There is a method to our madness. Read this and forever change the way you view your “systems”.
Computerization vs. Automation
In the mid 1990’s, while they were creating the first several versions of PracticeWorks, Brian Smith and Joel Kozikowski developed a philosophy that laid the foundation for PLZ: the concept that there is a huge difference between “computerization” and “automation”. Most Practice Management Systems (PMS) at the time offered only what Brian and Joel now refer to as “computerization:” the computer could perform a lot of individual tasks, but only after it was commanded to do so by a human operator. While this was a great time saver vs. manually performing the tasks, it still required orchestration by a human. Take for example the printing of “thank you” letters to referral sources.
- Someone in the practice has to know the office wants to generate thank you letters.
- That person has to keep track of when it's time to print referral letters.
- Finally, that someone has to actually find time in their busy day, sit down at the computer, tell the computer to print those letters, then manually process the resulting pile of paper.
When "someone" is properly trained, properly motivated, and can find a spare 30 minutes, the letters go out, and it's way more efficient than "pre-computerization", when the letters were hand-typed or hand-written. But as anyone who has ever worked in a dental practice knows, it's very common for these letters to never be generated. Why? Because the process isn't automated.
Truly automating the task would require that the computer be “taught” the rules under which the letters should be printed. The task could be broken down into small, manageable bites. (One letter at a time, instead of a month's worth all at once, for example.) Look at it this way:
- Someone is already at the computer after each visit, going through a “check out” process to complete the appointment.
- The computer knows if the patient being checked out is a new patient.
- The computer knows if the patient was referred.
- The computer knows how to print a "thank you" letter.
Why not have the computer print the letter right there on the spot as a side effect of performing the check-out? Doing so has several advantages. First, no one ever needs to be taught anything about referral letters: they only need to be taught how to check out patients. This is fantastic when there is staff turnover! Next, by printing each letter “just in time”, the job is broken down into small, easy to complete tasks (take a single piece of paper out of the printer, fold it, put it into an envelope, apply postage). The result? Referral thank you letters always go, because no one has to know they need to be done, know how to do them, remember to do them, nor carve time out of their busy day / week / month to do them. They just happen!
This principal can be applied to a huge list of tasks in a dental practice. The great challenge in automation, however, is that every office has its own set of policies and procedures. The computer itself has to be highly customizable to accommodate each individual office’s needs and desires. This is not a simple task, which probably explains why so few PMS's can do it. (PracticeWorks is the only one we know of, in fact.)
Working Smarter by Using Systems
Fast forward to 2003, when Brian and Joel joined forces with Allen Jorgensen to form Lighthouse Practice Management Group. Allen had already been managing his wife’s successful dental practice for 9 years at that point. Their very profitable and very efficient dental practice was all about “systems.” Not “systems” as in computers and software, but “systems” as in “methodologies.” Allen knew that you could do just a little work “upstream” in a process, and doing it correctly at that point would eliminate a huge amount of work “downstream.” He also knew that no process was going to be 100% effective, and trying to create perfect systems was not only futile, but also unnecessary, and actually counterproductive. Instead, he subscribed to an 80/20 philosophy: design the easiest and least expensive system possible that would handle 80% of the problem. Then, expend a little more effort dealing with the remaining 20%. Repeat until you’ve achieved your desired result.
(Example: Pre-appoint at least 80% of hygiene patients - that's the easiest and cheapest way to get a patient back in for their next hygiene visit. Then send emails and postcards to get 80% of the remaining 20% to call to schedule. At that point, 96% of patients are scheduled. The remaing 4% aren't worth any more effort - they'll call when they're ready, or they're not coming back for some reason.)
Most dental practices spend inordinate amounts of time doing work in the “downstream” phase. Making phone calls to confirm appointments, for example, is extremely labor intensive. If a simple, automated confirmation system could handle the confirmation of 80% of your appointments, the workload on “confirmation call day” would be dramatically reduced. This type of “working smarter” philosophy allowed Allen to handle all the administrative tasks of their large dental practice by himself – a fraction of the staff found at many practices – even smaller ones.
