Putting the Patient and Clinician at the Center of the Dental Experience This Week in Health IT David Baker
April 9, 2021

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388

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April 9, 2021: How does technology work in the dental world? Join David Baker, CIO for Pacific Dental on their Epic Wisdom journey.  IT is no longer in the background or in the ivory tower putting stuff together and pumping it out. It’s the opposite. It’s a field with teams working out what will make our lives easier, our workflows more efficient and then designing and building those solutions. In dental there’s a lot of different devices than you would have in a medical setting. How do you work with Epic to build the integrations, device players and partners into the system? What about scheduling? Do you use AI? How do you keep things contactless? What about interoperability? How do you free the data? How do you keep a high level of consumer centric thinking in your innovation? And how do you maintain company culture during a pandemic?

Key Points:

  • One of the legacy areas of technology that we knew we had to implement was a practice management system replacement. A thankless task but essential. [00:06:05] 
  • User experience integration is very manual and very average. So we went through a huge analysis on what systems could we move to? [00:07:00]
  • We firmly believe in what we call the mouth body connection or systemic health [00:08:10] 
  • CLM – career limiting move [00:19:10]
  • The bat cave for IT is now called Innovation Test Kitchen [00:21:25] 
  • You’ve got to find leaders with the right mindset [00:39:16] 
  • Pacific Dental

Putting the Patient and Clinician at the Center of the Dental Experience

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Putting the Patient and Clinician at the Center of the Dental Experience

Episode 388: Transcript – April 9, 2021

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] Bill Russell: [00:00:00] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged. 

[00:00:17]Today we have David Baker, CIO for Pacific Dental on the show. David is one of my favorite people. He is an innovator. He used to work for me and used to innovate all over the place in healthcare. And now he’s gotten into the dental space. He’s innovating there as well. [00:00:30] He’s doing some great things with Epic and really just moving the needle in the dental space. I think you’ll enjoy the show. 

[00:00:36] Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next generation of health IT leaders. If you want to be a part of our mission, you can become a show sponsor as well. The first step is to send an email to [email protected]

[00:00:51]Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a [00:01:00] health IT perspective. You can subscribe wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we’re out there. You can also go to todayinhealthit.com. And now onto today’s show. 

[00:01:14] Today we are joined by David Baker, the CIO for Pacific Dental. David. Welcome. Welcome back to the show. It’s been a while. 

[00:01:21] David Baker: [00:01:21] It’s been, it’s been a while for sure. A couple of things went on in between and I’m excited to be back here Bill. 

[00:01:27] Bill Russell: [00:01:27] Yeah, I’m not sure I’m going to hit the [00:01:30] COVID journey all that hard, but I absolutely am going to have to get an update on Epic and where you guys are going.

[00:01:37] I don’t know if you want to start there, if you want to start with, you know, our normal, small talk that we get into. What people don’t may not know is that we used to work together. You worked for me. You were the head of digital, head of experience, essentially. It was internal and external experience.

[00:01:54] And you were doing a lot of stuff. I jokingly  call you my [00:02:00] experienced mentor, my digital experience mentor, because you were constantly coming into my office saying. Look, Amazon is focused on this. They have, they understand how the consumer thinks and they’re there and we have to get better at this.

[00:02:12] And you were constantly pushing me in that direction and it’s still, it’s still in the back of my mind. Every time I see these innovations coming out, I think David would love this. This is very consumer centric and it’s really going to change the game. So are you doing anything fun these days with regard to the consumer experience?

[00:02:30] [00:02:30] David Baker: [00:02:30] Probably the nicest stuff you ever said about me Bill. So first off. So, but no, I did enjoy. I did enjoy being liberated in trying to lead through the eyes of the consumer, you know, the patient provider back in the day. And yeah, that’s definitely that continues and it’s still near to my heart.

[00:02:48] It’s taken many different iterations of what we used to call engagement manager. And now just, you know, it’s UX as well. I would say we, we refer to it as, but a lot of the products we’re [00:03:00] pushing out. Right now. It’s really cool. I’ll take it. That whole model is still in place, but only expanded where there is someone leading that user experience from the field.

[00:03:12] So we’ve merged our operators and our clinicians into IT almost. So there’s groups of folks and the products are designed, you know, I say, build on and talk about our offices, you know, 800 plus offices always say filled because there’s big groups that kind of look off those offices. And when we’re designing the product, it’s [00:03:30] not IT in the background anymore in the ivory tower, pulling together stuff and jamming it out. It’s the opposite. It’s a field. And our guys are on the field, designing, working out what will make our lives easier, our workflows more efficient, and then us building to their design. 

[00:03:43] Bill Russell: [00:03:43] You know, we’re we’re going to talk about the bat cave because the last time I was at Pacific dental down there in orange County, you and Mostafa took me into the Into the back room and showed me some of the cool stuff you’re you’re doing. Before we get there bring people up to speed, Pacific Dental. How many offices, what do you, what do you guys, [00:04:00] what do you guys do?

[00:04:01] David Baker: [00:04:01] Pacific Dental plus offices now. I say, plus because new offices opening every week had a little slowdown just, you know through COVID for obvious reasons, but we’re where an in-person business. We got to serve our patient population and our offices have remained open throughout even through that  emergency phase, we really kind of doubled down over that period.

[00:04:23] Bill Russell: [00:04:23] There was, there was talk of vaccinations dentists doing vaccinations. Did that ever [00:04:30] get any momentum? 

[00:04:31] David Baker: [00:04:31] A little. Probably not. I guess folks would have hope we were all over that in offering, you know, how can we help? And there’s a couple of offices that are actually doing it right now. I was reading this morning. Some that had that started. But yeah interesting planning around that for sure. So I don’t know that we’ve been as effective, not through our own fault, trying to help facilitate that. 

[00:04:57] Bill Russell: [00:04:57] It’s just the quantity [00:05:00] of vaccine didn’t allow for it. I mean, there were so many organizations that didn’t have enough vaccine and they had the clinicians to do it. So now we’re getting to that point where the quantities there. All right, let’s talk. We’ll talk about the bat cave in a little bit, but let’s first talk about your Epic implementation.

