Dr Michael Sernik, June 2006 - Dental Practice Management software tends to have features that are under-utilised. Most Practice Management (PM) software companies tell us that 85% of their features are not used by the practice. In our experience, this is due to a combination of factors.

Lack of training
The typical scenario is that the staff of a dental practice are initially trained in the features of the new software when it is installed. Time goes by and the staff become very familiar with the frequently used features and the other features get forgotten. To compound this, as most practices experience a degree of staff turnover, most practices do not have a protocol of sending the new staff for training. Most practices prefer to have experienced staff train and pass on their knowledge to the newer people. This of course is like trusting your practice operations to a game of ‘Chinese whispers’. The initial efficiency and effectiveness of the training is diluted and distorted.

This intellectual attrition limits the efficiency and thus growth of your practice and you as a practice owner. There could be many time saving features that you are missing out on or statistics that your software could be giving you that you will never see.

In order to utilise all your dental software features as effectively and efficiently as possible, you need to have a practice commitment to the training of staff. Not just at the outset when the software is being purchased but also training each new staff member. It is important that as a practice owner, you undergo training as well so that you know the features that are available.

Not being committed to software training almost ensures that you won’t be using the software effectively or efficiently. You will probably end up paying more in computer support, fixes and time lost than the software would have cost in the first place.

Unrealistic expectations
Many of the changes practices are trying to make by installing software are actually practice management protocol issues rather than software issues.
Moving onto practice management software doesn’t mean that your practice will necessarily become a streamlined efficiently running practice. For example:

• Putting workstations in the treatment room won’t necessarily eliminate the bottleneck at the front;
• Your appointment book won’t all of a sudden become more organised because it is on computer;
• Software won’t solve these problems until your management protocols are in place. Software can only assist you with the implementation once you have sorted out your protocols. Buying dental software is not a solution in and of itself. It is a huge commitment to change.

Poor integration of other systems
Over the last few years most software companies have added all sorts of modules that can be integrated. Most PM software has the capability of integrating with other hardware and software such as:

• Digital X-rays, digital Imagery, movie files, educational programmes,
• HICAPS,
• Stock control,
• Periodontal charting,
• Voice recognition,
• Insurance plan integration,
• Integrate with laboratory module,
• Any interaction with banking via financial management programmes such as MYOB/Quicken/QuickBooks,
• Automatic telephone dialing,
• Recall/reminder systems,
• SMS and email integration.

SMS and Email integration for example, has become almost standard in PM software these days. Integrated correctly, these technologies can:

• Increase efficiency and communication with patients;
• Decrease correspondence costs; and
• Show patients that you are an up to date, high tech practice

However thought has to be given to questions like:

• How will you know if an email or sms reminder actually went through to the patient?
• Will there need to be protocols for patients wanting to cancel and ask questions of the practice by sms and email? By emailing and sms-ing reminders to patients you are opening these avenues of communication from them back to you.

Integration of modules like the ones above has the potential to increase the efficiency of your practice in many ways. However they also have the potential to wreak chaos in your practice if thought hasn’t been given to how it will be integrated (the transition process), how it will be used once it is integrated and how the practice is going to avoid the potential pitfalls that could occur.

No knowledge of or commitment to updates
Software updates come out regularly. It is important as a practice owner to keep an eye on what is happening with the software has been incorporated into the practice.

• Ensure that you are receiving bug fixes and security updates.
• If you aren’t going to commit to the new versions of your software, then make sure that the company is still going to provide support for your version.
• Look into the new capabilities that the new updates give you.

One of the important new PM software updates that will be coming out from the progressive PM software companies in Australia/ NZ are Prime KPI's.
This is a standard benchmarking format has been developed and consist of 10 KPIs that can be accessed as a single report. Apart from being used by practice managers these KPIs are also being used by reps for HSR/Halas for the benefit of their clients. Having a uniform standard means that a rep can consult with their client and help the client understand how they compare with their colleagues. These are the 10 KPIs that a practice owner could look at.

1. Production per hour
2. Collection percentage: Amount collected divided by amount produced.
3. Clinician hours/month
4. New patients seen/month
5. Patients reappointed percent
6. Average amount paid (collected) per unique patient.
7. Average appointment Time
8. Number of active patients over the last 18 months
9. Number of indirect treatments done per last 100 unique patients
10. Attrition rate - number of patients who were seen 18 months ago who have not been seen in the last 6 months as a percent.

You will notice that these KPIs are all related to the production side of the equation rather than the expenses. All experienced dental practice managers understand that the major variable in the success of a practice is the production capability of the clinician, as opposed to the expense cutting capability.

Lack of a thorough evaluation process
When the dentist is faced with a bewildering number of software features and high costs, what should they implement? It’s difficult to wade through all the options and easy to get caught in paralysis.

It is reasonable to consult with the vendor but dentists should keep in mind that software vendors will sometimes have a different agenda than the dentist. You need to allocate time to judge what modules and features you need to implement. Ask your vendor for the names of dentists who are actually using a particular feature before you spend valuable time learning all about it.

As you can see purchasing dental software is a very important and significant decision for your practice. If done right, it can make life in the practice much more structured and streamlined. If done incorrectly it can be a costly exercise that may throw your practice into chaos. It takes commitment to ongoing research, training and protocol change.

[Published in Australasian Dental Practice, May/June 2006]