Focus on ROI: Is your technology delivering?

March 23, 2015

It was a fantastic gizmo when the sales representative showed it to you. You could hardly wait to bring it online. Everyone was excited in the office. But after a few months, excitement waned, and the gizmo touted to be the next best thing became the next big expensive thing collecting dust in the corner of your practice.

It was a fantastic gizmo when the sales representative showed it to you. You could hardly wait to bring it online. Everyone was excited in the office. But after a few months, excitement waned, and the gizmo touted to be the next best thing became the next big expensive thing collecting dust in the corner of your practice.

So what happened? Why aren’t you getting the return on investment, or ROI, that you should from your technology?

Dental Products Report spoke to a few industry experts about this issue. What we learned is if you feel like this about your technology purchases, you are not alone. Getting the most out of your technology is one of the biggest challenges related to technology for today’s dental professionals.

“It turns into the vicious circle of underutilization,” explained Dr. Lorne Lavine, DMD and owner of The Digital Dentist. “They [clinicians] purchase it hoping it would change the way that they practice, and thought they were going to see increased revenues, increased efficiencies and decreased costs. But because it wasn’t really being used to its maximum, it became an albatross-it hung around their necks. Now it is a monthly payment they couldn’t afford that wasn’t producing what they want. They didn’t keep up with the technology, so they were finding it difficult to use. A lot of times, those things end up becoming coat hangers.”

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The Future for Dentistry is Pixels not Paper
Experts agree that the future of dentistry is digital. From practice management to digital radiography to the more advanced and specialized technologies of cone beam and CAD/CAM systems, the future of the dental practice is getting away from paper and moving into pixels, explained Jenny Allen, regional technology advisor for Patterson Dental.

“We already see electronic services used for everything from insurance verification and patient statements on the front end. Clinically, we see digital X-rays, digital impressions and more. Everything is going toward technology,” she said. “The term zero paper is going to be a reality. Technology should allow offices to focus on their patients and not their software. For that reason, technology will be everywhere. We can look at every task and assume technology will be used to help complete that task. Somehow, someway, technology is going to touch it, and technology is going to change everything.”

“Technology is critical,” Dr. Lavine said. “We are continuing to see a shift towards high-tech offices. We see the price points come down on a lot of the high-tech items that were previously not very affordable, things like CAD/CAM, cone beam and digital impressions. They are becoming more mainstream. I wouldn’t go so far as to say they are standards of care, but as the price drops down, as people find it more affordable, then we are going to see a larger adoption of that in practice.”

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John Cox, vice president of technology sales for Henry Schein Dental, explained most dentists understand the importance of embracing the change technology can make for their business.

“In today’s environment, with insurance and the PPOs reducing some of the payments for procedures, practices need to become more efficient. Dentists are well aware of the fact if they are going to run a successful dental practice in today’s environment, they need to have a powerful business dashboard to run their business effectively,” he said. “They can’t just be great clinical dentists. They have to be that, of course, but they also need to be CEOs. They need to run their practices effectively.”

Allen believes dentists resisting change to digital technology in the practice could be in for difficult times if they don’t make the transition in the near future.

“They cannot run from digital technology. The technology is coming to them,” she said. “They should get in front of that technology. They should embrace it and learn how to use it before they are trampled by it. Then, they are left in the dark, and the time has come and no one in the office knows what to do. They are going to be left behind if they don’t embrace that change.”

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What Makes Up the ROI? It’s Not as Simple as You Think
Most clinicians realize technology is important, but they also know moving to a new technology can be a big investment of time and money. Many of them make the initial investment and attend the first training sessions. With the high price tag of the system and loss of production during the initial implementation, much of their zeal to adopt the technology wanes. Over time, they only feel the pain of the investment of time and money but haven’t looked at the return they will get on their investment after going through the pain.  

An ROI can be determined several ways. The most common is to figure all the monthly costs associated with the technology and then trace the direct production it supplies and subtract the costs from the income it generates. This concept is basic business and common sense.