Practice Consulting and Beyond
Lighthouse PMG spent the next several years combining the concepts of “systems” with “automation.” We started teaching them to the dental world via seminars and our on-line forum (Club Lighthouse). Over that period, we developed and refined our systems, installing them in hundreds of dental practices. We helped customize those systems for the subtle nuances of each individual practice.
While we were able to do amazing things in the eyes of our clients, we were constrained by the limits of the PMS's. Only PracticeWorks had any type of “automation” features that could be leveraged to create our automated systems, and even then we were limited. More important, only a fraction of dental practices use PracticeWorks. What about Dentrix? What about Softdent? What about Eaglesoft? What about dozens of other PMS's? We were unable to help the majority of the practices in the effective ways we knew were possible.
Just Say "PLZ"
Not ones to be accepting of limitations, we set out to solve the problem. We wanted to create something powerful. Something highly automated, requiring no human interaction whenever possible. Something highly customizable. Something smart. Something we could use to implement all of our systems. And something that could easily reach a majority of dental practices. While many new and innovative design ideas for the “ultimate PMS” had been percolating in our heads for years, one very real hurdle remained: the costs in both time and money for a dental practice to switch from one PMS to another would prevent a majority of practices from participating. The expense of a new PMS, the cost of re-training staff, the lost productivity of learning a new system, the cost and pain of a data conversion - all of these would be serious impediments to bringing a new PMS to enough dentists to really make a difference. Unfortunately, innovation by the PMS vendors seems to have stalled in the last decade. It’s getting harder to distinguish one PMS from another. At their core, all PMS systems do the exact same thing: they manage patient lists, they keep the schedule, they handle A/R and insurance. Does an office REALLY want to go through all that time and expense just to get an incremental improvement in SOME area of their practice? While we knew we had significantly more than just “some” improvements to offer the world, we really couldn't come up with a better way to print insurance forms.
One of the most significant developments in the world in the last 20 years is the Internet. Our world is now an “on line” world: our computers, our mobile phones, even our televisions. We communicate electronically now more than anyone could have ever imagined just 10 years ago. It’s important to note that all of the major PMS's were first created BEFORE the advent of the Internet, so a “connected world" is simply not in their DNA. The need for seamless integration with the Internet was in our design goals from the very beginning. We knew that “the ultimate PMS” would have an “Internet server based” component (now referred to as “in the cloud”), and an “in office” component. It was only after we started the R & D phase of our “ultimate PMS” that we realized that the “in office” component did NOT have to be something that we created. We developed techniques that allowed us to integrate with ANY PMS, and thus the concept of a Practice Management EXTENDED system was born.
A Comprehensive Approach
Ralph Laurie and Jason Laurie - two of the key figures behind the success of CAESY - joined Lighthouse in 2008. Their addition to the group added critical expertise in marketing: not marketing PLZ to dentists, but the ideas of how a PRACTICE needs to market to their PATIENTS. They helped round out the idea that a COMPREHENSIVE practice management system must include MARKETING to prospective and current patients to insure that the lifeblood of a practice is maintained. No automated system in the world is going to be effective if the practice does not have a steady stream of patients to serve!
PLZ – The Best Is Yet To Come
PLZ continues to evolve. While some reading our story on the origins of "practice management extended" software may say that what we are doing is nothing new, and that other companies are doing something similar, we assure you, they are not. We could talk about technical details like “business rules engines” and “workflow management engines,” but that may confuse the issue. Suffice it to say that PLZ is not just the product you see today, the product described in these web pages. It is a PLATFORM that has been specifically engineered to allow us to quickly bring innovative and EFFECTIVE automated systems to dental practices everywhere – something the PMS vendors have had over a decade to do, but seem to have failed. Every day, development continues on new features. As far as we are concerned, we are just getting started with all the cool and productive things we can do for your office!