The Group Dentistry Now Show: The Voice Of The DSO Industry – Episode 151

Elevation Data Group Discusses the Importance of Chargeback Data Management for DSOs & Dental Groups

Melissa Dell, Chief Product Officer & Jon Dell, Founder & CEO of Elevation Data Group discusses data management and its importance to operations, procurement & finance within your dental group or DSO.

Melissa & Jon discuss:

• What TRAM is and why it is so important to your dental group?
• What are the reporting challenges DSOs, DPOs & GPOs face?
• Does TRAM save money?
• Which vendor partners work with TRAM?
• Much more

To find out more you can visit Elevation Data Group – www.EDGNow.com

You can also reach Melissa Dell at m.dell@edgnow.com or Jon Dell at j.dell@edgnow.com

If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.

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Full Transcript:

Bill Neumann:

I’d like to welcome everyone to the Group Dentistry Now Show. Thanks for listening in today. I’m Bill Neumann. As always, we really appreciate your support listening in. Without a great audience like you, we would not be able to bring on guests like we have today. We’re going to talk about a really important subject. We talk about data a decent amount on the podcast and cover it a lot on our website. However, this is maybe a different take on data, a different segment of data that maybe you’re not necessarily focused on but should be. So we have two experts here from Elevation Data Group. We have the CEO, Jon Dell, and we also have Melissa Dell. She is the chief product officer and heads up TRAM, which we’re going to talk about today. Jon and Melissa, thanks for joining today.

Jon Dell:

Thank you.

Melissa Dell:

Thank you so much for having us.

Bill Neumann:

Why don’t we start with you, Melissa? Could you give the audience a little bit of a download on your background and then your role at Elevation Data Group?

Melissa Dell:

Absolutely. I recently joined Elevation Data Group, but I have come from the aerospace industry. I worked in that for 19 years. In joining Elevation Data Group, what I am responsible for is becoming the face and providing a bunch of information on TRAM, which is transactional repository of associative metadata, and trying to partner together with the vendors we currently work with and the groups to be an industry standard and help everyone be visible amongst each other and just relating everyone working together.

Bill Neumann:

Thanks Melissa. Jon, a little bit about your background. You’re obviously the CEO there. What did you do prior to Elevation Data Group, and what are you currently doing at Elevation?

Jon Dell:

Sure. Well, I should probably start by saying I’m the one who named the transactional repository of associative metadata, which should tell you everything you need to know about why we had to hire Melissa to come on to help me. My background is in data. It is in systems applications. I’ve been in the dental industry actually since 2010, so I’m entering my 14th year. Used to work in distribution in different systems management, but formed Elevation Data Group in 2018 really to address high-volume data processing. We saw it and we met with a lot of people in the industry who had a lot of data, data was increasing, and they just didn’t really know how to harness it, how to use it in an effective manner. Foundational data was how this company was started. We’ve been doing it, again, since 2018.

What we found very quickly is that the biggest, most exploding and most sensitive data point was all around dental special markets. We actually built a product in 2019, which was and remains today the industry’s only widely available remuneration validation program. There’s a lot of contracts going around with special markets. We built a program that works between vendors primarily right now between distributors and manufacturers to validate all of these contracts coming through, all the transactional sales, match them to the appropriate group, and we have spent the last five years working on that almost exclusively. It’s really the biggest part of our business by far.

As we were doing that, we started to uncover a really huge pain point in data association. Now, this isn’t a sexy topic by any means. It is to me because I’m into that kind of thing. This is foundational connecting of dots, right? It’s the equivalent, Bill, as you and I have talked before, of the social security number connecting somebody to a financial profile. Well, these distributors and manufacturers, they’re making agreements with all sorts of groups and GPOs and DPOs based on their performance, and the performance just isn’t being seen. So we saw this and it was a pretty glaring pain point for us. That’s why we decided to try to aid this transactional supply chain and really help the groups really help take better control over their data as it leaves their control. That’s a little bit about how our company has evolved over the last year, and really why Melissa was brought in to help head this transition to really incorporate the groups and bring this product along.

Bill Neumann:

Just so I clarify this, and correct me if I’m wrong, but you’re really working with data, and when you say special markets, for the folks that don’t understand what that means, I know a lot of you do, but that would be a DSO or a GPO or something that is not a traditional solo dental practice. For the most part, the industry considers special markets different than a traditional solo practitioner.

Jon Dell:

Yeah.

Bill Neumann:

You’re handling the data, Jon and Melissa, that is coming through agreements, contracts when it comes to pricing, so products that are negotiated by the DSO/DPO/GPO and the vendor partner. Is that right?