[00:05:18] That was that was that was a bold decision back in the day. I didn’t know of many, if any Epic implementations in the dental world. Talk about that decision. And how is that playing [00:05:30] out for you guys? 

[00:05:31] David Baker: [00:05:31] It could have been a CLM Bill. Remember you surprised me with that career limiting move? But it panned out okay. Really good. In fact, I mean, it’s been a great partnership coming from the medical world. This is, what’s been great with dental. We’re the second largest DSO in the US dental services organization. Our model, I think is pretty unique and, you know, seeing the success of these offices is just, is very [00:06:00] fulfilling.

[00:06:00] And one of the legacy areas of technology that we knew we had to implement, it really didn’t want to do again in my lifetime but it was a practice management system replacement. You know how fun those things are. Right. Because it feels a little thankless. 

[00:06:14] Bill Russell: [00:06:14] Yeah. That’s why I’m not as CIO anymore. I like being on this side of it. I don’t wake up in the middle of the night with but you had you, maybe this is too strong, a word, but you had a mess, right? You had a mishmash of systems and [00:06:30] you know, some, some client server stuff and whatnot. You had to do something about the practice.

[00:06:34] David Baker: [00:06:34] A lot of client service stuff and in fairness, the system was designed pretty well over the years from the traditional sense. So it got us to the first billion dollars in revenue but it’s you know, it wouldn’t, it certainly wouldn’t take us to the next level. It was kind of tapped out.

[00:06:53] We’re a big organization for, you know, when that product was originally designed and was only in a couple of offsets but, so [00:07:00] it served us well. But yeah user experience integration you know it’s all very, very manual and very average. So we set about and went through a huge analysis on what systems could we move to?

[00:07:17] And it’s an interesting space in dental. Cause I feel like it’s all private practice, right? Mom and pop shops, essentially one person practices. And then you get a few with, [00:07:30] you know, a few groups, five plus and then probably 3% of the market is in the you know the DSO space that. There’s plenty of opportunity there, but we’re underserved, the bigger organizations, the bigger they are certainly underserved in in software that could help run organization size in this space. 

[00:07:53] Bill Russell: [00:07:53] Well talking to healthcare market are the traditional players in this space. I mean, do you, I mean you’re going with Epic, [00:08:00] Cerner, Athena and allscripts. I mean, do they play in that space or is it very specific? Is dental very specific? 

[00:08:07] David Baker: [00:08:07] It’s like separate software, right. And what we want it to do, we believe firmly in what we call the mouth body connection or systemic health. It’s real. And you know, we’ve found a lead and Steve is a force to be reckoned with in the space. He passionately believes in it, and you know, dental, we’re not being that redheaded stepchild, right in the healthcare industry. Your head’s [00:08:30] connected. And we wanted to bring you know, more information to bear around that. And those, you know those true systemic links with your health from the mouth, essentially.

[00:08:41] So we we came up with the idea around approaching one of those big analytical organizations. Epic had some relationships with prior life. I have to say, I’ll be honest, right? It’s slow moving back in the day [00:09:00] from on the medical side, it was different. Dental is very fast moving. I’ll do it privately held us as well.

[00:09:06] So it feels even more entrepreneurial from our side. We get things done real quick. So this was a big deal and it had to be, my concern was can epic react quick enough to keep up with us and me and our aspirations to make the tenant world a better place and give out, provide us some really, really great software that compliments their workflow.

[00:09:27] So after multiple [00:09:30] conversations you know, the relationships that are developing and they were interested in doing something but being-

[00:09:37] Bill Russell: [00:09:37] Did they have something already or did they start to develop it with.

[00:09:40] David Baker: [00:09:40] Sorry, I didn’t answer that original question. So yes. They did but Kaiser and a few of them, multi you know facilities like medical and dental attached, they were using it so Epic did have a module. It wasn’t DSO ready for us with the speed that we needed to move at throughout our workflows. [00:10:00] And also the country of Finland were let up on that module and the national health service, you know, with their medical and dental. So that they had a whole country in advance

[00:10:09] We just, you know, we’ve looked at how do we you know turn the dial on making it DSO ready as we call it. 

[00:10:17] Bill Russell: [00:10:17] So DSO ready. So you guys are essentially dental service organization. You’re supporting all these practices out in the field. But it is distributed. It’s not like, you know, it’s not like big hospital [00:10:30] with multiple. Rolling this out is probably more akin to rolling out of the ambulatory system. Where you’re going out to all these different locations. Give us an idea of the process that I mean, let’s assume that it’s so Epic comes through with the build and we’ll come back to that. And you’re ready to go out. There’s a training component. You’re going out to some pretty remote places you’re getting this thing installed. Did you go with a cloud? I assume you went with a cloud type model [00:11:00] or did you go, are you hosting yourself? What does it look like? 

[00:11:03] David Baker: [00:11:03] So, yeah, you’re exactly right. It would be like in medical to the ambulatory kind of sets up. The module that sits on top of that is wisdom. We’ve been the vanguard partner to Epic and spent a year in the build-out. So what I appreciate about, you know, Judy and Epic and she’s been remarkably engaged on this. It’s been really fun you know, [00:11:30] working so closely with those teams is what we helped develop here is not only good for us, is good for the entire community.

[00:11:38] So there are many areas that are not going to be proprietary. And what I appreciate about this is that’s good for us because we want dental to be able to rise together to the point where. If we do this implementation well enough and it’s looking like it’s going that way. I would like to be able to offer the opportunity to assist other DSOs through the community connects kind of [00:12:00] initiatives.

[00:12:00] So if there are other DSO’s listening, I think what we have done is designed a platform play that we can help propagate and other folks can essentially plug into maybe DSOs that are too small to deal directly with Epic. We could assist there. So it’s a different model. It’s definitely more of co-operative thinking.

[00:12:19] And I’m just excited with the way that our teams came together. It took, like I say, a year to get that first iteration of the build that we were looking for ready. And we’ve been very aggressive with [00:12:30] Epic on the three monthly releases. So every month we’re deploying offices and we’re a couple of hundred offices now, which is great. And just turning the product out of the product, you know, rapidly. 

