Designing a Data-Driven Dental Practice

Part 1

Unless you’ve been trapped on a deserted island for the past five years (welcome back!) or you’ve been binge-watching every single episode of The Office on Netflix, you’ve probably heard a lot about the importance of data and metrics in dentistry. Whether those metrics relate to improving patient care, creating a more productive team, or increasing practice profitability, “big data” has become an important topic of conversation among dental practice owners, clinicians and office staff. In the simplest of terms, metrics or big data refer to all of the electronic information that is generated whenever you enter something into a computer database (i.e. your practice management software). This could be something about a patient’s treatment, the amount they paid on a bill, the hygiene appointment they scheduled six months from now, or any number of other items that describe their relationship with your practice.

This data can also tell the story of how your practice provides care to a single patient, a family or to every patient who has ever received treatment from you. As this information multiplies, there are opportunities to view trends, patterns and key performance indicators (KPIs). These key indicators enable practice owners and team members to make business-critical decisions as well as provide leaders with patient-related data that fosters improved care. In other words, this data is incredibly powerful, or at the least, has the potential to be powerful, but only when it is compiled accurately and presented in such a way as to enable understanding and empower effective action.

So, is your practice a data-driven one? What exactly does that mean? A data-driven practice is one that is built upon and guided by the facts and meanings relating to their KPIs. A data-driven practice embraces the insights received from data, even if those insights reveal flaws in leaders or systems. Problems are viewed as exciting opportunities to change and transform into something better. Perhaps most importantly, a data-driven practice is powered by a collaborative, blame-free culture that invites ownership and servant-leadership from all team members. Here is the story of how a practice became data-driven, and how that impacted the care provided and the growth experienced.

Growing Pains

During a recent review of their overall growth and performance, the leadership team at CarolinasDentist, a fast-growing, eight-location general practice headquartered in Fayetteville, North Carolina, realized there were several gaps between where they were and where they wanted to be. Aggressive growth was great, but it was also causing some real challenges.

  • Cancelled and “no-show” appointments were averaging 25-30 percent in some practices and were projected to cost CarolinasDentist $1.8 million in annual revenue.
  • Many patients were leaving the practice without a scheduled next appointment.

Treatment was being presented, but if it wasn’t accepted while the patient was in the office, they often got lost and missed out on needed treatment. CarolinasDentist’s hygiene departments were also underperforming, or at least, it seemed like they were underperforming. These and many other issues were creating some real headaches for the leadership team.

These leaders knew they needed to make some changes, and they also knew doing so would have a positive impact. But what could they change? And if they changed something, how would they know it was the right thing to focus on? Implementing change based on emotions or what one can visualize is one thing. But making adjustments or course corrections based on actual data is much more effective. Knowing this, CarolinasDentist began searching for a solution.

According to Josey Sewell, Vice President of Education at Dental Intelligence and former COO at CarolinasDentist, “We’d heard complaints that our hygiene team wasn’t producing to their full potential. At first this seemed valid, but in reviewing our numbers, we learned that what we thought was the issue, wasn’t really the issue.” As they took a deeper dive into their practice metrics using Dental Intelligence, the leadership team at CarolinasDentist discovered the actual source of their struggles. “Our real problem was cancellations and no-shows,” Josey said. “In some of our locations they were as high as 25-30 percent. This meant that on an average day, three out of ten scheduled appointments weren’t coming into one of our practices, which meant we weren’t providing our hygienists sufficient opportunities to diagnose and treat patients. With the patients they were treating, the data showed they were actually performing pretty well.”

After they discovered the source of their problems, the CarolinasDentist team went to work—as a team—to solve the problem of high appointment cancellations. “It was all hands on deck,” Josey shared. “We focused our entire team on lowering cancellations and no-shows. This included our front-desk team, doctors, office managers, treatment coordinators, and schedulers. Scripting was created that discouraged cancelling or missing appointments. Team members focused on helping patients understand how important it is to keep appointments. Within a few months, our cancellations dropped from 30 percent to less than 10 percent—a phenomenal improvement.”