Jon Dell:

That is. I think we can go even a step further because this data not only had the manufacturers and distributors and the groups all collectively agree to do business and to work on certain remuneration tactics that help increase that business. But there is now and what we’re doing increasingly is not just validating the numerical quality of the chargeback, meaning are they requesting the right amount of money, are we giving these appropriate rebates in the appropriate scale and quantity, it’s now become more about who’s qualifying for the right contract.

It used to be in the early days of special markets, there was a blanket contract. Everybody sort of fit in. That was that. Well, people have become much more discretionary, and these contracts have evolved. You’ve got multiple tiers of contracts. You’ve got separate contracts for small groups that are in the emerging side, you’ve got large group contracts, you’ve got different contracts for community health centers, and all these things that need to be parsed out. So when we’re validating these, we are now really the preeminent body that is qualifying these entities to participate on certain contracts.

That right there is the big intersection where there’s a huge gap from a data standpoint. Because the data may flow… If the CEO of a DSO is listening right now and say, “Well, we know who we are.” But what happens once your sale takes place and it filters through the distributor back up to the manufacturer, are you still associated with that sale? As Melissa can talk to with some of the stats, almost half the time that answer is maybe not. So it’s a very difficult and kind of a weird challenge to face, but it’s really something that the industry needs to address right now because it’s a huge pain point. I think it’s really limiting a lot of groups in terms of their efficiency in negotiating.

Bill Neumann:

I think this becomes… It should always be critical for groups, but I think it’s even more critical now as there’s more of a focus on cost containment and same-store growth with the slowdown in the economy over the past year, year and a half. So it’s great. I think everybody’s going to pay attention to this. Let’s talk about TRAM. Melissa, you talked about that. You’re heading that up. What is TRAM, and how is it powered by Elevation Data Group? Why is that important?

Melissa Dell:

Right now, the most thing to keep in mind is it’s a data network. It’s going to be a vault where all of these groups provide their operatory locations. The reason why that’s most important is that when the sales come through on the manufacturer side, a lot of times it is mostly just the basic information. Where is it being sold to? Names, addresses, and the initial affiliation that might have existed from the groups to the distributors never flowed through all the way. So we’re, over the past couple years with what Jon’s built, trying to match that up. Some of it is very simple. Some of it’s more complex, harder to discern out and make sure that they’re in the appropriate spot.

So we’re working on this as more of a place for all of us to work together, where the groups are providing the information that what they’re giving to us is quality data in order to match it against this. They know who they’re working with. They know the office locations. By giving that to us directly, we can trust that information and, therefore, the manufacturers can trust it. Why it’s relevant that Elevation Data Group is behind TRAM is because we’ve already built these relationships with the manufacturers. They trust what we do. They understand that if we’re working on this product, it’s to help everyone be elevated and everyone to be seen because their biggest complaint that they tell us is that we don’t know who exactly this is. You guys place your best estimates into it. You use a lot of qualities to try to make sure that they’re captured correctly, but most of the time there’s a lot of gray area where they just kind of go to the side.

So when these groups are working on stuff saying, “Hey, we’re doing these sales, we’ve added more operatories, we’ve added more into our catalog of locations,” it’s not being seen on the other side of it. When they’re trying to work on either improving to bring costs down or whatever the case may be of what they’re contacting manufacturers for, if the manufacturers can’t see that, why would they do anything different? We want to make sure that they can get everything that they should do with all of their hard work to be building their market share and let that be their negotiating power as opposed to this gray area, like, “Well, we’re doing all of these sales. You might not see it, but you just have to trust us.” Well, we’re going to be here to help make sure that that is seen, that they can use that in their discussions with providing the best cost for them.

Jon Dell:

If I can just reinforce that, because I think one of the things we really talk about is we know that this industry is evolving rapidly, especially with dental special markets. I know that some of these acquisitions may have slowed slightly. But we live in a world where this data moves so incredibly fast. I should also state that a lot of these groups are already sharing their full member list with their partners anyway.

The issue is they want to disseminate this information, but we have to think about, how are they sharing this? They’re sending an email with an Excel file to one of their contacts. That contact’s got to take that Excel file. They’ve got to move it up to whoever in their organization is responsible for loading this into their system, to reconciling their system. Are they reconciling for future-forward sales or future-forward association? Are they looking back at prior sales and attributing them now to a location that may be a part of a new group and does that matter? How do we handle that? There’s all sorts of questions that have to take place every single time that information is sent. So when you’ve got hundreds of partners potentially, you can see that it doesn’t take… Just one person that doesn’t forward that email, all of a sudden that information never gets constituted down the line.

