Implementing Technology to Its Fullest Advantage

Do you spend a fortune on technological advances but are unable to incorporate them fully into your practice? Innovation is often stalled due to resistance to change or the daunting challenge of implementing wide-sweeping improvements while running an already busy practice. For these reasons, some dentists shun new technology entirely. As a result, many are missing out on the substantial benefits of today’s advances.

What does a successful, high-tech practice look like? To demonstrate, let me introduce you to a respected Pride alumnus, Dr. Brad Dykstra. He is a general dentist in Hudsonville, Michigan whose articles have appeared in Dentistry Today. To highlight the technological advances that Dr. Dykstra uses in enhancing the new patient experience, let’s describe the visit of a typical new patient, Mary Smith:

• During Mary’s brief wait in the reception area, she watches the Smile Channel on a large plasma screen. Seeing segments on veneers and tooth pain gives Mary ideas for improving her smile and a heightened awareness of dental health issues.
  
  
• Mary is escorted to a photo room, where an assistant takes digital full-face and smile photos. They are instantly added to Mary’s electronic chart and available to doctor and team for treatment planning and for identifying patients by appearance without having to ask who they are.
  
  
• The assistant takes a digital panoramic x-ray, then escorts Mary to a treatment room with computer screens behind and in front of her chair. The assistant reviews her dental and health history with her and enters the data into her e-chart.
  
  
• Dr. Dykstra can view Mary’s panorex from any computer in the office and instruct his assistant to take additional x-rays.
  
  
• Mary meets Dr. Dykstra, who establishes a relationship with her by asking open-ended questions and active listening. During the co-diagnostic examination, he calls out his findings to Mary and to his assistant for entry in the e-chart.
  
  
• As Dr. Dykstra takes intra-oral photos of areas of interest and uses the Laser Diagnodent to probe suspicious areas, the new methods, along with the doctor’s relationship-forming skills, builds Mary’s confidence in him.
  
  
• After leaving the room, Mary mentions to the appointment coordinator that she is going on vacation in Hawaii. The staff member enters the information on “Team Talk,” a feature of Mary’s e-chart where her personal comments, as well as other important information, are recorded and instantly available.
  
  
• During the consultation, Dr. Dykstra reinforces what was co-diagnosed in the clinical exam, which indicated that Mary has periodontitis. An intra-oral picture and x-ray magnified almost 100 times show bone loss and tartar spurs dramatically.
  
  
• Dr. Dykstra’s exam also revealed that Mary does a lot of bruxing. On her smile and intra-oral photos, she clearly sees the signs of wear. The doctor’s compelling, magnified images and persuasive influencing inspire her to accept full treatment.
  
  
• Mary meets with the financial administrator, who instantly pulls up Dr. Dykstra’s treatment plan on her computer screen, prints it, reviews it with Mary to establish payment options, and schedules her next visit.

In subsequent visits, the team easily open and refer to Mary’s photo and personal relationship-building information, making her feel recognized, unique, and cared for. They instantly see Mary’s treatment for the day, x-rays, and other vital information without having to rummage through a paper chart. Mary will experience dental lasers and other technologies that promote the highest level of comfort and care. It is no surprise that Mary and others like her become loyal, committed patients who value, accept, and follow-through with treatment and enthusiastically refer others to the state-of-the-art practice.

Do you want your patients to have this kind of experience? If so, read on to learn the five critical steps that Pride Institute teaches dentists like Dr. Dykstra to establish a high-technology practice and state-of-the-art care.

1. Develop a vision and strategy for technological advancement.

Halt! Before introducing technological change, the leader must have a clear, compelling reason for the upgrade. Otherwise, the staff will feel the new method is just another task in a series of tasks that can feel like a drudgery. How many times have you returned from a dental convention excited about introducing innovations—only to get the look of the dead from your staff? It’s not a piece of equipment that creates excitement; it’s the outcomes the equipment can provide that inspire. A “vision” is a compelling picture of a future outcome that ties to the practice’s values and inspires doctor, team, and patients. A vision aligns the goals and actions of staff and doctor in a focused, efficient way.

For example, if you are introducing digital radiography, it is your job as leader to paint the picture of a compelling future that the innovation will bring so that everyone can get excited about it. If your vision is to give patients the best, state-of-the-art care and service, then discuss with your team how digital radiography supports this goal. We learn from Dr. Dykstra’s example that digital radiography’s sheer size on a monitor enhances patient care by allowing people to see and understand dental conditions that they could not decipher on traditional film. This technology also enhances service and makes the staff’s jobs easier by eliminating film development.

A vision without a strategy is but a vacant hope. So the second part of this step is to develop the overall strategy that makes the vision possible. This includes ongoing meetings with the staff to determine action steps, assign responsibilities, and create a timeline for accomplishment. Dr. Dykstra holds regular digital staff meetings, which are a forum to deal with the implementation process, including the problems arising and progress with timelines. Further support for technological advancement can be provided by a field trip to an office using the new technology, a course, or a vendor demonstration, as this helps both doctor and staff in visualizing positive outcomes.

Develop a strategy to span several years; and remember to involve your team in the process because you will vitally need their cooperation and commitment in implementing your plan. In strategizing, don’t try to do everything at once. This will overwhelm you and ultimately cause burn-out. Dr. Dykstra points out that if you begin with practice management software that will support a digital office, then you are poised to add subsequent technology to it. You may decide to introduce computers in the operatories prior to digital x-rays so that you will have monitors to display the x-rays on. If you begin using the computers for scheduling, then everyone can become familiar with them before other systems are added. Introducing digital charting prior to digital radiography will mean you’ll still need paper charts for the x-ray films, so you may decide to update the radiography first. Plan carefully, then proceed.