[00:12:42] Bill Russell: [00:12:42] So it was a pretty easy transition from the operator and the dentist. What was that an easy transition or was it a significant UI change for them? 

[00:12:53] David Baker: [00:12:53] It’s significant. It is. There’s no getting around it. It’s very different. Good in a good way in [00:13:00] the most. Think of it like this, do you remember the like, was it Saber that the airline system views as very. 

[00:13:05] Bill Russell: [00:13:05] Yeah, the green screen with the little blinking cursor. 

[00:13:07] David Baker: [00:13:07] So imagine that but what you’ve got to remember people who have been with the company for say 15 – 20 years is that it’s like becomes like a second language.

[00:13:14] So they’re just hacking away oh, it’s fine. So that some people were not upset. It was the new folks that came in and it took four months of ramp time to get them up to speed back in the day. They’re the ones that are like, what is it? Why can’t I use like my, where are the graphics? Whereas the UI. So it’s just [00:13:30] it’s different. But in a good way, the ramp time is quicker.

[00:13:34] First of all can be, you know, horrifying for folks because the change is enormous. I think on the clinician side, the back office, as we call it, is definitely that’s very quick, right? It’s familiar in terms of those layouts and those flows. The big build for us has been on that front end right. And the automations that we’re able to now provider our [00:14:00] workflows that we couldn’t before. So it’s very different in the guts of the system, let’s say. 

[00:14:06] Bill Russell: [00:14:06] How, cause dental is different than medical. So  in dental, you have a lot of different devices than you would have in a medical setting. The integrations, did the device players and partners, did they work with Epic to build the integrations into the system? Or are there not that many integrations? 

[00:14:24] David Baker: [00:14:24] Oh, no. It has a ton of  integrations. So we have, we have our middleware team. If you like [00:14:30] integrations teams, we call it between, you know, our true integration, what technology, there’s a few pieces that are plugged into that, right and if sometimes there’s even more traditional integrations that are required, we can get to like an RPA, like a robotic process automation kind of level to make sure that we’re still moving things around in and as automated manner as possible. But ultimately a lot of folks that come together to do true ATI based kind of integration, [00:15:00] which has been fantastic.

[00:15:01] There are just a lot of them. So I have a whole team specifically working on that. And then there have also been, you know, problems with some of their hardware vendors, I would say in dental. It’s very proprietary. It’s like folks almost locked into certain ecosystems where they buy this software and then this hardware, and I’m like very old thinking.

[00:15:20] So we actually forged a a dental advisory council where we invited essentially a lot of these [00:15:30] vendors to the table and we have, you know, three was three months. It was six monthly meetings now where we’re kind of, you know, talking about why is it. Why is it good to lock something down? Right. We get that.

[00:15:42] But let’s think about if we open some of this stuff off and we let the open market be able to develop on some of this right with us. Why do you care for selling the hardware that you also try and force people down a certain software lane. So I think that’s been really [00:16:00] good and certain vendors and partners have been mind-blowingly open to you’re right. Let’s we can do better. Let’s do this together. So it’s been fun. 

[00:16:10] Bill Russell: [00:16:10] Interesting. The interoperability aspect, which is probably one of the reasons you went down this path, right? You want to be able to share the data back and forth with health systems to can start to get integrated into that 

[00:16:22] David Baker: [00:16:22] Yes free the data Bill. Free the data. I think I stole that from you. 

[00:16:26] Bill Russell: [00:16:26] Free the data so the interoperability, is it the [00:16:30] same Epic tools that we’re used to today, the care everywhere and those kinds of things. Epic my chart and whatnot. 

[00:16:37] David Baker: [00:16:37] Yeah, there’s a lot that I think are way more open than most recall. And just, I think I’ve been a good driver in the interoperability actually and helping you know, move some of that data around and not just obviously from a security standpoint, it’s very important that you know, it is locked to an extent, in its own way but there’s much [00:17:00] of that day that we need to liberate to be able to drive our other workflows and that there are a lot, there’ve been a lot of successful methods that were able to do that. 

[00:17:08] Bill Russell: [00:17:08] So let me ask you this. So is this the case scenario? So let’s see, who is well Memorial care in your market is on Epic.

[00:17:18] So if I’m a Memorial care patient and I’m a Pacific Dental patient and I have MyChart. Am I going to be able to see dental and medical yet? 

[00:17:27] David Baker: [00:17:27] Yes. There you go. That’s exactly [00:17:30] why. Right. Finally, we were the first dental organization in the US to bring this type of data together. So there’s, yeah, there’s a couple of methods, but assuming, and there is some versioning dependencies on some of the medical side, but yes, ultimately with patient’s authorization both sides of the care spectrum can see all of your data finally, which is we think pretty huge. 

[00:17:55] Bill Russell: [00:17:55] What are you doing for scheduling? Just out of curiosity, because I know you’re actually thinking about [00:18:00] automation and making that process easier. Are you going through those tools or have you developed tools outside of it that you’re just going to continue on with and plug them in? 

[00:18:10] David Baker: [00:18:10] No it’s a combo. We’ve embraced as much on some of the, I mean, Epic do things like, is it fast pass? Always reminds me of that Disney concept, but essentially if you want to If you want to get an earlier appointment, it will, you can say yes.

[00:18:25] And the cancellation comes up, then let me know. And it would be like round Robin on the first five folks [00:18:30] that said yes and see kind of who picks it. So there’s some nice innovative stuff that’s in there and scheduling to us. It’s just such a cool component of our business because there are so many appointments across so many operatories that happen every day.

[00:18:43] So we have our own proprietary system that’s been very successful on the legacy practice management system. And we’ve as a combination but yeah in the most we have totally available online scheduling across the board and have [00:19:00] been for some time. I think you know the UI looks good. Now we’re able to sort of facilitate that through initially our office page and then ultimately MyChart.

[00:19:10] Bill Russell: [00:19:10] Yeah. So CLM, you mentioned earlier career limiting move. It doesn’t sound like it’s been for you. And actually the reason that, where that came up is you’d come into my office saying I got this great idea and I would say great run with it but it’s you have to own it. It’s your idea.