In some cases, however, this basic approach misses some of the ROI benefits the technology provides. Dr. Lavine said he believes there is more than the direct production that results from the technology to consider when determining ROI. These are things that are harder to determine and measure.

“Are you getting new patients because of that technology? Are those patients telling other people? Are your patients not leaving your practice because you are perceived as high tech? It’s hard to measure what you would have lost if you didn’t have that equipment in place,” he said.

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Cox agrees that some benefits are harder to measure in dollars and cents, in particular, the patient experience.

“I think a lot of technology is purchased on the ‘WOW’ factor that it can deliver, or it could be the clinical efficiency it provides, but I think the patient experience sometimes gets overlooked. So if the patient can receive the treatment in a shorter time frame with fewer visits without compromising the quality, and more comfortably and conveniently, that’s a huge win. And that will translate to a positive financial ROI for the practice. It might not be evident up front but it will certainly result in that in the end.”

Allen believes that if dentists have realistic expectations from what the technology is going to be able to do for their practice, they are going to see the best results from it. Too many offices blame technology for problems that aren’t the technology’s fault. If they ignore the cause of the problem in their practice, Allen believes a practice will just continue to work harder not smarter.

“Technology can’t come in and fix what’s wrong with a practice. It can only enhance what’s already working well. For that reason, the maximum return on investment comes when the technology is used to improve and streamline processes that they already have in place,” she said. “On the contrary, the offices that have embraced the technology have learned how to implement it. They take time to learn new things continually and adapt to the technology-led processes. They get the most out of their technology. They see that ROI tenfold.”

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Cox said he believes that a firm ROI on the technology is the result of its ability to automate systems that affect productivity and efficiency in the practice. He encourages clinicians to consider whether the technology is going to enhance the patient experience and reduce chair time appointments by eliminating steps in the clinical workflow.

“Less chair time means more profitability in that procedure, which obviously leads to a higher level of profitability,” he said. “When you have a 20- to 25-percent reduction in payment from PPO, you have to introduce efficiencies in your business. You can’t afford to have open chair time. You can’t afford for scheduling not to be effective and efficient.”

Cox also thinks clinicians should consider the impact on the staff. New technology affects staff attitude and the culture of the practice. Will they be excited to be a part of the leading edge of dental technology? Excitement breeds a more productive and happier culture at the office, which improves the employee experience, as well.
“It’s more than just the bottom line,” he said. “ROI can be measured on many fronts. More and more dentists realize it’s not just based on the financial numbers.”

Where Does it Go Wrong with Dental Practice Technology?
The obvious question becomes where did it go wrong with the technology purchase? The answer relates to training.

“When it comes to technology, one of the biggest mistakes practices make is not getting ongoing training,” Dr. Lavine said. “We’re talking all technology. You forget stuff. The software comes out with new features that you might not be aware of. For something like practice management software, the typical office uses 5 to 10 percent of its capabilities. That’s it. It’s because they never got the training and refreshed themselves on what they did know.”

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All three of our experts agree the problem results from the implementation process. From poor planning to not enough investment in training and even staff resistance, there are many reasons why technology doesn’t have the ROI it could for a clinician.

“The most surprising thing for me was the poor planning. A lot of times, I had assumed that the practice had planned for the change, planned for this implementation, and they hadn’t. Nobody likes change. We know change disrupts habit, and anytime someone adopts new technology that means they have to embrace that change, they have to do things in a very different way,” Allen said.  

"Change is never easy. It’s got to be managed. Like anyone else, we are creatures of habit. Anytime we try and do something different, there’s a process of education that we have to go through,” Cox said. “I think that’s the single biggest reason technology sits in the corner. There’s not a great change plan or adoption plan.”

