The Benefits of Digital Workflow
Offices that incorporate a digital workflow see a variety of benefits in terms of patient care and profitability.
For the patient, the advantages are enormous, especially when practitioners have milling capabilities in-house, Augins explains. Patients like that the whole process, from consult to restorative insertion, can occur in one appointment. “They also understand that digital means high accuracy, and they have a high level of confidence in a practitioner who uses the latest technologies,” he says.
For the practice, Augins notes that preliminary research shows that an average restorative office produces $850,000 to $880,000 in revenue per year. Adding digital workflow with in-house milling increases that to $950,000, and if orthodontics and implants are added, revenue can grow to $1.4 million. In addition, a long-term study with Pacific Dental where digital workflow was initiated versus conventional methods resulted in much higher employee and patient satisfaction and retention.
All this adds up to an excellent return on investment, but Augins has a new definition for “ROI.” Where currently the majority of focus in the digital workflow arena is restorative, his ROI stands for Restorative, Orthodontics, and Implants. He sees those latter two areas of dentistry as the next major components walking down the digital path. The key to success, he concluded, is a fully developed and validated clinical solution that provides the best and most efficient outcomes.
As we look into the future, the exciting news is that technologies created in other health care areas are finding their way into dentistry and will continue to shape our profession and redefine the digital workflow. In the coming years, the digital workflow may include new exciting technologies like the patented OCT (optical coherence tomography), which is basically an ultrasound technique that uses light (laser) instead of sound waves. The use of OCT in dentistry could allow us to “read” hard and soft tissue (penetrating up to 5 mm) without the use of radiation. This obviously would change all digital workflows—imagine doing a virtual biopsy, measuring the thickness of enamel before you cut, seeing the depth of demineralization, or for the first time measuring a pocket without having to create one (by probing). In the restorative world, it could mean scanning and marking margins without cord or soft tissue management (ie, seeing and marking margins below tissue).
As materials continue to improve, milling and grinding may eventually be replaced by 3D printing. Where 3D printing is having an immediate effect now is in the fabrication of models, retainers, and partial dentures. The restorative materials presently available to us for 3D printing don’t have the strength and the durability as those used in milling, says Augins, but that is only a matter of time.
I want to thank Michael, Henk, Mark, and Henley for their critical insights. It is an exciting time in dentistry. Manufacturing leadership is paving the way to provide digital tools that will enhance our ability to diagnose and treatment plan more accurately. This assists us in our ultimate goal—to work more productively and efficiently and provide better clinical outcomes for our patients.
I hope you will take some time to study the graphic provided (Figure 1) and that, along with this article, it will provide you a clearer understanding of what will become the standard of care in practice in multiple disciplines. Dr. Jablow will address available digital technologies in more depth below, and the enclosed Product Resource Guide gives detailed information about many of the major products that are part of the digital workflow as we have defined it here. For those from the manufacturing community reading this article, I hope the future will also include the creation of “digital workflow specialists,” whose job will be to provide the dental practice with all the necessary hardware and education to fully implement a digital workflow from one source.
About the Author
Dr. Shuman is personally known for his expertise in Internet strategy, emerging technologies, e-learning applications, and digital marketing methods. Highly respected in the dental corporate and education community, he is an executive consultant for Kavo Kerr Group (KKG), Propel Orthodontics, WEO Media, Zquiet, HR for Health, and Implant Direct. He is also the managing editor of Dental Sleep Practice. Dr. Gordon Christensen cited him as “one of the most influential dentists in the country today.”
PART 2 | Digital Technology in the Modern Dental Office
What does it mean to “go digital” in the dental office? It all depends on where you sit. Front office staff sees the going digital as new ways of office communication, along with the digitizing of the paper charts, leading to a paperless office. The back office staff is replacing film with phosphor plates or sensors, performing panoramic imaging and cone-beam scans, and taking digital impressions. Some dentists are using digital technology to design and fabricate restorations as well. All these processes are allowing the dentist and staff to harness the power of computer technologies. This computing power allows for easier access to information and provides increased accuracy in information, diagnosis, and treatment.
Everything in the dental office starts with the patient. Patients connect to the dental office in many different ways. Patients are no longer looking through Yellow Page advertisements, but rather they are using search engines such as Google to locate dentists. The very first encounter with your office may now be the office website or Facebook page. These digital services allow you to provide detailed information about the dental services your office offers.
The old reliable telephone is still used, but many patients now send messages to the office requesting appointments through the office website or directly emailing the office. The use of email to connect with patients allows for the timely interchange of information without interruption that a phone call may demand. Many people cannot take a phone call at work but maybe able to correspond via email. Use of email allows patients to respond when it is convenient for them. The same goes for the front office staff, as having patients on hold on the telephone while trying to check out patients is not something an office strives to do. Email allows for a more efficient communication method for the front desk personnel as well as the patient. There are digital services available where an appointment may be scheduled directly through the website. Thus there maybe no direct patient contact until the patient arrives in your office. Remember when using digital correspondence to ensure you follow the Health Insurance Portability and Accountability Act (HIPAA) protocols your office has established for online communications.
After the appointment time is established, basic demographic information must be gathered. In the past, the patient would fill out forms in the office and the information was then transferred into the practice management software. The forms can now either be downloaded or emailed to the patient for them to fill out prior to the appointment. Would it not be easier if the patient entered the information through a website portal, a kiosk, or tablet? When patients enter their information digitally, the front office staff no longer needs to transcribe anything, reducing errors and making the initial encounter with the front desk more efficient. After patients have secured their appointments, digital reminder systems can scan your appointment book to automatically send them a HIPAA-compliant email or text message reminder about their upcoming appointment. These systems will drastically reduce the number of “no-show” appointments. These service work with all of your appointments for both new and established patients. Reducing the number of missed appointments allows the office to be more profitable.
Clinical Protocol: Diagnostics
We now have the ability to gather diagnostic information like never before. Digital imaging has evolved and with software we can now have abilities to make better diagnosis decisions then ever before. Through the use of intraoral sensor or phosphor plate systems, we can now capture radiographs digitally. In the past, we used film for radiographs; these were not, in most cases, archival quality and had a tendency to be misplaced or lost. Using imaging software, the long-term archival storage of radiographs is no longer a problem, and the ability to exchange these images for consultation with colleagues is much easier.