The Group Dentistry Now Show: The Voice of the DSO Industry

Applying Software Innovation to Build Successful Dental Membership Plans

Christopher Hayes, Chief Product Officer of Kleer & Membersy, joins the GDN Show. Chris shares his insights on:

Trends in healthcare software
Analytics
Integration strategies
Security and more

To find out more about Kleer Membersy and get a demo visit – http://kleer.dental/demo-gdn

You can also connect with Christopher at christopher.hayes@membersy.com

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Applying Software Innovation to Build Successful Dental Membership Plans. Full Group Dentistry Now DSO Podcast Transcript:

Welcome to the Group Dentistry Now show, the voice of the DSO industry. Kim Larson and Bill Neumann talk to industry leaders about their challenges, successes, and the future of group dentistry. Visit GroupDentistryNow.com for more DSO analysis, news, and events. Looking for a job or have a job to fill? Visit JoinDSO.com. We hope you enjoy today’s show.

Bill Neumann: Welcome everyone to the Group Dentistry Now Show. I’m Bill Neumann. And as always, we appreciate you watching us. Always have some great conversations and going to discuss some really cutting edge topics, talk about technology. When we talk about software innovation and really how it applies to dental membership plans and the importance of those, how it relates to same-store growth and making your DSO and your patient experience a better thing, we have Christopher Hayes. He is the Chief Operating Officer at ClearMembership. Chris has been in the healthcare IT space for a while. He graduated from Carnegie Mellon University. After he graduated, he co-founded NetHealth. They were focused on electronic health records and analytic tools for underserved healthcare specialties. Chris joined Member-C in 2023. And then, of course, Clear and Member-C merged this year, and he is the Chief Operating Officer at Clear and Member-C. So, first off, Chris, thanks for joining us today. Always interested to talk about technology and how we can leverage software to really have a better patient experience and help our DSO partners operate more efficiently. Great to have you here.

Christopher Hayes: Thanks, Bill. I appreciate being here as well.

Bill Neumann: So maybe a little bit about your background. I talked a little bit about Carnegie Mellon and your first – that company that you founded. It would be great to kind of find out what you learned working in the healthcare space. What was the healthcare specialty that you were focused on or specialties?

Christopher Hayes: Yeah, so Net Health started by focusing on chronic wounds. So we provided electronic health records to hospitals that ran outpatient wound clinics. As we grew and diversified, we introduced an electronic health record for physical therapy and occupational therapy. We also had home health software. And so, you know, the whole focus was really around not only providing electronic health records, but how do you help those using those tools through analytics and to help them both operationally and clinically. and always focused on the specialties that the big box EHRs really didn’t serve all that well. And my role there as a chief technology officer. So I was responsible for really all of the innovation that happened both from a product management perspective in driving the roadmap, but also executing from an engineering

Bill Neumann: So you joined member C, which is now clear member C in 2023. What is your role, your chief operating officer? So maybe describe kind of your 2023 to now and some of the changes that you’ve seen there, because that’s a long period of time when it comes to software.

Christopher Hayes: Yeah, sure. Definitely an exciting period. When I joined, we were in the midst of a replatforming of our core software at Membership. And a really big driver for me joining was to oversee that project and bring it to fruition into our clients’ hands. And so my role not only involves the engineering side, but also overseeing all of our customer service implementation as well. So one of the things I really like about this role at Third Member C is kind of the molding together of both the engineering and the services side, which allows me to stay super close to our customers and make sure that what we’re building is really hitting home and having the

Bill Neumann: So, let’s go back to that experience that you had in the medical space and talk about some of the trends that you saw there and then maybe how it relates to similar trends in dental. to mention this because I’ve been in dental for quite a while. And what you hear from people that come in from outside the space is that we’re a little behind the times. We tend to adapt a little bit more slowly than other industries do, which isn’t always a bad thing because we can peek into other industries and see what the trends look like. And the idea is that They’re probably going to end up in dental at some point soon. So maybe some of the overall dental software trends or maybe medical trends that you’re seeing and how some of those are coming over to dental.