So I think that’s really where we’re seeing some of these gaps. Again, the problem is it’s a lose/lose for everybody when that happens. I think why it’s important for us to build a product like this is the industry needs a standardized data exchange for this to happen. It’s as simple as that. I think the reason why Elevation Data Group is in a great position to do that is because we are a data processor. We’re an independent body. I should also say we don’t sell data. It’s not in our business model. It’s just not what we do. We build architecture, infrastructure, and data processing know-how that the industry can use. That’s how we make our money. So I think that it allows us to be a trusted partner for the different members of the supply chain. That really, really is exciting to us. Although a lot of people say, okay… because we’ve been so successful on the manufacturing side, but the groups don’t have a lot of experience with us. So we’re really eager to share that message and let them know what we do.

Bill Neumann:

I think it’s important. We see a little bit of it, just to give you our experience and how relevant this is. I know you talked, Jon, a little bit about maybe this slight slowdown in acquisitions. We do a thing called the DSO Deal Roundup every month. There’s still so much movement. Maybe it’s slowed a little bit, but I feel like sometimes we don’t see that. To your point also, we’re not always getting the updates from the DSOs. We capture what we can capture, but how many things do we miss? We have DSOs that provide data to us, but they’re not always great about it and also some don’t. That’s one thing to be able to provide that on a website to keep people informed. It’s another thing when you’re a DSO and you want to get the correct pricing or fulfill your agreement with a vendor to get the correct pricing next year or better pricing.

Jon Dell:

Exactly.

Bill Neumann:

So this is really, I think, super important. I see it from a different perspective. Yeah, it’s got to be a huge lift for you. Let’s talk a little bit about this. You probably already went over it a little bit. Why did you create TRAM and the relevance to the dental industry? I think we’ve already talked a little bit about that.

Jon Dell:

I know Melissa could talk to this, and just expanding on what she had said earlier, too, it’s just building a gateway. The groups really have one place they have to update their data. We use words like private vault because we want to take and build out this repository and share it with vendor partners. That’s sort of the model so that you can update in one place. You can provide a central repository of where all this information will live, not just the member list one time, but monthly updates, giving them changes on a location-by-location basis.

I think downstream, we have to think about compliance. On the group side, on the special market side, there’s a lot of compliance from your vendors that you need. This is something that supports that effort. Because, again, if you email that off, it’s totally out of your hands. It’s up to them to do whatever they need to do. But if you provide access to a centralized resource, then some of your vendor partners, especially ones that are more sophisticated and that list is growing by the day, they can build automated processes to ingest and update these records in their systems. So think about that.

I want to share a quick story I had with you that was so powerful. I was talking with a contact in the distribution space, one that is pretty tightly integrated with some of these procurement softwares. They’ve got formulary details that are flowing back and forth from their infrastructure into these group associations. There was all this talk around rapid price increases. As we went through the inflationary crisis, prices had to be stepped up maybe a little bit differently than they normally did. They weren’t getting disseminated in a timely or efficient manner from a data standpoint. The changes just weren’t being absorbed.

What was happening was it was putting at risk sales. So these procurement programs will stop somebody from buying a product if the price doesn’t match what it’s supposed to. This was happening for no reason other than the fact that the price increase or the price contract or renewal didn’t come through and wasn’t able to filter down because it got lost somewhere upstream. It’s a terrible reason for business to be halted or interrupted in any way, shape, or form just because there’s no real applicable way and centralized way of managing this data.

So we’re talking about it from an associative point. We’re talking about it from a metadata standpoint, which is really supportive data, data that helps business function in the way it ought to here in 2024. Everything is connected, and the dental industry is really behind in that space. But I think with the advent of TRAM and building this infrastructure and laying this ground, I think we’re going to find very quickly that we can make rapid gains on this.

Melissa Dell:

I know from my viewpoint, with everything that I’ve ever touched on in life with my past career and this one, I always try to see what’s going on and try to provide a very efficient way to get things done, cutting things out that’s not necessary. Here, it just seems like there’s such a simple way to resolve all of these extra time spent. Anything that is time related is a cost to a group or a manufacturer. If you’re able to come up with a very streamlined way where if there’s turnover that happens or anything with just different complex parts of it, what’s the best way we can simplify something to make sure that everybody is winning at the same time?

By having one central spot and with us working to figure out what is the actual details we need so it’s not like you’re sitting there, groups figure out, “Well, what do I have to send to you?” we would provide everything just so that way we can get them up and running and just let it be that it’s a simple thing where they can go, submit all of their updates to us. Then when we run the transactional stuff from our manufacturers, it just matches them up simply and it’s done. It’s not this back and forth of auditing and having to look through and see. Like, I asked my vendor partner to say, “Give me an audit? Why am I not getting the better deal? Why are you changing what I want to do next year?” and just allowing it for a way for everyone to be seen and just serving this community and this industry because we just want to help everyone out. We see what’s going on, and we want to make sure that any pain points there might be we can try and resolve as simply as possible.