[00:19:26] You’re running with it. I haven’t really prepared you for this. I mean, these [00:19:30] kinds of decisions are the kind of thing where everyone’s looking at you going, are you sure? I said, there’s probably a couple of times during a project like this, people are going, are you sure? Are you sure? And you’re like, yeah, I’m sure I believe in this, we’re going to do 

[00:19:41] David Baker: [00:19:41] Tons of people, tons of people and you know you’re right. I’m fortunate to have a great partner and CEO who’s you know very digitally forward and just, you know, we worked through it together. But I, you know, when it comes to signing time it’s a huge deal. I mean, Im pretty much over a ten year package and [00:20:00] it’s yeah.

[00:20:00] Bill Russell: [00:20:00] It’s a lot of money. 

[00:20:01] David Baker: [00:20:01] Yeah. It’s an a hundred million plus kind of initiative so there’s a lot of investment that’s going into it. 

[00:20:06] Bill Russell: [00:20:06] Yeah. And you guys are you guys privately held? 

[00:20:10] David Baker: [00:20:10] Yes. 

[00:20:10] Bill Russell: [00:20:10] Yeah. So you’re not just printing money, like some other organizations, you guys. Or actually you work hard for your money.

[00:20:19] David Baker: [00:20:19] Look after, treat every penny as if it’s your own as well. 

[00:20:23] Bill Russell: [00:20:23] Absolutely. Let’s talk about the bat cave which is what I called it. You guys just had a [00:20:30] really cool innovation room back at the headquarters down there and you were showing me some things you and Mostafa were sort of walking around and showing me how you were thinking about every aspect of the experience as the person walked into the office, how they were received, even the chair.

[00:20:48] I mean, you had certain aspects of the chair and just crazy stuff. You guys, you guys are, you guys really are looking at the entire experience. [00:21:00] And how did that become a part of the IT part of the organization. Was, was there somebody who was doing that before, or did you guys just sort of, just sort of step into a void potentially?

[00:21:13] David Baker: [00:21:13] You know, sometimes I say, when you’ve got talent, it’s just, you got find them a job. So when I knew Mostafa was on the market, I was like, all right, I got to find a job. And the perfect job is this, is our innovation. So we call it a test kitchen but essentially we have a separate [00:21:30] group within, right which is a spin-out for PS innovations.

[00:21:33] And that’s what Mostafa leads and as you autonomate to fail fast and experiment. So there’s a, there’s some R and D budget. Again, we’re very fortunate. I pitched the idea and he knows what we’ve saved. Then of course it’s like finding some of the, essentially we’ll look for gaps internally, right?

[00:21:51] This is what I love about the group. We’ll look for gaps and that involves a lot of you know, observing workflows and folks in action in the opposite, [00:22:00] which is fun. And seeing why they doing it in that way. How can we give them time back or, you know, workflow savings or ultimately giving them, you know, more face-to-face with the patient saving the money, whatever it may be in terms of one of those key buckets or the pillars as we call them of why would we do this?

[00:22:18] Then they will come back and prototype sometimes, you know, vendors come to us and we’ll be like, you know, we’ll take the look, but there’s a lot of fun stuff that goes on. So we’ve built out a pretty impressive team in the [00:22:30] AI space, in the RPA space down there. And now also. On the payment side. So I’ll give you an example.

[00:22:37] The way people pay for things is horrible and not very transparent. You know  similar to healthcare. Not as bad actually, just because the healthcare space, just a bill turns up still. And you’re like, how much I have no say in this. So dental is a lot where to do it work a lot harder upfront talked about this is what we’ve covered in this as [00:23:00] well.

[00:23:00] You know, it could be out of pocket and, you know, here are your options. So anyway, It was just, and especially when you get down to a point, for example, not only taking the, no one wants to touch stuff anymore. Right. So we had to get better with touches that it would QR scans better. We saw an opportunity to move away from those old school payment systems, to iPad driven  situation right with for taking payments. And then of course, if you needed, you know financing, for example, Horrible. Right. It’s just [00:23:30] kind of almost embarrassing. But once again, comes back to user experience. So you’re interested in financing, to put on a piece of paper right now, right?

[00:23:37] We’re a little more boxer, right because there’s an electronic device. But we were like, we want to spin this on its head. Everybody gets finance. We just have sort of set the deals up with the right partners behind the scenes. So now you can know as a patient, you’re going to get finance and we’re going to predetermined right using our AI and the platform that we’ve built the best the best deal for you essentially, based upon a number [00:24:00] of softballs in the background. So that now is seamless. If you could scan the screen and then you just apply for the credit essentially on your own device if you want it, you could take the tablet there’s many ways. But I give you that as one example of that’s kind of stuff that seems looking to solve. 

[00:24:17]Bill Russell: [00:24:17] You guys are doing the, like the implants and those kinds of things. I’m trying to think what I would need credit for but you’re doing the serious things where you’re actually like replacing teeth with 

[00:24:29] David Baker: [00:24:29] Yeah, [00:24:30] we think about, I mean, yeah, we’re doing, you know, a number of procedures, you know, across the board that you do add up and unlike health care, right there’s a cap. So think about your dental insurance. Most people, if you’re lucky are going to have like a whole, you know, 1500 bucks to spend every year and you’re going to try. 

[00:24:48] Bill Russell: [00:24:48] That’s exactly what I have is 1500 bucks. Is that enough? 

[00:24:51] David Baker: [00:24:51] That’s the magic number. It depends on how much candy you’re eating Bill but not always, right.

[00:24:57] Not if you’re going to need an implant, for example. [00:25:00] All right. And you’re going to need, you’re going to need a crown potentially. It depends on the treatment. So there are lots of scenarios where finance is required, right. And there’s a large number of patients that that do that. And for me, it’s like, how can we do this in a way that is not obtrusive, not embarrassing and just is part of the flow and makes them feel good about their decision to get the dentistry started. So I think we’ve worked hard on that experience and [00:25:30] you know that’s coming to to fruition. If you go on the, look at the Peloton site right. A firm who are big in the FinTech space right now, for example, which just, Hey bill, we’re going to split this bike up in six easy payments.