Christopher Hayes: Thanks, Bill. So I would say you’re spot on in terms of dental being more of a kind of close follower than leader in some of the technology innovations. I’d focus in three areas that I think are really interesting in healthcare space, and I think we’re seeing them come into dental as well. So first is around interoperability, both between healthcare entities, so from one healthcare system to the next, but also between HIT systems. And really the drive there is like no more silos. You can’t have data for patient split between these different systems without any sort of communication between them. The real advance that we’re seeing is going from kind of exchanging data to having embedded technologies. A good example of this is the company Epic, which really dominates the hospital EMR space. Epic has what they call the Epic App Orchard, where any any software company can build and get approved to launch their tools right within a patient record, which is very, very, very powerful. So you’re no longer limited to what that EHR has built. You can launch, whether it’s analytics tools, whether it’s any sort of kind of valuable add-ons directly within the platform. And we’re seeing that happening more and more, which is exciting. The second area is around analytics and AI. So when I think about the blending of those two, it really is about moving from what historically has been descriptive reporting, so what happened in the past, which takes a lot of work. You’re running it and you’re trying to figure out, how do I apply that to what might happen in the future? And the trend is, well, let’s provide predictive reporting. So predictive reporting is going to go ahead and show, based upon all of the data we have, we think here are the likely outcomes. And that can be at a clinical level, that can be at an operational level. And so that’s something that It really allows, whether it’s an office staff or provider, to spend more time looking forward rather than backward, which I think is really powerful. The third one is a huge trend within healthcare overall, and that’s the impact of social determinants of health on healthcare. I think it’s, to me, it’s very obvious that those who have a tougher socioeconomic situation, their healthcare suffers. And I think that’s really prevalent in the dental space as well. When I think through about a third of the country does not have dental insurance. And so they’re often not getting the routine care that they need. And so what we’re here for, we as in clear membership, is trying to figure out a way to provide more affordable care to everybody. And so to somewhat level the playing field is what the goal is there.

Bill Neumann: So you really mentioned three trends. You talked about interoperability, you talked about analytics and AI and social determinants. Any thoughts on, you know, where the industry dental is? You know, again, we talked about being behind. I kind of think of, you know, maybe start with interoperability. And you mentioned Epic and their platform. And then I kind of look at, you know, some of the dental practice management softwares and how a lot of them are very, difficult to work with. And I don’t know if that’s changing or you’re seeing them becoming, and not all of them are, but some of them becoming a little bit more open. But it’s always been, I know, a challenge for outside companies to kind of come in and plug in to a practice management software. So that’s one. I’d love to get your thoughts on where things stand. And you see, is there optimism for things opening up?

Christopher Hayes: I think there is. If you go back to General Health here with Epic as an example, they were not overly open until the government stepped in and really started driving it hard. I think in dental, there’s a couple areas that we see that are shining a light on, I think, where we’re going. So one, because historically, it’s been challenging to integrate effectively directly with some of the practice management systems, these third party aggregators have stepped forward. And so that’s an option. And it’s a good option, because you can go ahead and integrate with one of these vendors. And that can get you access to a lot of the different practice management systems. So that’s good. One area that has held the industry back a little bit is the lack of standards. And so HL7, Health Level 7, is the standard that’s been in place in healthcare for many, many, many years, decades in fact, and that’s lacking in the dental space. What I really was excited about is Open Dental’s API is using some elements of what’s called FHIR, F-H-I-R, And that’s some more codified API standards that are prevalent within the healthcare space. And I’m happy to see them beginning to be adopted within the dental space as well.

Bill Neumann: So on the operation side of things, some of these shifts that we’re seeing, how do you think it’s going to impact the DSOs operationally?

Christopher Hayes: I think it’s terrific, to be honest. I think as you increase scale, the more you can effectively exchange data within the systems, the better the patient care is going to be. When I look at these large DSOs, whether it’s Aspen or Heartland or small brands, they have patients that are often being seen in one location for part of the year, maybe they go down and they winter in Florida, and being able to effectively maintain the continuity of care across these locations is really critical. And then you look outside of just the clinical part of dental care and think through the DSO’s desire to build their patient base. And if we can go ahead and have a great exchange of data between a PMS system and a marketing tools, then you can create really great opportunities to attract patients into the system, which is always needed within whether it’s a private practice or whether it’s a DSO. And then finally, what I would look at is the DSOs have a strong need to report and aggregate data across all of their offices. So if they have 250 offices, we want to be able to roll that data up. and show whether it’s at a regional level or at a national level, what are the trends that they’re seeing? If they’re going ahead and applying some sort of experiment to see whether they can attract new patients with a certain campaign, can they see how effective it is across all their practices? And so that’s where I think the kind of changes in tooling and technology is really an asset towards the DSOs.

Bill Neumann: You actually pretty much answered the next question I have, but I was kind of curious as to, you’re seeing these trends, what changes have you made at Clear and Member-C really to kind of build the software to take advantage of these opportunities? And it sounds like you’ve done a couple of things. Anything else maybe that I missed there as far as some of the changes that you’re making with the platform?