Bill Neumann:

What are, you already touched on a couple of them, some of the reporting challenges that you’re seeing that the group practices and DSOs are facing? Then another question would be, does this apply to all the different business models? We have DSOs, we have BPOs, we have GPOs, we have buying groups. So talk a little bit about, depending on the model, would TRAM work within those different business models?

Melissa Dell:

Well, I’ve listened to a couple of your podcasts and listened to some of the vendor partners discussing things in the groups. I think one of the prides which allows an autonomy for a business partner that joins in their organization to maintain their branding is a really good point for the dentist operatory. But at the same time, from a data standpoint and on the other end of it, it’s very complex of, how do we know you’re a part of it? When they rebrand something completely and it’s very easy to identify this is a part of this larger group, then it’s simple.

Why shouldn’t it be that way? Why should someone who wants to maintain the brand that they worked so hard with but get the benefit of joining a group or DSO? This is how we counterbalance that and making sure that, even though they’re wanting to be the Jon Dell Dental Office, that we know what they’re really a part of because that group gave us the information, and we can just ingest it and it’s simple. I think that it could be a struggle for groups that feel that they should have a better buying power, but they’re not quite getting over that step. This is how we get them there because it’s just data. That’s what, at the end of the day, we’re all just trying to do the best that we have, and right now it’s missing this portion of it.

Jon Dell:

That’s a great point because let’s take some of these large, large groups. It’s very different with the external branding for, say, a Smile Brands versus an Aspen Dental. When you’re looking at that on the data standpoint, manufacturers may have varying degrees of ability to associate those. But it really, really depends. I think the point is it shouldn’t matter. That’s what metadata is for. It’s saying, “Hey, all these groups are linked under this umbrella. We all know who they belong to. You can attribute all these sales performance metrics to this entity,” if you want to call it a parent entity or a family entity. So I think in that sense, at a very basic level, yes, it applies to all different organizations, and it might apply to them a little bit differently.

I will tell you that probably one of our greatest opportunities is in the GPO space and also in the emerging group space. I’ll handle those from a data standpoint a little separately. From the emerging groups space, what we’re going to see is we really need to address the rapid scale of change. Again, new offices are being affiliated maybe monthly, maybe weekly even depending on how quickly these groups are moving. So we need to ingest those things industry-wide, and those changes, we need to ingest them immediately, and we need to spread those across the industry and unify everything.

Also, when we’re talking about things like year-over-year performance, remember I talked about, are we only associating future forward? Well, that’s not what we do. Our program TRAM looks back and attributes historically. It’s evolving. It’s living because you’ve got a living data repository so we can do that. Now when you’ve got a new location that onboards with your group and you go back into negotiations, you want to be sure that these organizations that are using TRAM, they’ve got the right association. They can see year-over-year performance. They’re not just looking at, “Oh, you’ve got two months worth of sales data because now I know you’re affiliated with that group.” No, no, no. This group may have 18 months of sales history that we can now base a better decision on. So I think that’s really important.

Then with the GPOs, certainly the rapid changes are even more pronounced, because in GPO, you’re going to have more of a hop on/hop off environment. You’ve got people who are members of a GPO, and then they are not members at some point. I talked to another distributor. There was this whole issue of somebody was a member of one GPO and they moved to another GPO. Because the data wasn’t reconciled, they couldn’t get the right pricing. I think if you talk to any of your contacts or anybody in the GPO world, this [inaudible 00:23:40] is probably saying, “Yep,” they’ve probably seen it a hundred times because they have to negotiate all this on a vendor-by-vendor basis in the background.

Again, in the world we live in, there’s really no reason that has to be the case. We’ve got sophisticated enough systems. Certainly, TRAM is a data architecture that can support these rapid changes, can support effective dates of membership, things like that, that are really important and just need to be centralized throughout the industry. Yeah, I certainly think it’s appropriate for all of these different components of special markets.

Bill Neumann:

How is the data…? It’s provided by the groups. Then how do you protect that from outside sources?

Jon Dell:

Great question. I think there’s a couple different ways of doing these. Number one is probably what I consider to be one of the best features of TRAM. It’s really about how we associate this data. Again, we told you that we have a variety of ways of associating data to groups because, again, we’ve been doing this for many, many years. We’ve developed hundreds of rules that are already in place right now with our vendor partners and our customers that are associating groups based on pieces of information in the data, and we do that to their benefit.