[00:25:43] Well, yeah, that would be that’s nice. And it gives me an immediate, like, okay. And then takes you through. That’s what we’re trying to create, you know, in the dental space with even more intelligence. 

[00:25:52] Bill Russell: [00:25:52] Well, you touched on it a little bit, but the pandemic has brought to the forefront this new term that we didn’t really [00:26:00] think about before, which was contactless. Contactless experiences.

[00:26:04] Right? So it’s, it’s it’s not handing them a clipboard. It’s not handing them a piece of paper and now it’s almost mandated. I’ve talked to some CEOs who were essentially saying to me, you know, I tried for years to get rid of the clipboards and what I couldn’t do over a three-year period Covid did in two weeks.

[00:26:21] Yeah. Yeah, no, nobody wanted a pen. Nobody wanted a clipboard that they were going to carry around, that somebody else had just had. And [00:26:30] so have you guys really thought that, is there a lot of areas where you had to adapt and look at contact lessons or were you already heading in that direction? 

[00:26:38] David Baker: [00:26:38] I think we were accelerated, definitely accelerated some elements of the contactless.

[00:26:44] We were pretty, you know, pretty paperless in the most anyway which was, which was great. But things like, you know a good crisis, right drives some of this innovation for sure. And well, we’ve made, we came up within two [00:27:00] weeks or I think it was penned for like a, you know, a 12 to 18 month initiative. And that was the the tele, telehealth, teledental consults, which you’re like, well, that’s, is that a thing in dental?

[00:27:10] And I would say, yes, it is and it’s, growing and it will get, it will get better. There’s only so much you can do, obviously. Right. 

[00:27:17] Bill Russell: [00:27:17] So is that like, Hey, I have some pain or I have some thing, and then we get on a call like this. Or are there, are there a set of tools other than the initial consuklt like this. 

[00:27:28] David Baker: [00:27:28] So now the initial consult’s like [00:27:30] this to gauge, you know, how bad are the symptoms and how soon should we try and get you in as an emergency essentially.

[00:27:37] Right. And how, how can we, how can we help with the tools available now. Those said tools will only advancing. We’ve got some really fun stuff going on with some internal opportunities and stuff, and, you know phone-based situations where you can really get more of a, more of a closeup visual of the mouth.

[00:27:54] So during the, you know, during the pandemic, it went from, we didn’t offer [00:28:00] tele visits to two weeks later, we were alive across 800 and whatever it was 20 offices at a time. And then, and we did over 5,000 virtual visits and in the subsequent weeks. It was like insanity. And so there wasn’t a mark and people just wanted to have that initial consult. What was also good was it built you know, it built trust initially, because we were picking up so many patients from offices that were closed and there’s a need, you know what it’s like when you get [00:28:30] a tooth ache Bill it’s like, it’s like, it is the worst. Then, you know, we did a big campaign because every 14 seconds someone with a toothache was walking into an emergency department. Right. And essentially, what are they doing? They’re going to get narcotics, right to try and help the LPs the pain there. So it’s just not an ideal solution all around. So our campaign was that, you know, really we’re open and we’ll help you out.

[00:28:55] It’s just like dental pain the worst. So we focused in on those emergencies [00:29:00] and we kind of doubled down on the tele visits initially, which worked out pretty well. I mean, they definitely declined obviously you’ve gotta be in front of you your dentist right. But  but at that point in time, I think it was just a great bridging kind of solution to help in the initial engagement.

[00:29:17] Bill Russell: [00:29:17] I learned a ton of stuff from you around culture. You invariably always had the most fun team in our IT organization and that’s if June and Robert are listening to this. I’m sorry [00:29:30] but David seem, always seem to have more fun than the other, the other teams that were there. But the pandemic sort of put a crimp in the face-to-face things and the you know, hanging out with the team and all that stuff. How have you adapted and kept the culture moving forward? 

[00:29:49] David Baker: [00:29:49] It’s a great question. I think the most important thing to me is that you know, outside of a good structure is that is, is the culture. I’m fortunate to have some phenomenal leaders. It’s still the [00:30:00] most fun department. So likewise, if I got my PDO at brethren listening yeah, we all,  definitely wwe do have a lot of fun. I do. I coined a few things from you again, shameless, right. But I think some of the stuff you did was fantastic with the town halls and that. We have have big town hall, you know 250 folks on there and just trying to try and make sure everyone’s connected with the overall kind of vision.

[00:30:24] Obviously a ton of video. We’re a big video company as everyone is in fact probably. [00:30:30] Overly. So it’s like, do we really need meetings for this? I’m a strong believer in not meetings for meetings sake but video is the next best thing. Right. So. And we’ve got a lot of us are out when we’re out in the field, but we are coming together it’s with the PPE and stuff. Obviously the dental company is pretty, pretty good at that, that those practices anyway. But all the knowledge workers, there are obviously lots that were moved to home in short order. Thankfully I had a lot of that tech in place, but it’s important to have regular open [00:31:00] communications and it helps to havet a little fun around some of those meetings. So I think it’s still prominent and we’ve been fortunate. I think we’ve got amazing culture, especially in our IT group. Passionate about keeping everyone together and getting after it. Yeah. 

[00:31:16] Bill Russell: [00:31:16] Well, so talk to me about the priorities going into into 2021. Obviously you’re at 200 offices. You still have. You still have a fair amount of the organization to go with if you’re only at [00:31:30] 200 offices? 

[00:31:30] David Baker: [00:31:30] Yeah, just a couple. So yeah, we’ll be 500 deep by the end of the year. We’ll be where we complete it next year Q1 .You know, it’s getting into a good cadence.

[00:31:40] It gets to a point that you get that you hit that tipping point where people you know, those early adopters are like, all right, this this is now moving. It saves time in these areas and you know, there’s. 

[00:31:51] Bill Russell: [00:31:51] So are you using coz, people may not recognize this. I mean, you’re, you’re in a lot of States and you’re in a year in a lot of States, a lot of remote places. [00:32:00] Are you using partners to roll some of this stuff out? 