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Cox considers implementation as the key to the process and sees that it’s a ball that gets dropped a lot by clinicians. When a technology purchase occurs, the organization behind it should have a solid program for training and transitioning the practice. It’s incumbent on the vendor to stay close for the first 100 days to make sure the practice understands the patient and the practice benefits.

“At Henry Schein, we follow this blueprint of success when we sell a technology to a practice, making sure it’s the right one, and then stay close to make sure the implementation goes smoothly. At the end of it, it’s not sitting in the corner collecting dust,” he said.

Allen agrees that training needs to be a priority for clinicians, but it often isn’t. She describes the sentiment that “working on anything other than dentistry is often perceived as a waste of time and money.” Like Cox, Allen deems it the responsibility of the company providing the technology to take the lead in the training endeavors.

“From the beginning, the training has to come from the distributor you are working with to get an idea realistically how much time is it going to take me to learn this. They know better than you. They have trained hundreds of offices, so they know how much time is going to be involved in training,” she said.  

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Dr. Lavine agrees that training is an ongoing investment and one that many clinicians aren’t willing to make.

“The typical practice, once they get the bill for all this technology, there is a fair amount of sticker shock, and you do everything in your power not to spend any money in the next five years. It doesn’t work like that. You have to look at maintenance and support and ongoing training as part of the equation. That has to factor in when you are doing that five-year ROI study,” he said.

Staff resistance is another reason that technology isn’t used to its full capacity. Some staffers don’t care for changes in their day-to-day activities. Allen describes it as a fear factor but thinks positioning the point of the technology here is the key.

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“If I take that piece away and automate it, I have to help that person understand that I’m doing so to improve their lifestyle and to give them more time to focus on quality patient care,” she said. “Let’s use technology to take care of that busy work and improve the time that they have to spend with patients and make their experience better.”

How You Get the Best ROI on Your Technology Investment
Getting the best ROI for your technology has a few different key actions. The first action starts before the investment. Dr. Lavine encourages doctors to enlist the help of experts to navigate the various technology products to find the ones that benefit their practice the most. The Digital Dentist works with practices all across the country to help them establish the right technology for their practice.

“Work with someone like myself or a practice management consultant, an accountant, anyone that can say, ‘Okay let’s look at this from a business standpoint,’” he said.

Cox agrees that clinicians should partner with an expert. His team regularly does a practice analysis. The reps spend a lot of time getting to know the practice so they can get an idea of what technology meets those needs. Having a great partner and a plan for implementation will help clinicians get more from their investment.

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“Technology will continue to change at light speed. In dentistry, technology is starting to change at a fast pace. You need a great partner to help you navigate. A great partner will help understand the needs of your practice and give good vision and direction as far as introducing technology as it can have a positive impact on the ultimate goal: To deliver quality dentistry faster,” he said.

Allen advises doctors to involve their team. Overcoming staff resistance to technology is easiest when they are involved in the decision from the beginning. Most of all, the doctor needs to communicate with the team their desired outcome and the plan to get there.

"They have to share their vision and their goals with the team to make sure everyone is on the same page, involve everyone from the beginning and make sure they have the right team attitude. I think that is so important because without that attitude, nobody takes the time or the energy to invest in learning a new technology,” she said.

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Allen also cautions doctors to invest their time in training, either in office or using another option. Patterson has webinars, online tools and numerous training videos available for use after hours if closing the office isn’t a desirable option. Whatever option for training they choose, however, she emphasizes the importance of training on the product.

“What they have to see is that training has got to be considered as part of their technology investment. It’s not an optional expense. They should plan for that. They should expect it. And they should take the time to learn it,” she said.

Dr. Lavine wants clinicians to look at their technology investment like any other investment.

“Don’t buy it for technology’s sake. Invest in it. Like any investment, you have to reevaluate it on a regular basis. You have update it. Just like a stock or a mutual fund, you have constantly nurture it. Make sure the equipment is up-to-date. Service it. Make sure that you are getting training and getting the support that you need because it is a long-term investment if you use it correctly.”

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