But we also go out and we will collect some data that is publicly available on our own. Certainly, we do that to support and supplement the data, and we verify and re-verify that data. But we think the real key here is going to be having the groups themselves exercise some control over this data, having the group say, “Here’s our member list. We’re going to send this to you every month. We want you to ingest it and maintain it and manage that in a proper data stewardship and a master data management mindset.”

But where it really becomes, I think, good in terms of protecting the data for the groups is that we use a process… When we associate this data, we match it. There’s a probabilistic matching algorithm that we’ve used for years and have really dialed in. You might call this scrubbing. Essentially, what we’re doing is we’re taking these transactions as they flow and we match it up to the TRAM database. When we do that, though, we use something called declarative matching. What that means is we’re only matching the data we see from our partners.

Let’s say we’ve got a manufacturer partner and we’re processing their data and we’re matching it. What we’re doing is we’re picking up all those associations to the sales the manufacturer has already done. This is a really important piece because we’re not sending these lists out unless the groups give us explicit permission to do so as the distribution piece. We’re not just selling this list and saying, “Here you go. You figure it out,” and we’re not giving locations that haven’t bought the product. I think that’s the important thing. We’ve talked with some groups that have some legitimate concerns over that. They said, “We’re going to give you your data. Then what? You’re going to sell that?” It’s not what we do, but the fear is there.

So what we’re allowing the DSOs and the groups to do is say, “Hey, we’re going to curate this list, we’re going to manage it, but it’s going to act like a black box where the sales transactions are going to come in. They’ll pick up the associations, and they’ll go out.” We provide very little additional information other than the fact that it’s associated with this group. Of course, we provide high-level metrics, so this is the parent group name that we use, because we have to have a standardized name, and this is how many total locations they have, and that’s it. So I think it’s a really safe way to transmit this data. I think one of the things that Melissa’s a big champion for, and Melissa, correct me if I’m wrong, but just the fact that the groups are able to control this data more efficiently, I think, helps protect from misuse of that data or that missing data downstream. So I think it’s really, really important.

Melissa Dell:

[inaudible 00:27:21]-

Bill Neumann:

Go ahead, Melissa.

Melissa Dell:

Oh, I was just going to say, we know that obviously there’s hesitation to do something with a new company, new to them, EDG new to the groups. That’s why we try to share how much we’ve already been working with their vendor partners because they understand also the complexity on that side where they want to make sure that… We already have some of their data, but now we can just do so much more with what they give to us to make sure that they’re having a complete picture on the manufacturer side of how many sales they’re actually doing as opposed to part of it being fractured where, yes, we know for sure this group or these operatories are part of it and they’re matched up. But there could be other ones that are just floating around. We want to make sure that everything is under the correct umbrella and give that to the manufacturer so that way they’re all in the same playing field and they can go ahead and discuss any future contracts or discount deals or whatnot with all having the same kind of information.

Bill Neumann:

I think that’s a really solid point, Melissa. Because when you started in 2018 and 2018 until now, for the DSOs and the emerging groups and the GPOs that are out there listening to this, you’re already working in, I would say almost every case, with some of their vendor partners. In essence, you have access to some of that data already. They may not even know that they’re working with you, but with the vendor partners that they work with, you work with them. So you came in on the vendor side first, and now you’re just trying to get the holistic. You’re trying to get the data from the DSOs to make the process even more accurate.

Jon Dell:

That’s exactly right.

Melissa Dell:

Yeah, by having them participate, we’re championing for them to have a better skin in the game for the most part because we know what struggle they might have just on what we see. And we’re not even a part of their group. We’re not a part of the manufacturers. But we just see it in general, saying, “This shouldn’t be this way.” That’s why we created it because we wanted everyone to know, “No, you are doing a higher volume than what it appears to be because of just looking through certain details where we can see how easily stuff is missed.” We just want it to come directly from them so we can say, “Yes, you have now a clear picture on the manufacturer side to go and continue with negotiations.”

Jon Dell:

This is so important. We have five employees, and so we’ve got analysts that are working with our customers. I don’t work with everybody directly. We’ve got some employees. We meet every couple of weeks, and we talk through some of these special market affiliation changes. We could talk for hours about this because we all come across all different scenarios with different partners. You’re right. We’re working with this stuff. I can guarantee you that some people, maybe even listening on this call, have gotten audit reports that we generated on behalf of the manufacturer using these matching algorithms.

The problem is it is not efficient to do this one by one. Because as I mentioned, we do not sell any data with our organization, so everything we do has to be within the environment in which we get it. So if we’re working with a partner and they get a list from a group, we can only use that list for their business because that’s part of their agreement we have to honor, and we’re happy to do that. That’s how we operate. But we really believe that we need to scale this out because the group should send this list away once. That list should be immediately disseminated throughout the entire industry through potentially hundreds or thousands of partners one day as the industry grows. It should be all done electronically. It all should be accurate and live. That’s what we hope we’re laying the groundwork for. So I think there’s safety in continuity of data, there’s safety in accuracy of data, and I think there’s safety in the architecture, too.