[00:32:03] David Baker: [00:32:03] No we’ve got a team that travels you know, extensively on this. We’ve looked at a number of different models and because you have to be kind of so deep with the product and you know, have the confidence to be able to, we have at the hit support on those, on, you know, that, that first week.

[00:32:21] And it’s always different. You can go into any training class, right? I’ve done some of the train glass in myself when you’re sat there and an office. [00:32:30] Behind that front desk and patient comes in, you know, when they’re in pain, you’re like, okay, it’s showtime, you’re like w I just forgot everything. What do I do again?

[00:32:38] What’s your name? It’s totally different when you’re, when you’re live patients in front of you. And I think we’ve just got, I think we’ve got an outrageously talented team who travel, light them up, you know, enjoy the work they’re doing. And then we, you know, we get them flying as fast as possible.

[00:32:56] Bill Russell: [00:32:56] I mean, they’re literally seeing most of America then. I mean, because [00:33:00] you guys are all over 

[00:33:02] David Baker: [00:33:02] Yeah. About 17 States. I think I’ve got the official status. It changes changed regularly. But yeah, we are spread. But we do also have, you know, we have big support presence across obviously California, a large presence in Vegas where I’m moving to. And then Texas as well. Right? There’s some big hubs there. So now when we’re recruiting, the beauty of having this kind of size is we can attract talent from the talent from, the talent [00:33:30] doesn’t all have to be in one geography. 

[00:33:32] Bill Russell: [00:33:32] All right. Are you up for talking about healthcare in general? I know you’ve been out of this out of health care, the healthcare provider space for awhile. I know you’re still in healthcare, Pacific Dental. 

[00:33:44] David Baker: [00:33:44] Tons of friends in there, but it does, it is a boring subject Bill because there’s a lot of talk and not much action as you know, so. 

[00:33:50] Bill Russell: [00:33:50] All right. So let’s talk about the action. The action you know, just this week, if people will be able to figure out when we’re recording this, Amazon announced Amazon Care to [00:34:00] 50 States for their employees first and foremost. And as you told me many times, nobody understands the consumer better than Amazon. I mean, they have a ton of information on them. They have that mantra of designing everything around the consumer. And then they are going to essentially find the weak spots that exists.

[00:34:20] And one of the weak spots in healthcare is it’s inconvenient, hard to schedule. It’s hard to access. It’s [00:34:30] it just, all those things that how did, how did Feinberg said it this way, he said the, the waiting room represents all that is wrong with the healthcare, we call, we make our consumers come and come to us, sit in a room and wait until we’re ready.

[00:34:48] We’ve make them wait 10 minutes longer than we told them they were going to. Then we put them in a room. They don’t even talk to the person that came to see. They, you know, they sit in that room, then we close the door, they sit in that room by [00:35:00] themselves for another 10, 15 minutes before the person they came to see actually comes in, that person spends about five minutes with them leaves and then they go, and I think don’t think that’s going to be the experience with Amazon.

[00:35:12] Amazon has Amazon Care as a concierge level service. They’ll come to you. And they will ship your meds too. It’s and if you do get sick as an employer program, if you do get sick, if you have cancer, they’ll send you to the city of hope or they’ll send you to some other really reputable academic medical center around [00:35:30] the country who is known for that specific disease state.

[00:35:33] And it, it feels to me like we are starting to see what we chatted about maybe five or six years ago this the tech players finally figuring out healthcare in giving us what we all want as consumers. Is that what you’re seeing or is that what you think when you hear about that? 

[00:35:55] David Baker: [00:35:55] Yeah, totally. It’s all about, I think it’s about bringing the backend together and [00:36:00] then, you know, disrupting essentially that traditional workflow. Like you say, a front office, sit, wait, go to this other, you know, another office, another room, wait, someone knock on the door and then, you know, eventually you might get, see the doc if you’re lucky.

[00:36:13] So it’s that it’s an inconsistent experience. So the difference I say, and I’ve been lucky to have the opportunity to be part of one is is more of the concierge medical and that being the gateway, you know, little like the your PCP, right? Your primary care [00:36:30] physician is that gateway. The jack-of-all-trades if you like.

[00:36:34]Bill Russell: [00:36:34] So you’re a part of a concierge medical medical program. 

[00:36:37] David Baker: [00:36:37] Yes. And it’s, you know, it’s 24 seven. I could text my doc now. He’ll text back. We have a relationship. Right. And it’s really cool. And yes, you know, there’s always going to be that added expense, but I see the model becoming more normalized like that, where you have, you know, more technologically advanced areas that are looking at you know, way [00:37:00] more measurables they have before, right?

[00:37:01] Everything from DNA, to the food and allergy testing, or, you know, I do a full annual checkup, which is like insane. And I usually say, let’s do more. I love studying what foods could I be allergic to? How can I get more energy, you know, every day? How can I say we run through true wellness, right. And I love playing around with, you know, I’ll track diet, I’ll track vitamin supplements, and.

[00:37:26] That’s kind of fun to me. And the difference [00:37:30] is that when something you know, I had a bulging disc which I didn’t expect at some point, I was like, Oh my goodness, what’s going to happen. Right. And then they took me on that kind of referral through the specialist kind of network to get, you know, to, to get me where I needed to go.

[00:37:44] So it’s like, it’s guided, it’s like a healthcare navigator, if you like. And that’s what I think is starting to hit a tipping point. I see more and more of these concierge places opening up. 

[00:37:55] Bill Russell: [00:37:55] Yeah. And that’s, I think that’s what we want from our [00:38:00] healthcare providers. But I mean, you worked at a healthcare provider. I worked at a healthcare provider. It’s, it’s yeah. It’s not just the technology. We can probably stand up the technology to do it right. It’s, I mean, because you can do it with, with a phone and texting back and forth, and it’s, it’s really rethinking the workflow that has been in place for decades.

[00:38:23] And that’s the hard part. It’s redesigning it in a way that is consumer centric. [00:38:30] How do you, how do you get that level of design thinking? That level of consumer centric thinking in your innovation? Is it just hiring the right people to think that way? Is it hiring onto an organization that already has that culture?