Lessons Learned

This is a great example of how a data-driven practice should function. Did you notice principles that could be followed in your practice? For example:

  • They went where the data took them. Instead of relying on feelings, this team explored the information in front of them until they could validate what it actually meant.
  • Once they identified the real problem (cancellations and no-shows), they spent time discussing why this was happening. This was a collaborative conversation. They didn’t point blame at anyone or make excuses. They recognized they had a problem and began the process of understanding why it was happening. They knew that until they found the source of the issue, they couldn’t solve the issue.
  • Finally, their entire team was involved in developing and implementing solutions. This is so important. In order to build a culture of unity and leadership, everyone needs to feel they have a part to play. This also allows the entire team to feel they contributed to the successful outcome.

Becoming Data Driven

But what if your practice isn’t there yet? How do you go about creating a data-driven practice? Although there isn’t a one-size-fits-all solution, there are some principles and processes that can be applied in almost every dental practice. But don’t force it! “If you have a broken culture and we bring in metrics and numbers, a lot of team members might feel threatened,” Josey said. “If they already feel like they’re being micromanaged or their efforts are not rewarded, then sometimes that can be scary. But I think the first thing is, it’s so simple, but so many people miss it—it’s the dentist painting the vision of why this matters and then modeling the ability to be vulnerable and talk about where they want to go with their practice and to give people a purpose and a reason to change. Help them to understand ‘What’s in it for me?’”

Practices that have established a data-driven culture quickly learn how important it is to engage their team in the process. Trying to do this in a top-down approach is rarely effective. A collaborative model is much more likely to hold up when the inevitable hiccups happen. “When we can explain it in a way for team members, what’s in it for them, they can get more excited about it than even we can,” Josey said. “For example, using metrics to demonstrate to a front-office team member the value they bring to the practice or showing them how to use digital systems to keep better track of patients instead of fumbling through all of their notebooks and their sticky notes and things like that. Or for clinicians to understand their ability to care for patients is enhanced and not diminished through data. The more they know about the history of a patient, the more effective their care will be for that patient.”

It’s Personal

While serving as COO for CarolinasDentist, Josey had many opportunities to help new and existing team members develop a vision of the value of using data to improve patient care. This usually began in a group setting, but would then likely involve additional one-on-one conversations with team members. Given that most people don’t like to voice concerns in meetings, this makes sense. If you announce in a meeting that you are switching over to a new system or software solution and don’t follow-up with individuals to identify and address their feelings about this change, you’re likely to experience some significant resistance in the future.

Here’s how Josey handled this situation: “I think a lot of people can struggle as a dentist or an owner by feeling ‘My team owes me,’ rather than being able to say ‘My team enables me to do what I’ve been called to do or what I chose to do.’ And we make it all about the dentist’s goals or the leader’s goals without taking into consideration what the team members’ goals are. We know the workforce is changing, and people are not motivated by the same things they were before. And those team members need to feel important. They need to feel valued; they need to feel appreciated. What has worked really well for me is having a conversation with team members about their personal, professional and financial goals. We all want to feel we’re making a difference. We all want to be team players—to contribute. Frame these changes in the context of the things that matter to them.”

A good example of this was an experience Josey had with one of CarolinasDentist’s hygienists who shared her goal of growing into a leadership role. “We began that conversation with me asking what the next 12 months looked like for her. Meaning, even if this goal takes you out of being a clinical dental hygienist in this practice, tell me what’s really important to you and let’s maximize what we can do together. My objective was to try and find how I could marry the experience she wanted with what our business needs were.”

“We were able to come up with a plan where she wanted to try some training,” Josey shared. “I didn’t have time to sit chairside and train dental hygienists, and so I was able to delegate that task to her, meaning we both won. She felt really important. She felt really good about herself. She started doing the clinical training for our hygienists. Now she had the responsibility of helping others improve and got to see how important data was in her efforts. If I needed her to provide training for a hygienist who was struggling, we would look at their metrics beforehand and then she would do the training and we might go back and look at it together afterwards. By supporting her in her goals and helping her use the metrics from Dental Intelligence, she became one of my most engaged hygienists. Allowing team members to set their own goals is critical. People don’t want to be managed. People want to be coached.”

Energy, Value and Purpose

Are you starting to see the vision? Data is NOT just numbers and reports, as important as those are. Becoming a data-driven practice is a journey toward real, sustainable growth. A data-driven practice has energy. There is a palpable feeling of value and purpose in every team member. This kind of practice thrives. Everyone is engaged in a shared purpose.

Once you’ve established a data-driven practice, how do you sustain it? We’ll learn more about what Josey and the CarolinasDentist team did to build on their success and expand their services and locations in the second part of this article. Stay tuned!