I guess we would be remiss if we didn’t talk a little bit about the point that our data is protected and encrypted both at rest and in transit. We are a data engineering firm at our core, so we take that very, very seriously and have built our whole relationship on that. But maybe more even than just the technical security implementations that we have is really just about our reputation in the industry, and our business model is about serving the dental supply chain. It’s not about taking this data and using it for personal gain. Our personal gain is providing these processes. We make a great living on that. That’s what we want to do, and that’s how we aim to grow. So I think that’s an important thing just to say so that I make that very clear.

Bill Neumann:

Let’s talk about how TRAM can help during daily operations. When I think about that from the DSO group practice standpoint, more than likely it’s probably somebody in procurement or somebody in operations. So can you talk a little bit about how you can help alleviate…? You talked a little bit about… Well, maybe tell us this. How are DSOs and groups now sending the information to their vendor partners? That’s probably a good question.

Melissa Dell:

Most likely-

Bill Neumann:

Or is it all over the place?

Melissa Dell:

Well, we can’t see into their office workspace. We can only imagine based on our experience with maintaining just anything within our own households or own companies. Typically, there’s going to be someone who’s responsible, has ownership over knowing all of the office operatories, sending out these emails of “We agreed to this vendor that we’re going to send it out to them, go ahead and email it.” Maybe they have some kind of scheduled regularity, whether they send it on the first of the month or the 15th or as it happens, who knows except for them personally.

But just an overview of it, there has to be someone that’s keeping an eye on it. There has to be someone that’s sending it out. If there’s multiple vendors, there’s someone who has to make sure that “I checked the boxes. Every one of you got it.” Well, part of it is that’s a lot of time. Administratively, that’s… Even if you had someone that’s very entry-level type person taking care of that, that’s still a cost that they have every single month. But now layering on top of that, part of what we’ve all seen in the employment scope of life and people are changing how they’re wanting to do their work or whatnot, there’s a lot of turnover on both sides of things in every type of environment.

Now let’s say you’ve said, “Okay, I’ve got someone. They’ve dialed in. They know exactly what they’re doing,” and what happens if they leave or if they get sick or if they’re out for a long period of time? Now what happens? It’s not guaranteed that there’s a lot of crossover training. But by us having it a little more simplified where they can just have it as a line item for this person, “Here’s where you send this every single month,” and it’s something very simple, if they’re out, “Okay, here. Give it to Susie next door and have her take care of it,” as opposed to knowing how they currently do their standard.

If there are so many steps, how great of a pain point would it be if someone is out or switches over and now you have to start from scratch? Not only do you have to just train them on your own employment protocols or whatnot, but now you’re adding this other layer to it. As Jon mentioned before, if anything holds something up and it just affects so much more in the future with transactions, what does that look like from an auditing perspective now because stuff got missed? It can snowball very quickly.

That’s one of the reasons why, for me, I wanted to make sure that it was something that’s very easily to get done and to send over to us, and then that’s just it. It’s one tiny little thing, 20 seconds, and then you’re done, as opposed to what is probably occurring right now at each group. Who knows who that person could be. If they’re not at a large organization, it could be someone that’s higher up taking care of this, which is even more of a cost burden when it can be something very simple.

Jon Dell:

Melissa’s wearing her special markets hat, if you will. She really does a great job of and understanding of what goes on there. But remember, I’m coming at it from a system standpoint, so my experience is we have to also look downstream. So even if you as a group do everything perfectly and you get this information out on the second day of every month and that information is perfect and accurate and you send it out to 45 of your vendors, how likely do you think it is that all 45 of those vendors ingested that data properly, efficiently, in a timely manner? What are the odds that somebody who was on the receiving end of that was on vacation for a couple of weeks, comes back to 700 emails, and yours is one of them and it doesn’t get forwarded to the pricing team or doesn’t get forwarded to the member update team, whatever the case may be? It only takes one error to cost you money, and that error could be something completely out of your control.

Again, going back to a centralized, standardized data architecture, it’s not sexy. I get it. We’re not talking using AI to develop new insights. I get that this is a very boring data topic. But it is so critical, and it is so lacking. Because with compliance, with vendors downstream, we’ve got distributors and manufacturers we can pipe into this so that they also don’t have to rely on outdated techniques for ingesting this data. So it’s really important not just for the group. It’s almost like helping them help you. You know what I’m saying? It’s kind of like, “Hey, we’ll contribute to this repository,” but now the expectation is that the vendors can use this repository and be more efficient so that everybody gets better because that’s all everybody wants.