[00:38:45] Because at PDOs you have them, you have it. You know, you have a team, you have a leadership team that thinks innovate, innovate, innovate. And you hired Mostafa. So you were able to build the team that you wanted to build. But  imagine I just [00:39:00] hired you back to where you were before and we have to do this. We have to sort of change the experience. We have to rally a whole bunch of doctors to really change the culture. I mean, what’s, how do you approach that? How would you think about approaching that? 

[00:39:16] David Baker: [00:39:16] You’ve got to find the leaders of the right mindset, because you’re going to find folks as we did, you know, regularly in the EDs where some of our toughest customers, but it was, it was important to support the relationship with the leadership in the ED and then the right docs or the right [00:39:30] mindset and let them know that that you don’t think you understand the pressure that they’re under. Right. And I think a lot of times you don’t until we pull an all-nighter and sit in the ed or night, watching them and watching, you know, horrific things happen and amazing things happen. They they’re literally saving lives. That’s, you know, I don’t miss that pressure and that’s all I’m gonna say but that’s where that’s the only way you can kind of shift the mindset in saying just because it’s the way it’s been done this way [00:40:00] is this right? And with the it’s with it’s getting those folks behind you and then having them be part of potential new designs that you can quickly iterate on and fail fast on. Right? So like you said, not just the technology, it’s the workflows. So while you run it across that room to pick up a prescription, On a printer that’s a hundred feet away.

[00:40:21] It makes sense. Why would you not move simple stuff like that all the way. You’ve got to start and the fundamentals, right? There’s a lot of good teachings, I guess, in [00:40:30] agile workflows and stuff in those clinical settings. But ultimately it comes down to finding the people in the right mindset. Because if you have people that can tell you is gonna fail and never works the way it’s been done this way, then nothing’s going to change. So you’ve got, you’ve got to change the folks, driving the bus. 

[00:40:46] Bill Russell: [00:40:46] Yeah. And you you did preach, you know, walk in their shoes, get out there and walk in their shoes, hanging out. 

[00:40:54] David Baker: [00:40:54] Yeah. The ivory tower hanging out there. I mean, yeah. Sleep in, sleep in the beds in the [00:41:00] ED. I’m always my best time during the practices with the docs running around. 

[00:41:04] Bill Russell: [00:41:04] I was going to put you on the spot and say, do you still get out there? Cause it gets harder when you get into that CIO chair. Cause you have so many meetings and stuff you have to go to. 

[00:41:12] David Baker: [00:41:12] Always. You have to make time. It’s easy to, there’s two things that are easy to kind of just push you off. One is being in the field, right with your actual customer. And then two is, you know, the strategic planning components. Something that always feels like homework. Some of the best like weight comes [00:41:30] off your shoulders. You have a plan, the team are marching towards, you know, the ultimate strategy, but it’s so easy to say, I’ll do that next week, next week, next week, and help your teams understand what success looks like. Very important.

[00:41:40] Bill Russell: [00:41:40] All right, I’ll push it. You know, we’re getting close to the end of this call. I’ll push it. Just like a, an executive coaching session. How’s your work-life balance. Do you have work-life balance? 

[00:41:50] David Baker: [00:41:50] I hate that term Bill. I’m really like it’s an awful term 

[00:41:54] Bill Russell: [00:41:54] Is work, work balance. Is that what you’re saying? 

[00:41:56] David Baker: [00:41:56] There’s no such thing. If you have what life balance then you must hate your work. [00:42:00] The only, only option there is work work-life blend. They’re both one and the same. I love doing, being at home with family. I love my work too. It’s like, and I can’t just, I’m not going to switch off at five o’clock it’s impossible. Right. So, but when I need time back and I’ll take the time back. The new world is having a little more autonomy.

[00:42:19] So honestly, I think, I really believe in that work-life blend. It’s take the time when you need it and go all in when you you know, when you work at. 

[00:42:28] Bill Russell: [00:42:28] Yeah. So [00:42:30] essentially what you’re telling me is you’re, you’re a lot more relaxed since you’re not working for me anymore. 

[00:42:35] David Baker: [00:42:35] Yeah. You making me punch that clock every day.

[00:42:37] Bill Russell: [00:42:37] Punch the clock.

[00:42:40] David Baker: [00:42:40] We always had, we had, you know, I always enjoyed that autonomy if you need those strong leaders in there. Right. And then they can build that culture with people that are passionate about what they do. And you know, we’ve spoken about it before. Opportunities just don’t land on your lap every day. So the folks that are there hanging their jobs, hating their lives, I always tell to say to everybody, if you don’t like what [00:43:00] you’re doing, then you’ve got to take, you’ve got to be the change agent for yourself. Invest in yourself. There’s so many opportunities right now.

[00:43:05] Bill Russell: [00:43:05] I mean, what I’m telling people is essentially 70% of the time you have to like your job. If not, you should, you should be looking for something else because 30% of our job, we’re never going to like, I mean, you just you sort of go, ah, today’s one of those days I just got to do the 32nd.

[00:43:21] David Baker: [00:43:21] It’s not unicorns and rainbows every day, for sure. But if more of your day is spent hating what you’re doing, then you’ve got, life is seriously [00:43:30] too short and there’s an old cliche, but you’ve really got to, you really got to do stuff that makes a difference. 

[00:43:34] Bill Russell: [00:43:34] So you’re a big runner and both adjectives actually work you’re six foot, whatever, 600 and a hundred. What are you? 6 6? 6 7? 

[00:43:45] David Baker: [00:43:45] 6 8

[00:43:46] Bill Russell: [00:43:46] 6 8 runner. That’s not a normal thing, I guess, but are you still running a lot? 

[00:43:52] David Baker: [00:43:52] Yeah. I do a little bit more well Peloton now. Yeah it’s it’s quicker and a little bit more [00:44:00] intense. I guess I’m not on runners brain but no I still run. It’s fun. It’s fun. It’s a good all mind and body kind of workout 

[00:44:06] Bill Russell: [00:44:06] I’ll tell you what David, almost everybody I know who ran has given it up as they’ve gotten older because of the pounding on the knees and back really. 