Christopher Hayes: Yeah, I’ll cover two that I think are pretty interesting. So one, it really touches on security. And it’s, you know, single sign-on is very prevalent across all businesses. And it allows the kind of corporate entity, so the DSO, to administer all and provision all accounts. And so that’s one, it doesn’t, It’s not necessarily the most fun change that we’ve made, but it does drive a really great security model that we really like. A second one is around, and this is something that we’re just working on right now, it’s around benchmarking. And so it’s really terrific to be able to see an office and see how that office is operating as compared to the rest of their cohort. And that cohort may be their DSO, or maybe we take a step back and say, well, how does this office operate as compared to the peer membership membership cohort? And so you’re looking at thousands of offices and you can see whether They’re having a similar number of memberships sold. What are the services rendered as well? How does that look? So benchmarking in my last company at NetElf was extremely valuable and important to our clients. And that’s something I’m trying to bring to our current clients at ClearMembership.

Bill Neumann: You had mentioned that, you mentioned the use of AI and analytics as an overall health care trend. And so are you incorporating, when you talk about the benchmarking, is that really in that analytics platform that you have? And are you leveraging AI to kind of monitor that? What does all that look like? And I guess it’s great. I mean, it sounds great if you’re able to benchmark. It certainly benefits the DSO and the well, the practices that are performing well and the others, it gives them an opportunity to catch up. How about from a standpoint of benefiting the patients?

Christopher Hayes: Yeah. So, to me, the primary application for AI that I see in the probably nine to 18-month zone is reg-sizing plans. And so, what I mean by that is if you can identify around a office let’s say a five to 10 mile radius, what the socioeconomic data looks like, can we then build plans that maximize the opportunity for patients? So some patients may be looking to find a plan that covers a lot of their routine care. Other patients may look to identify plans that are more heavy in services. And really, we can take data both from publicly available data, but also data coming from practice management systems. and understand what’s the profile of these patients that will allow us to build a plan that really matches what their needs are. And, you know, that both helps them from a financial perspective, but it also helps them make sure that they’re getting the right care and the dental care.

Bill Neumann: Let’s go back to interoperability. I mean, it’s the second hottest topic in the industry. If you do the top three, it will be same store sales growth, followed by interoperability, followed by security. Those seem to be like the three. I might have missed one, but I think we’re pretty close on those. I guess depending on what your role is, they may flip around a little bit. Does that kind of jive with what you’re seeing?

Christopher Hayes: Absolutely. Yeah, 100%. I think the idea that independent healthcare software will continue to be on an island without any sort of connectivity, those days are in the past. The efficiency lost, if you have a practice management system, you’re entering the patient, all the demographics, all of the data about them, and then you’re going to another software system, and you’re adding that all over again. It’s a waste of time. And so the efficiency is lost, but also the rate of errors is significantly higher as well. And so being able to build efficiency, improve accuracy is really critical. When I think of interoperability, there’s two aspects of it for me. So one is read access. And so when I say read access, that’s really data coming from the practice management systems to us, to the membership platform. And that allows us to accurately profile and enroll patients. The other part of the interoperability is right access. So when data is coming from our system and is being written back to the practice management system. So examples of that would be, well, they purchased a membership and we want to get that payment back to the patient ledger. And so that’s one way that data flows. A second would be, well, right when a patient signs up for membership, they’re likely a new patient. They may never have been to that practice before. We want to immediately create the opportunity to schedule an appointment. And so can we create a scheduling appointment message that automatically creates an appointment within the practice management system? And so we’re kind of moving down that direction. We’re able to streamline that patient’s activity, make it easier for the front desk person because it’s automatically sending a message. So that’s where the value of both the read and write interoperability comes from.

Bill Neumann: Back to security again, one of the hot topics and I just got back from a DSO leadership summit in Atlanta and actually had the opportunity to sit in on a tabletop cybersecurity exercise really, really scary, quite frankly. But, you know, it’s top of mind. You know, we had the Change Health incident. We had one of the big distributors that had a breach. And, you know, it seems like every couple of weeks, you know, you see some press release where a group or dental practice is disclosing that there was some type of whether it’s phishing or whatever, that there has been some personal information that’s been leaked. And so that’s becoming more and more a concern for dental practices and DSOs. And so security, I’m sure, is a hot topic. So I know you talked a little bit about it. Anything more you want to touch on as far as your approach to this security when it comes to the Clear membership platform?