2. Communicate the vision for change so the team truly hears it.

One of my favorite books, The Leader’s Voice, notes that the difference between a vision and a hallucination lies in how many people see it. How many of us have walked into a staff meeting clearly seeing a vision of what we want to accomplish, only to walk out feeling it was a hallucination? There are four assumptions we make that lead to misfires in our communications:

• Your team understands what you say. Dentists are prone to communicating in technical terms devoid of emotional components. You’ll lose your staff if you spew factoids about the megabytes of a new hard drive. Repackage your message to fit the recipient. How will the hard drive make your team’s job easier and help the patient?
  
  
• Your team cares about what you say. Your team listens to WIIFM, the station that plays “What’s In It For Me.” Two other radio stations you need for broadcasting your message are: WSI (“Why Should I?”) and the most important of all, MMFI (“Make Me Feel Important!”). Your staff won’t care about a change that benefits only you or the patients. There must be specific advantages for all in order to win their support. For example, when introducing the CAESY communication system to his team, Dr. Dykstra asked his team questions such as: “How would it be if you didn’t have to repeat the same information over and over to patients? How would you like watching a presentation with the patient, then elaborating on it and answering questions? Wouldn’t that be easier, more effective, and fun?” Through this process of discussion, the team realizes that implementing the new technology gives the patient a more visual and compelling picture of dental problems, and it also makes their jobs more efficient and fulfilling. This motivates them to embrace the change.
  
  
• Your team agrees with what you say. Silence is not agreement. Dentists who avoid conflicts are quick to assume that a silent team is a supportive team. A team that voices its concerns is a team much more likely to succeed in implementation than a passive team that will yes you to death, then go about their business as if they never heard you. The most courageous thing you can do when you introduce innovation is to provide a forum for your staff to safely discuss their misgivings without fear of repercussion.
  
• Your team will take appropriate action. Even a supportive team needs resources, an action list, and timelines established to implement new technology. For example, when Dr. Dykstra introduced digital charting, the staff continued to cling to the paper charts. He realized that he needed more training to lead and train his staff before the new system would take hold. He took the vendor’s training, realized everything the digital charts could do, and demonstrated the new methods to his staff. He agreed to lighten the schedule for a week, and his team agreed—with trepidations—to a timeline of one week to drop the paper system and go fully digital. The result was that within one day of using the new system, with the doctor helping them with their digital entries, they were able to make the transition. They never used the paper system again.

3. Be prepared to handle the staff’s resistance to change.

Staff members are engaged in countless activities just to make the practice run as is. Before technology reduces the work load, it can create more activities and confusion that overwhelm the staff. Therefore, they may view the change as threatening, which triggers stress. We’ve all been at staff meetings in which the team is in fight-or-flight mode over a proposed change:

“We already tried that and it didn’t work.”
“Why do we need this when we’re so successful already?”
“The patients won’t like it.”
“Oh, please don’t do that to us!”

Doctors unable to manage conflict give up in the face of the team’s resistance. Our view is, no guts, no glory. This means: Expect resistance and handle it. Emphasizing how the proposed change will benefit the staff, as mentioned above, is especially helpful in overcoming resistance. For example, when Dr. Dykstra introduced the scheduling of hygiene visits from the treatment room, the hygienists could easily have viewed it as more work for them. However, Dr. Dykstra stressed how wonderful it would be for them to be able to customize the hygiene visit to meet the patient’s needs. As expert clinicians, hygienists know which patients will need more or less time. Therefore, scheduling their own appointments allows them the flexibility they need to give their patients ideal care.

Inertia and complacency also stem from employees feeling uncomfortable when old habits are abandoned and new ones created. They automatically revert to the familiar old ways, especially when under pressure. Your coaching and support throughout the change process keeps the staff focused and positive. Enlist the help of those who quickly grasp the new methods to help those who are struggling. Eventually everyone will master the new skills. The biggest reason failures occur in implementing new technology is that the doctor woefully underestimates the amount of coaching and support needed. So fasten your seat belt and stay the course all the way to the point when the new skill is so integrated that the staff doesn’t even have to think about it. Dr. Dykstra observes that he encountered staff resistance to change initially, but if he were to take away any of the technology today, his staff would quit—and so would he!

4. Modify existing systems and processes to support the proposed change.

In the most sophisticated offices, we find that if the scheduling, financial arrangements, patient examination, continuing care, and other systems do not change to support the new technology, the implementation is thwarted. For example, when Dr. Dykstra implemented his new methods, it threw his scheduling system into chaos. He needed to keep the foundational basics of scheduling to meet production goals and optimize use of his time; but he also needed to make major adjustments in the scheduling system for new technologies. Dentists must realize that systems that worked great in the past may not work with new technology. Be prepared to reorganize.

5. Create milestones for success and celebrate your accomplishments, both big and small.

The worst thing a dentist can do while implementing technology is to adopt what Ken Blanchard calls “seagull management.” This mean waiting until an employee does something wrong, then swooping down to eat the person for lunch. In our attempts to do things perfectly, it’s easy to get frustrated when the staff doesn’t instantly perform new skills. If you want to stop change momentum, fail to acknowledge the baby steps.

New technology increases production, efficiency, and balance. This means more money for salary and rewards, more quality time for preparation, education, and celebration, and more gratification for jobs well done.

I know of no profession that is more exciting and ever-changing than dentistry. We can embrace advancement with a practice culture firmly rooted in the five steps for implementing change. If Dr. Dykstra can do it, so can you. Pick a change you would really love to make but have been hesitant to try. It’s as easy as one through five.

Amy Morgan is CEO of Pride Institute.

Originally published in Dentistry Today, September 2006