In doing this since 2018, I’ve never seen any member of the supply chain trying to unfairly get with somebody. I’m sure something’s happened. But in my experience, everybody just wants to grow the business. They want it to be appropriate. The groups just want, “We’re not asking for extra sales. We just want our sales to be seen and to be accurate.” That’s what these audits are for. So I think it really can save on both ends, both directly for the group and then just in overall efficacy downstream.

Bill Neumann:

How often are the groups required to submit those member affiliation changes, and is that automated?

Melissa Dell:

We would want them to do it each month just to make sure that when we process and run against the transactions that, for the next month, it already shows a complete picture. Obviously, if things happen and someone is out, it would just be that it’s delayed a month. But the more often they’re able to do it to make sure it’s done by the due date of once a month, it would benefit them the most.

Jon Dell:

Yeah, monthly is really probably what we would highly recommend just because data’s changing that quickly. In order to do that, from a technical standpoint, we’ve created a couple of different ways to make it easy for our TRAM subscribers to do this. Essentially, we’ve got a standardized template that’s in Excel. It could be very simple for even the smaller groups to manage very, very easily and say, “Okay, we fill out this little template, we send it in every month, it’s done.” That’s certainly one way they can do it. We can also create custom imports for a group’s specialized format. So if you’ve already got a format that you’re using that has all the information we need, you can just continue to kick those things out. It’s a very small one-time fee for us to map that custom import, but once it’s done, you don’t have to generate anything custom moving forward.

But again, we’re dealing with a lot more sophistication nowadays. The nice thing is we are able to immediately accommodate complete end-to-end automation on this as well, which would include either an SFTP delivery of a flat file and automatic ingestion on our behalf, or even using a REST API. There’s a lot of technical ability to make this super, super easy for the vendors to make these updates. Because if it’s not easy, they’re probably not going to do it. For us, the most important thing is that these updates are made in a timely manner because everybody benefits from that.

Of course, one other thing that is really important to this is that we do require all TRAM subscribers to provide a member ID for each location. This is absolutely critical when it comes to updating. You really need a standard, unique identification for each of your members. So if that’s one thing that you don’t have as a group, I would really recommend that something you look to do. Because when you’re talking about applying changes, these are not just, “Hey, we have a new customer or a new location that I need to submit.” These could be changes to either a brand of a location, maybe the name changes of it. Maybe you’ve got an address change. You might’ve relocated to a new office site. As we’re doing matching and everything behind the scenes, we need this metadata to match up. So when you’re submitting a change or if you’re a GPO submitting a deactivation, these unique IDs for each of these groups is really, really important. We can certainly assist you with that. But it’s really important that that takes place, and it’ll help all of your vendor partners make these changes more efficiently.

Bill Neumann:

How would a group know if TRAM is working for them? Then the second part of that is, how do they know that it’s…? Will it save them money? Because that’s important.

Melissa Dell:

Yeah, we all want to save money. I think the first spot is that immediately on their side of things with the staff maintenance, I think that’s where you’ll see the initial immediate savings. Then a second spot would be with auditing. That also goes to, how will they know if it’s working for them? If they’re receiving audits from their vendor partners and all of a sudden now it looks more complete with what they run internally, they’ll be able to have less time spent on going through and resolving any kind of discrepancies. I think that’s where you’ll see it most impactful immediately, any kind of savings or a benefit to them.

Jon Dell:

You’re also thinking about… We are adding matches that didn’t exist prior. So think of this, this data’s in, it’s being viewed by the manufacturer as unclassified because they don’t know what group they’re affiliated with, or perhaps it’s got an old classification and their classification split between the new group name and the old group name depending on when their partner started using the particular name. I think the benefit here is this only adds to the efficacy of their sales performance. So if you figure yourself, let’s say optimistically, you’re at a 75% association rate. If you go to 85%, you only go up is, I guess, what I’m saying. It’s not like we go through it here and say, “Oh, you were being associated, but now you’re not because we’ve matched it differently.” It doesn’t happen. It’s an additive, so I think it really only serves to enhance sales performance visibility through all of your partners.

Bill Neumann:

I guess as we start to wind things down here, a couple final questions. Are all vendor partners, all vendors working with TRAM right now? How does that work, and how would that affect a DSO?

Melissa Dell:

Well, all vendors can. Right now, we have our current existing network that we’re able to have the benefit for them immediately. We know that, as we’ve seen over the past five years, or I guess six now because it’s 2024, the dental industry is very intimate. So as soon as somebody is seeing something working and discussing it, then it’s like, “Oh, well, I want to have that pain point alleviated as well.” So it could be something that it quickly snowballs into something larger as well with more vendors signing on. But initially, we already have our group of manufacturers and distributors that have expressed this need, excuse me, the desire to have this result. So we know that that’ll already be plugged in immediately for them, and it can only grow from there.