Christopher Hayes: Uh, absolutely. I mean, security, cross healthcare and, and, uh, in the dental space is, um, it, it has to be a priority. Uh, and you know, it’s, uh, it’s sad, uh, that there are so many bad actors out there that are looking to make money by, uh, hurting others. I mean, I’ve seen situations where, um, a, uh, pediatrics children’s hospital, uh, is taken down and they can’t access their medical records, which is really a terrible situation. But what are we doing about it? We really look at security in three ways. So one is around our overall kind of hosting or servers, how we’re providing the software and ensuring that everything there is sound. So we have tools that allow for great observability. So we have what we call site reliability engineers. that are constantly monitoring, reviewing logs, ensuring that any sort of intrusions are being stopped. And thankfully, there’s tools, and we talked about AI earlier, but a lot of this observability and resiliency tools are embedded AI. So they’re regularly looking at new threats. Every day, they get updated through your partner to go ahead and get these new rules put in place to ensure that it’s always evolving. A second area is around our code itself, so the product that we’ve written. And so every two weeks, every month, we’re releasing updates to our software to continue to add new features and enhancements. So we have tools that automatically scan for any vulnerabilities so that there’s nothing that we’re introducing that’s going to create any problems. And so that’s a second area. The last one, though, is by far the most important, and that’s around people. And 85% of all ransomware attacks are caused by human error. And so we can do great on the first two, but that’s only covering about 15%. The 85% are really related to training people. And so we really invest heavily into ensuring that our employees are trained effectively, that we’ve got rules and password requirements that are ensuring that nobody can make kind of simple mistakes. We also do a lot of phishing tests and try to make sure that our employees are being subject to the type of attacks that they would see, and then we can do additional training. So we really focus heavily on that third one, knowing how great of a risk all employees are, not just at ClearMemory, but across all companies.

Bill Neumann: Right. Yeah, that’s like I said, after kind of going through that tabletop exercise, it’s very and some of the things that you’re doing a clear member see are similar to what the recommendations were there. You know, the education component, because it is so much of it is human error that really you need to educate the humans in order to try and prevent that. And I’m sure the threats are constantly evolving and changing and unfortunately becoming more and more sophisticated. So it’s great that you all are doing that. As we start to wrap up the podcast here, Chris, Any final thoughts? I’d love to get your feedback on where you can see ClearMembersy and your platform and offering evolving in the next 12 months. Give us a little, maybe a sneak peek into what the next 12 months of the organization look like.

Christopher Hayes: Sure. So I’d say the biggest area that we are focusing is right now we’re doing really, really well in serving the members that we have and helping them get better access to dental services. but there’s a lot of patients that aren’t reached yet. And so there’s a revenue optimization project that we’re working on that will help our practices identify what is the right level of membership. We’re not sitting here saying that 100% of patients should be members. We think that there’s a clear space for insured patients and there’s a really great model there, but there’s a lot of opportunity and helping and partnering with offices through technology to identify what’s the correct penetration, the type of plan you’re selling for the type of patients you have within your practice so that they can be right size there. So that’s kind of from the practice perspective. I touched a little bit on some of the ways that we’re trying to ensure that patients can be reached with the right plans as well. And that’s another thing in the next nine to 12 months that I’m excited about in terms of us delivering that.

Bill Neumann: Great. Well, thank you so much, Chris. This has been great information. If people want to find out more about your membership or they want to touch base with you, what’s the easiest way to do that?

Christopher Hayes: So a number of ways. So one, both being that we’re recently merged, we both still have our own website. So clear.com and membership.com have a great information. I think following both of us on LinkedIn is terrific. We’re regularly posting updates around what’s happening. So that’s a good path as well. And then obviously, if you’re ever at any of the conferences, we love seeing people in person. So we’re always a presence and enjoy that part of our interactions.

Bill Neumann: Yeah, absolutely. We’ll drop the URLs in the show notes. And also, yeah, you have a lot of great blog posts. We have a plethora of content that Clear and Clear Membership have shared with us and really recently, but I’d say the past three or four years, you can kind of go back to our archives of group dentistry now and see some of those articles. So I’ll link a couple of those up, the more recent ones. in the show notes, too, so everybody can have access to that. But thanks to Christopher Hayes, the COO of ClearMembership. Appreciate you stopping by today and sharing those insights. The future looks very bright for membership plans for the dental industry as we slowly catch up, but we are catching up, and that’s a great thing when it comes to advances in technology and software. That’s all today. Thanks, everybody, for watching us. This is the Group Dentistry Now Show, and I am Bill Neumann. Thanks again, Chris.