[00:44:16] David Baker: [00:44:16] Yeah. Yep. Definitely. So, plus I was scaring people running down the street so. 

[00:44:21] Bill Russell: [00:44:21] So tell me about the Peloton experience. I’m sorry, I got another five minutes with you, so I’m going to get every minute I can. Tell me about the Peloton experience? I mean, is that I [00:44:30] mean, that was a healthcare type purchase? 

[00:44:35] David Baker: [00:44:35] Yeah, I mean, my wife does  a lot of running stuff. Same thing gets a bit creaky. Right? So we, we started spinning and it was fun. COVID hit. And then we bought, we have a home gym which has, which was lucky and it has been great. Especially, you know, from a time perspective and the fact that we can actually work out. So we bought a Bowflex machine first of all, I’ve dropped some names there because their customer service [00:45:00] sucks.

[00:45:01] Here’s what, here’s what happened. The thing turned up and it’s actually pretty cool. And it links into the Peloton system and it’s way cheaper. Right? The experience is good. It’s not like being on Peloton on there. So we ended up, you know, I use it a ton and then we said, let’s just get a Peloton. The new one came out and it’s a game changer. Obviously I was like seeking out, you know, the best gadget again but the screen’s huge. The sounds amazing. And here’s the thing then new machine, you know, I love this [00:45:30] right, as you’re doing the class instead before you’re tweaking the dial and putting the resistance up or down now they do the automated resistance for you, if you want and you just get button and they change the resistance. And I’m like, this is like, now you can just focus fully on the class and experience more what they’re going through. So I’m like, that’s a game changer for me. It’s such a good experience. 

[00:45:49] Bill Russell: [00:45:49] Is it weird having people come into your house and you’re riding with and have them yell at you like they do at spin classes 

[00:45:57] David Baker: [00:45:57] You know on the screen, it’s less [00:46:00] intimidating I guess.

[00:46:02] Bill Russell: [00:46:02] I don’t know. I, yeah, I don’t know the all of those, the Peloton experience has been something that people have talked about and said it is a, you know a phenomenally well thought out. But you know, at that price point, it really should be, I mean, When we buy an Apple over an Android, somebody said, you know, why would you spend so much for the Apple.

[00:46:24] And I’m like, you’ve never owned an Apple phone. They was like, no, I haven’t. I was like, you wouldn’t ask that [00:46:30] question if you owned an Apple phone after owning an Android. 

[00:46:32] David Baker: [00:46:32] Exactly. Yeah. Right. And that, and that’s what they did. And, you know, I was like, I’m not wasting that money. That monthly seems excessive. And so I go down the more economical route, which was okay. It was good, but now I can tell you as a convert, the experience is so different. It’s like, yeah, we have my Apple experience on the exercise bike there that. 

[00:46:53] Bill Russell: [00:46:53] Gosh, back when I knew you, you were a penny pincher, now you own a Peloton. That’s a, yeah that’s a [00:47:00] significant, significant change for you. 

[00:47:01] David Baker: [00:47:01] I’m investing in my health there Bill.

[00:47:04] Bill Russell: [00:47:04] Actually yes, you have. You’ve actually given me books about my health. So that’s the kind of employee you want to have somebody who wants to. Once they help you to stay alive so. 

[00:47:15] David Baker: [00:47:15] Are you running, are you running still Bill? Just off the bat?

[00:47:18] Bill Russell: [00:47:18] I am. No I gave up running a long, long time ago. I’d do bikes, but not nearly as much. It’s not spinning. It’s biking. Literally. It’s [00:47:30] driving going, you’re going around this circle. The circle is roughly roughly a mile. And go around and a couple of times but it’s not the same for me.

[00:47:42] I need to get into a routine of some kind. How does just turn into being about me? 

[00:47:46]David Baker: [00:47:46] You see thats psychology 101. Let me just spin out there. 

[00:47:49] Bill Russell: [00:47:49] Yeah. Yeah. I’ve got to work on it. David, fantastic conversation. I, I love following this journey. We were there when you guys made the decision to go with Epic [00:48:00] wisdom. And I’ve talked to your CEO and a couple of other people from your company as well, and got to interview you and Mostafa in the office and to see, and finally get to this point 200 offices in. And it’ll be interesting to see when you get to, well, you’ll never be at a number. I mean, Pacific Dental, you guys are always, there’s always more offices too. 

[00:48:21] David Baker: [00:48:21] So much opportunity, you know? It’s true. And it’s yeah. It’s It’s been a crazy ride. I love hypergrowth. It’s been awesome. We’re always looking to [00:48:30] hire. So if anyone hears this.

[00:48:31] Bill Russell: [00:48:31] And this is, this is a case where the technology becomes a game changer, right?

[00:48:35] I mean, you get Epic Wisdom in there. It’s highly integrated and you have the stuff that Mostafa is doing around the experience. And now all of a sudden, somebody comes in and looks at it and goes, wow, that’s a lot better than what we’re doing. You know, let’s join this team. Let’s be a part of that and that’s where that, I mean, that’s where technology really takes an organization company to the next level 

[00:48:57] David Baker: [00:48:57] Proven technology. If you think about, you know, [00:49:00] dentists coming out of school, this is a great model for them to accelerate that business ownership and growth. Then Paul, all of that is, you know are proven technologies. Where the biggest, biggest, same day crown miller in the, in the US so. I mean, we do, you know, chairside. No more putty in the mouth and sending off things to labs in the most, right. We can, we will literally 3D scan you and mill your crown while you are sat in the chair. So things like that, technology wise, I [00:49:30] would certainly say it gives you the edge. Same day dentistry is real.

[00:49:33] Bill Russell: [00:49:33] Awesome. David, thanks for your time. Really appreciate it. 

[00:49:37] David Baker: [00:49:37] Thank you Bill. 

[00:49:38]Bill Russell: [00:49:38] What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to this show. It’s conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, [00:50:00] Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We’re out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That’s all for now.

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