Bill Neumann:

If a DSO wants to get started with TRAM today, how easy is it to do that, and what’s the process?

Melissa Dell:

Right now, all they would have to do is just go to our site. The one we have specifically for TRAM is tram.edgnow.com. They can sign up. The fee is very low. It’s $9 a month billed annually. Then we would work with them directly to say, “This is exactly what we need, or what do you already have that we might be able to just use?” and as Jon said, just map it to make it work correctly. That way we can have them up and running potentially within the next month so that way their transactional sales run against this and have a more immediate auditing perspective to see how well it works for them and the manufacturer side.

Jon Dell:

We really want to make it easy for them, especially as we build out this product. Because obviously the deeper that repository goes, the more value it has for all vendor partners. So I think we’re going to hit that tipping point here in the future. But I think it’s important for us to say, “Listen, let’s focus on getting this data in and integrated as quickly as possible at nine bucks a month,” as Melissa said. It’s pretty clear, this is not where we’re making the money. The money is just to help support the repository and some of the maintenance and database costs that we’re associated with. It’s really about making sure this data is pushed throughout the industry. Increases in our services and the matching that we do on the manufacturer side, that’s really where the revenue for us comes in. I say that just from the standpoint of reassuring that this data is protected and is really treated in a sensitive way by us because it’s really something that is important for the industry to move forward.

If I may, Bill, give you one more example because this is really, really fresh. Actually, just two days ago, we were running a sample. We had a very specific use case, and I won’t go into a lot of the details. There was a vendor of ours, a customer of ours that said, “We really have trouble associating this one type of business.” We went out and we actually were able to collect this data publicly. So we got this very small little data set and dumped it into TRAM and ran that matcher. We were able to associate nearly $100,000 in non-associative revenue in less than 23 seconds. That’s how long the system took to do that. So we’re talking about getting people up and when will we see the benefit and all of that, this was a really very small use case. You could even attribute this maybe to the size of one group, if you will, but it was so, so powerful. I think that’s what really got us excited.

For TRAM, for even this call today, because we’re coming fresh off that test and we’re geeked out, we’re ready to go because we know it works, and we’re excited. With each customer that comes on board, I think, is going to see that value pretty immediately with their vendor partners. I think we’re really optimistic that’s going to grow pretty rapidly over the next couple of years.

Bill Neumann:

If any DSOs or emerging groups or GPOs out there are interested in learning more about TRAM, the URL, and I’ll make sure we add this in the show notes, is tram.edgnow.com, right? Did I get that right? Tram.edgnow.com.

Melissa Dell:

Yes, yes.

Bill Neumann:

Then you can book a free 30-minute call. Also, I want to make sure that if you’re a vendor and you’re not working with Melissa and Jon, you should definitely look at it from that perspective, too. They’ve done a lot of incredible things with a lot of vendors that we work with and have really helped them out. Really, they sit in a very interesting position within the industry where they’re really helping both vendor partners and DSOs really have a truer idea of the business that they’re doing in the industry right now.

I really appreciate you both being on the show today. We’re going to drop… Oh, Melissa and Jon, would you mind shouting out your email addresses in case people want to reach out directly to you if they have any questions? Melissa, what’s your email address?

Melissa Dell:

Sure. Mine is m.dell@edgnow.com. If you want to guess Jon’s, it’s j.dell@edgnow.com.

Bill Neumann:

Great.

Jon Dell:

Yeah, and we’re both on LinkedIn as well. Feel free to reach out to us. I’m sure we got a lot of common connections. Yeah, we’d love to hear from you. Even if you just have some questions and aren’t quite sure exactly what we do because we know it’s a little bit of a complicated topic, I’d be happy to jump on. Melissa and I can have a further conversation with you, or we’re happy to direct you to some of our clients if you want to learn a little bit more about what we’ve done maybe for them. If you know them, we’d be happy to do that.

Bill Neumann:

Thank you both.

Melissa Dell:

Thank you so much, Bill, too. We really appreciate it.

Bill Neumann:

Yeah, yeah, thank you. I think it’ll definitely be new territory for some DSOs and groups, but I bet you the procurement and operations people understand what you’re talking about, and those are the ones that are going to be reaching out to you.

Melissa Dell:

Yeah.

Jon Dell:

I think so.

Bill Neumann:

Thank you both, and thanks everybody for listening in today. Until next time, this is the Group Dentistry Now Show.