award for both innovative product and innovative equipment. But some years, we really haven’t seen anything so innovative that we believe it’s a game-changer. A great example of innovation is this year’s winner, Monobond Etch and Prime from Ivoclar Vivadent. This product eliminates a step in bonding a restoration, which saves time and avoids handling hydrofluoric acid.
“Our first question was, ‘If it eliminates a step, does it cut down on effectiveness?’ In this case, we had the opportunity to independently test the product in our laboratory and clinically, and confirmed excellent bond strengths.”
Sometimes, The Dental Advisor is presented with products that may be innovative in concept, but not necessarily in clinical practice, continues Yakas. For example, a product or technology that adds extra steps to the dental staff’s procedures may be innovative or cool, “but you may be creating a problem where there isn’t one, or your solution may be creating an extra step.
“Our experience shows that if you are adding steps, clinical teams need to see the benefit of doing so.”
Cost-effectiveness
Like all healthcare providers, DSOs today need technologies that are innovative and cost-effective, according to those with whom Efficiency in Group Practice spoke. They must also balance the need or desire to be an “early adopter” with the need to carefully evaluate new technologies that come their way.
“It may add extra steps, change a traditional process that is working well, or be too cost-prohibitive for practices to adopt,” says Yakas. Is it cost-effective, for example, for a practice to replace the impression materials with which they are comfortable, with a $20,000 digital impression unit? “Perhaps. But nothing is a magic wand, especially when it comes to technology integration.”
On the product side, disposable items may only cost a few dollars, she continues. “But just because it’s disposable doesn’t necessarily mean it’s cost-effective.” That’s because in addition to the purchase price, one must figure in additional costs, as well as waste management for these items. The same can be said for reusable, sterilizable items, she says. “Though they can be reused, often, sterilization guidelines are not followed for reprocessing, and this can cause breakdown or cross-contamination issues.”
Says Strohschein, “Many times, vendors price themselves out of consideration,” he continues. “Five hundred dollars per doctor for a solution may not seem like a lot… until you consider hundreds of doctors.
“We have a very thorough process for benchmarking, and we have key executives and management who have worked in a variety of industries, so we have a good feel for what a product/innovation should cost. We certainly understand that the vendors need to make a profit, but it needs to be a cost-effective solution and a good partnership for both sides.”
Evaluation process
Making the right decisions about new technologies may differentiate successful DSOs from less successful ones. That’s why they take the evaluation process very seriously.
At Great Expressions, “the IT department vets the concept initially, and if we find value, our next step is to involve our senior management to get their feedback, as well as the feedback from potential key users in the organization,” says Strohschein. “If it is a clinical-specific product, GEDC’s National Doctor Panel reviews it and remains involved in decision-making.
“If the product is deemed a viable solution, we will test it in a single location or market to work out any operational concerns and get direct feedback from the end users. We then use this feedback to go back to the vendor and make any needed adjustments, and make adjustments on our end in order to roll it out to all offices, or decline the technology altogether, if it’s not a fit.”
The key to implementing any new technology or supply is its acceptance by the office and/or clinical staff, he says. Great Expressions uses a variety of methods to obtain feedback, using everything from GoToMeetings to steering-committee meetings, onsite visits for observation, dedicated support phone lines, and continuous open dialogue with team members.
“While called many things, ‘evidence-based’ solutions are a requirement,” Strohschein continues. “The best partnerships are those in which both sides have skin in the game, and both sides are willing to make the test/product successful with ample support.
“Lastly, I want to see a product work in our environment – or talk to another DSO that already has the solution in place.”
Sound science
Says Yakas, “As materials and equipment develop, we are forced to stay on top of changes and improvements, so that we can appropriately put them to the test, both in the laboratory, and clinically through practicing dentists, who also want to know about product performance over time – which is where our long-term studies play a role.
“We also need to keep in mind that adults do not typically change unless they see a need and value to do so,” she continues. “Our job as evaluators becomes looking at what is and what can be, and providing sound science to back it up, so that readers can make informed decisions based on independent testing.
“We are and have always been a scientifically based company, founded by two PhD dental materials experts,” says Yakas. “They taught us to question everything from bond strength to the design of a syringe.
“‘Evidence-based’ has gotten quite a bit of focus over the years due to transparency laws and consumer knowledge of who funds studies and how they may be skewed based on who pays for them. We are proud of our reputation of remaining a scientifically based company that provides unbiased, third-party information to the dental profession. That position is not an easy one to maintain, as many times, results delivered are not as hoped.
“Our view has always been that if we use good science along with honest information, it improves patient care in the end. Maintaining our integrity in the process of what we do and assisting manufacturers with development and improvement of products, as well as reporting to dental professionals, is a cornerstone of why we have the trust of the industry.”
The early adopter
It’s great to be an early adopter of new technology, but one must tread that path carefully, according to experts.
Like many solutions in the dental industry, early adoption doesn’t necessarily mean implementing a new technology, but rather, implementing a technology from another industry, says Strohschein. “It is important for Great Expressions to be an early adopter, but only when the impact of the solution or product is thoroughly understood as being of value for the patient and/or our clinical team members. GEDC has the ability and talent to customize technology, or build our technology as needed. This helps us meet the needs of the patient and our clinical team members to help move the office ahead via technology.”
Says Yakas, “Many DSOs have a young workforce, as many students exit school and go straight to DSOs to gain experience. The benefits of early adoption are that patients will perceive the practice as being on the cutting edge, and young dentists – who are eager to learn and integrate new equipment and techniques – will be attracted to it.
“On a negative side, any change to process requires time for training and integration,” she continues. “This is where we see most ideas fail: Practices don’t put aside time away from patients to allow the staff to learn about proper usage and adoption of new products or read instructions carefully.”
Doctors fall in love with a new product or device they see at a trade show; buy it; then integrate it with their team, often with little or no training, she says.
“In general dental professionals are perfectionists. They are taught to fix the problem. However, failing to plan ahead means unnecessary stress. You’re putting stress on people by not giving them time to make sure they don’t make mistakes while working on patients.”
That’s a high price to pay for innovation.
Editor’s note: The Dental Advisor is available to train group practices on the latest materials and equipment. For more information, visit https://www.dentaladvisor.com.
