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The world of dentistry and the world of technology are becoming more closely intertwined than ever. Although many practices currently operate without it, advanced technology soon will become a necessity, not an option. As many of you know from my columns in Dental Economics, the Levin Group is dedicated to implementing highly specific systems to maximize the productivity of each client with whom we work. Based on that, we have begun to examine the process of technology as it will function in the

New patients and new technologies

Roger P. Levin, DDS, MBA

The world of dentistry and the world of technology are becoming more closely intertwined than ever. Although many practices currently operate without it, advanced technology soon will become a necessity, not an option. As many of you know from my columns in Dental Economics, the Levin Group is dedicated to implementing highly specific systems to maximize the productivity of each client with whom we work. Based on that, we have begun to examine the process of technology as it will function in the future.

One interesting area to examine is the impact of technology on the average production per new patient. We typically see practices that are 300 percent below where they could be in the area of average production per new patient. According to the Levin Group management model, approximately 40 percent of production should come from new patients. Imagine the impact if that 40 percent production were to be increased three times!

Until now, the new-patient process has been handled in a step-by-step manner without the use of a specific technology sequence. Even some of our most highly productive clients do not take advantage of the technology available in dentistry today.

Let`s look at all of the steps that occur when a new patient comes into the practice:

1. New patient calls the office.

_ Welcome

_ Schedule

_ 30-second script

_ Medical and dental history notations

_ Special situations

_ Welcome letter sent

_ Confirmation call registered

2. New patient receives confirmation call.

3. New patient arrives at the office.

4. New patient receives follow-up and treatment.

Of course, you want to reduce the system to as few steps as possible. In business, simplicity is essential, but efficiency, speed, and effectiveness are all key components of a successful practice that wants to take advantage of the production value of new patients.

Now, let`s plug the new-patient experience into a technology sequence to capture that 300 percent increase in average new-patient production. Imagine the following:

1. New patient calls the office

_ When a new patient calls the practice, have a written script to follow. This script would be viewed by bringing it up on the computer.

_ Next, the computer would prompt you to ask a series of questions to best understand and accommodate this patient.

_ Search the schedule to find an appropriate appointment for this new patient. You should have blocked out a specific number of new-patient appointments - approximately 75 percent of the average number of new patients per month should be preblocked as a series of morning and afternoon appointment times.

_ Once the patient has been scheduled, give him or her an overview of the practice to create a sense of value. This 30-second script would appear on your computer terminal so that it is immediately accessible to address the key points that make your practice valuable and desirable. While all of this is happening, the computer would be creating a new-patient file to be deleted in approximately 16 weeks if the patient never appears in the office. This file also would include information on any premedication or medical factors that should be noted. Special notes could be included as well.

_ A script for thanking the patient and telling the patient you are looking forward to seeing him or her would then be generated.

q Once the call is completed, the computer would generate a welcome letter to the patient with a reminder about the date of the appointment and an address label. (Please note that not all computer systems can offer all parameters yet ... but they will, eventually.)

_ If the patient has to be placed on hold, he or she should hear an educational message about the practice to build a sense of value. The average patient on-hold time is two-and-a-half minutes. You might not believe this, but we have timed this with a stopwatch and noted that the on-hold time is much longer than perceived by the people in the office. The staff members are busy while the patient is on hold, so they tend to not realize the amount of time that goes by.

Obviously, it is far more desirable for the patient to hear positive messages about a dental practice than silence or music. Keep in mind that patients want to hear wonderful things about their dentists, because there always is a level of anxiety when dealing with a dentist.

2. New patient receives confirmation call

_ Your software would automatically log in a confirmation call to be made to the new patient. (In the future, many confirmation calls will be automated, yet highly positive, so that patients will view them as customer service. After several years of testing these messages, I have found that they are outstanding and personal despite the fact that they are automated.)

_ Once the confirmation call is completed, the patient`s name would appear on the schedule on the day of the visit. The software would highlight that this is a new patient, alerting the practice to be fully prepared for this patient.

3. New patient arrives at the office

_ When the new patient arrives in the office, have the front-desk coordinator come out, greet the new patient, and shake hands. This makes an excellent first impression.

_ The front-desk coordinator would give the patient a packet that was generated by your software with the patient`s name on all of the forms, including a welcome letter and dental/medical history form. If the patient doesn`t show, you simply eliminate those pages that include the patient`s name. By personalizing the forms, you show that you are ready for the patient, highly organized, and caring.

_ The new patient then would fill out the medical- and dental-history forms. Any special alerts would be immediately entered into the front-desk computer and reflected in terminals in every operatory and other locations throughout the office.

