COVID-19: The unintentional accelerator for dental industry transformation

The dental industry is still reeling in the midst of the pandemic and in the throes of a national struggle for our lives and our democracy. Leaders and CEOs have found themselves at a historic crossroads, managing short-term pressures against medium- and long-term uncertainties. Our dental frontline workers have faced the unprecedented stress of caring for patients in risky and sometimes untenable working conditions, as COVID-19 continues to reveal inadequacies, inconsistencies, and inequities in our systems.

And yet, in the midst of such tragedy and uncertainty, there is the possibility to rebuild better. The immediate response to the public health crisis is causing seismic shifts in how and where care is provided to our communities. The COVID-19 pandemic has forced dental professionals to establish new norms and operational best practices to benefit frontline workers and their patients, ushering in a new era of innovation, collaboration, and curiosity.

“There are so many moving parts to this pandemic,” said Joe Fogg, founder and CEO of onDiem, a national on-demand dental staffing platform that has responded dynamically to the pandemic by providing crucial employment opportunities and workplace safety resources for the dental community. “Having one person or organization try to put their arms around all that and really know what they're up against is impossible. How do we make this a safe environment for the teams? How do we make it efficient for them?”

In an industry that can sometimes be slow to explore new methodologies or potential best practices that aren’t by the book—a natural inclination, considering the nature of our life-saving work—the pandemic has accelerated emerging practices, persuaded dental service organizations (DSOs) to adopt new technologies, and shifted the care delivery model light-years forward.

In our new reality, where real-time innovation, telehealth, and the need for cloud infrastructure have shifted patient care expectations, innovative companies such as tab32 have set the standard for patient-centered cloud-based practice management software and seen quadrupled growth in the past six months. Their telehealth tools—viewed before the pandemic as mere afterthoughts—have seen a dramatic increase in demand. Staffing and training models have also been transformed in the wake of COVID-19. Dynamic on-demand staffing companies (like onDiem) have allowed practices to more efficiently manage inconsistent schedules, workforce efficiency, and workplace safety.

Start-ups such as Dentira, for instance, have helped alleviate some of the unique financial burden that has fallen upon dental professionals and practices during our public health crisis. Dentira was founded before the pandemic, but its services are particularly needed in these trying times. The platform allows users to compare prices for dental supplies across several suppliers and streamlines procurement and inventory management. In a dynamic market, even essential supplies such as personal protective equipment (PPE) can come at a steep cost.

“Even before the pandemic,” said Vikas Gupta, founder of Dentira, “there was no price transparency. It was just a lot of time and research and hassle for dental staff, especially for practices. Now, during the pandemic, some people are selling N95 masks for $1—and some are selling them for $9. We’re helping people gain more transparency into these prices, so that they can avoid spending thousands more dollars than they need to per month.”

Beyond the cost of dental supplies, and as patients and procedures return in waves, revenue cycles will continue to face unpredictable work volumes over the next 12 to 18 months. Given this volatile environment, traditional staffing approaches have shifted to next-generation revenue cycle management tools such as Zentist—a venture-backed start-up that uses big data and machine learning to automate insurance claims management.

“We have seen dental practices rethink how they deploy staff safely—and they have seen Zentist as the safest, most cost-effective, and most reliable way to maximize their insurance revenue. Because our technology leverages automation and artificial intelligence (AI), it allows practices to quickly scale output up or down as conditions demand without the added precautions and inconveniences of staffing during this time.”

The dental delivery value chain

During the global pandemic, the dental delivery value chain is undergoing five key shifts that will lead to vast potential across infrastructure, geographic distribution of providers, and care settings:

1. Data-driven models: Operational excellence and efficiency will be driven through the adoption of critical data-driven models.
2. Transparent dental procurement: Supply chain management and dental procurement will be optimized for dental professionals and practices, thanks to new transparent models and platforms.
3. New infrastructure technologies: The emergence and adoption of new infrastructure technologies will create efficiencies in dental workplaces. It’s worth noting that while representing only a minority of all dental practices, the number of practices with more than 10 employee dentists, as well as the number of practices contracting with DSOs to streamline business operations, has been rapidly expanding.¹ Massive financial losses during the pandemic may hasten the consolidation of dental practices under new infrastructure models that can better weather financial uncertainty.
4. Bold learning at scale: The intersection of dentistry and modern education technology has allowed for streamlined learning. This has been exemplified by the free Smart Safety COVID-19 course,² made possible thanks to the education technology of Silicon Prairie start-up Higher Learning Technologies and the medical safety expertise of BioShield Healthcare and Forca Healthcare.
5. Collaboration for social impact: Dental practitioners across the country have created support groups and resource-sharing communities that help our community grapple effectively with the financial, emotional, and mental stressors of the pandemic. Oral Health United, for instance, has built a thriving community of more than 45,000 dental professionals and has partnered with onDiem and Zentist to offer a free bundle of services to support practitioners during this difficult time.

Despite our cautious optimism, we see a series of challenges ahead—challenges we must be prepared to face head-on. The average dentist operates in a solo practice, and 40% of dentists are over age 55.³ If shutdowns persist, many older dentists may retire rather than resume practice after suffering a prolonged and costly gap in operations. Dentists in rural areas in particular tend to be older, which means practice closures could compound existing geographic disparities in access to dental care. The vast uncertainty that still shrouds the novel coronavirus and its spread is perhaps the most troubling challenge ahead, especially as frontline workers grapple with a deadly second wave.

Dr. Ryan Lee, dental oncologist and implantologist for the U.S. Army National Guard and co-medical director of BioShield Healthcare, warns that we must remain vigilant and mitigate the damage that comes from growing emotional numbness to the pandemic.⁴ He says, “I’m afraid that, because it’s been relatively quieter in the last couple of months, in contrast to the early days of March and April, that...we’re sort of resting on our laurels. History tells us that [things] are pretty ugly after the initial wave, but the secondary waves are deadly. None of us really knows exactly what’s going to happen; we hope for the best, and control what we can control.”

The traumatic and collective experience of 2020 has demonstrated the potential for fundamental and revolutionary shifts in the dental delivery model—from the training of dental workers, to the sourcing and inventory management of critical care equipment and PPE, to the optimal settings for care delivery and how it is reimbursed. The future success of dental professionals will be determined by our industry’s ability to remain hypervigilant, adjust to the new normal, deal with a specific set of new or accentuated challenges, and capture new opportunities at optimal speed.

A series of webinars will be held by leading brands across the dental and medical industries to help more practitioners and businesses harness the full benefits of our industry’s inevitable transformation. For updates on this webinar series, please sign up via Oral Health United.

References

1. How big are dental service organizations? Health Policy Institute. American Dental Association. April 2019. https://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIgraphic_0419_1.pdf
2. The free Smart Safety COVID-19 course. Care for a Better Tomorrow. https://www.careforabettertomorrow.com/the-free-safety-course
3. The dental workforce – key facts. Health Policy Institute. American Dental Association. https://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIgraphic_0716_1.pdf
4. Walsh B. Why we’re numb to 250,000 coronavirus deaths. Axios. November 21, 2020. https://www.axios.com/coronavirus-death-toll-psychological-reaction-f5aab275-1c93-444e-9914-5b0bf8fe07d9.html