_ The practice should have multiple terminals so the clinical staff can be alerted that the new patient has arrived. The assistant would then escort the patient to the clinical area.

_ The assistant should have a computer-generated new-patient orientation packet that we have been using successfully for certain clients for quite some time. This is a new step in which the assistant would spend 8-10 minutes reviewing the practice, doctors, services, and other general information as part of the new-patient orientation. This packet should be placed in a professional-looking folder that includes the practice logo and name, which impresses the patient and creates a sense of value. The packet also would encourage the patient to ask questions about other services and to gain a sense of trust in the doctors.

4. New patient receives follow up and treatment

_ The day will come when all patient information will be immediately entered into your computer system via terminals in the operatory. The new-patient visit then would include an assistant entering information into the terminal while the doctor is speaking or diagnosing the patient. However, for every advance in technology, there needs to be an equal advance in maintaining human relations with patients.

_ Once the assistant has introduced you to the new patient, you should spend a little time interviewing and developing a relationship. This usually leads to positive feelings on the patient`s part, an increased sense of value, and increased case acceptance. Initially, this information could be placed on a personal-information form, but should later be copied into the patient`s computer record. This would allow doctors and assistants to quickly review personal information in the future to maintain a strong relationship.

_ In the technology-driven practice, the new-patient exam would include the intraoral camera. Monitors in the operatory would allow patients to watch everything the dentist does. These images also would be immediately stored in the patient`s virtual file. The digital clarity of these images is improving, and soon the appearance of the mouth and teeth will have tremendous clarity on the monitor and when viewed from the patient`s file. These images would be used for treatment-planning, insurance-company filing, patient education, and patient motivation.

The exam should include automated probing, which takes far less time and requires only one individual. All recordings and information about the periodontal condition of the patient`s mouth should immediately be entered into the patient`s computer file. This would provide not only a permanent record, but could be transferred with other information to insurance companies at the appropriate time. It also would be immediately available for diagnosis and treatment-planning.

_ The tooth-by-tooth comprehensive exam of the patient also should be immediately entered into the computer record. (This will happen in the future by voice recognition, foot pedal, or an assistant who enters data as the dentist explains it to the patient during the diagnostic phase.) All of this information would be stored in a structured manner so that a treatment plan could be constructed later using all of the data.

_ Once the doctor has completed the comprehensive exam, an assistant should take a full-mouth series of digital images, which would replace traditional radiographs. The quality of these images also is improving.

_ At the end of the visit, any notes made by the doctor should be entered into the patient`s computer file to be reviewed when preparing an overall treatment plan. Obviously, patients should be extremely impressed with this high-technology process and should feel a strong sense of confidence in the practice. Remember, in the mind of a patient, technology proves quality!

All of these steps should be more effective and faster based on new technologies. These technologies will allow us to create higher levels of value, be completely prepared for patients, and not have to rely on our memories to take care of certain activities.

Dealing with dental insurance

In the very near future, all dental-insurance communication will be electronic - and so will just about everything else! All diagnosis and treatment codes will be assigned to the appropriate diagnosis or treatment, and insurance filing will be done through an electronic-claims modality. In addition to the insurance report, intraoral camera images, digital-radiographic images, automated probing information, etc., can all be electronically transmitted to the insurance company. This will result in an immediate and comprehensive review without the continual request for information that has not been provided. Inevitably, this will speed up the insurance payments to the practice or the patient.

Additional technology benefits will include all scheduling being handled in the operatories before the patient is escorted to the front desk. This will relieve some pressure on the front-desk staff to get it all done, and they can then focus more on financial issues and customer service. Eighty percent of the patient conflicts with dental practices revolves around financial and insurance issues. That`s why we want to provide as much focus on and attention to this area as possible. Because the assistants and hygienists schedule patients in the operatories, they have the best understanding of what the patient needs for the next visit. This can shorten the time required to handle this particular step.

The establishment of the next patient appointment automatically will create a "confirmation call" computer entry so that the patient receives an automated call as a reminder before his or her next visit. There is an endless list of emerging technology, but this gives you an overview of how offices will be run in the future. The truth is that the main key to success still is to have excellent step-by-step systems. These systems need to be well-defined and carefully followed.

Always keep in mind that advances in technology do not replace the personal side of dentistry. We use technology to increase efficiency, speed, and quality. It also can be used to enhance relationships and positive feelings.

Ultimately, technology, interpersonal relations, and customer service must all be carefully integrated. New technologies are making life easier and better for dental practices, but we continually need to advance the state of our patient relations.

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