Opening The Service Delivery Black Box and Measuring Patient Experience with Dr. Matthew Allen

Alec Goldman:
Welcome to How I Grew My Practice, a podcast presented by NexHealth. I'm your host, Alec Goldman. In this episode, we have Dr. Matt Allen, CEO of DifferentKind, here to talk about opening the service delivery black box and measuring the details of the patient experience. Matt, welcome to the show. How are you doing today?
Matt Allen:
I'm doing well, Alec. Thanks so much for having me. Excited to be here and chat about this. It's something I care deeply about and am always happy to talk about.
Alec Goldman:
Well, we're very excited to have you. For those who do not know Dr. Matt Allen, Matt, can you just give a quick intro on who you are, how you got into the industry, and how DifferentKind came about?
Matt Allen:
Yeah, for sure. So I'm a dentist by training. I live in the mountains of Colorado. I was doing my specific area of expertise in patient communication, specifically in an evidence-based methodology called motivational interviewing. So lots of great evidence out there on how that helps both patients and, you know, actually doctors and staff, you know, communicate more effectively together. And so when I was doing a lot of consulting in that area, I kept getting this question of like, how do we measure this? And one of the gaps that I've always seen in dental is, I'm sure you all see very well as well at NexHealth, is there's a lack of data that really helps us make good decisions or at least inform our decisions instead of just kind of guessing. And so, you know, DifferentKind really started from that question from a lot of my customers and clients at that time, which was, how do we measure patient experience? And how do we know we're getting better?
Alec Goldman:
Very cool. And, you know, I guess the words patient experience are thrown around, like what does it mean? Everybody has their own definition of patient experience, I guess before jumping into how we measure patient experience, Matt, what, how do you define the patient experience?
Matt Allen:
Yeah, that's a great question. I tend to look at some nonprofits in this space that I think is very helpful, right? Because they've just been thinking about it for a long time. And they generally tend to be in the medical space, right? If you ask a dental person in the world what is patient experience, they'll give you an answer. But generally, it might not be, it might be an anecdote, right? Instead of, hey, we've actually researched this for a long time. And so one of my favorites is from the Barrel Institute. a great kind of nonprofit think tank where they do a lot of research, have a great newsletter, lots of good information on patient experience. But it really talks about the idea, and we actually just put this in our white paper, We started with this definition, right, of hey, here's the definition of patient experience.
I don't have it in front of me right now, so I'm not gonna get it perfect. But the idea that it is the sum of all interactions, I think is really one of the most important parts of the definition because... When we think about patient experience, some people are like, oh, I like to focus on this or I like to focus on this or here's a really important part. And yes, that's obviously all true, but it is the sum of all of those interactions across the spectrum of care. And I think that gets into what we'll talk about more at DifferentKind in terms of how we're thinking about it and where we see some gaps. Cause I think there are a lot of great solutions when it comes to improving patient experience, including NexHealth, and how we fit into that ecosystem, I think, is something we'll continue to discuss.
Alec Goldman:
Yeah, so what's really interesting is typically we have a lot of folks who come on the show and are talking about almost everything that's not the actual in-office experience, right? With NexHealth, we're really doing tons of work to help before the visit in all the communications from scheduling, forms, reminders, and then post, which is payments, reviews, and recalls. We would love to learn a bit from you here on how you're thinking more about measuring the in-office experience, right? From the moment they walk into the door until the moment that they walk out.
Matt Allen:
Yeah, that's exactly right. I mean, that to me, is the service delivery black box. That is the place where a lot of what I would consider in a healthcare journey, a lot of the trust is built, right? Um, on the front end, there's a lot of convenience and on the back end, there's a lot of convenience and we can and should be better as an industry about having convenient solutions for patients where they're at and when they need it, um, for those types of things. But the moment you walk into an office, right now, all of a sudden, It's no longer can technology make this more efficient. And of course, there are ways that can happen in the office. And that's certainly our hope, right? Is it that we use technology to enhance that experience? But it really is a human-to-human interaction, right? That is where trust is built in any relationship. You imagine going to a coffee shop with a friend, right? And you're talking with them, right? Those are the moments when trust is actually built. And so what we see as a gap there is we just don't have any data in general on. not how we perceived the visit to go, right?
There's a lot of, oh, our patient experience is great because we do X, Y, and Z, but that's the clinician's voice or that's the office voice. And what we wanna help practices, in general, bring into that part of the equation is what does the patient actually think and what does the patient feel? You might think, hey, wow, I have the nicest front desk space in the whole world and our office is beautiful and whatever, but does that actually matter to patients? Do your patients actually care? And those are the kinds of measurements, right? There's a number of different points, both, you know, on the acquisition phase or kind of the, Hey, like we're doing things before they get to the office, as well as the retention phase. After they leave the office, we measure some of those pieces as well. But especially in that kind of service delivery phase, it matters if somebody on your team is dismissive to a patient, right? They might, you might have done everything right along that journey. And one bad interaction with a staff member can make it so that patient
Alec Goldman:
Yeah, and I know you mentioned before, that the patient experience is the sum of all of the interactions, right? So how you interact with a hygienist, a dentist, the front desk member, all of these interactions, all these moments play into somebody's experience and what they think. But I think traditionally what's so hard is that a lot of this, to your point, goes totally untracked. Right, so what methods and tools are being used by DifferentKind to measure the patient experience so that we're evolving and improving it at dentist offices?
Matt Allen:
Totally. That's a great question. And I'll start at the kind of some back to the beginning of where we started on some of this because I think it's important, right? Again, we're not building, you know, out in, out in space, you know, on, on no foundation, right? Like there's been a lot of it, you know, research over the past number of years in the medical space on this. And so what we did when we started the company, actually, before I probably even started the company was go and really take a look at all of that research, collated it all. And then we looked at, Hey, what are the factors along that journey that tend to drive? trust and loyalty the most. Because you can measure anything, right? You can say, hey, you know, how nice is our bathroom, right? And people might give you an answer to that. But if you really wanna make a difference, then let's look at the things that tend to drive trust and loyalty the most. And so that's where we started. Again, you can measure 75, and 100 different aspects of the patient experience. That's obviously too many. We kind of collated that down and we said, okay. We have 14 experience metrics. We also measure patient-reported outcomes. So actually looking at a patient's overall oral health from their perspective. So, you know, how are they feeling overall? Do they have dental pain, right? Those kinds of outcomes and indexing that against other offices to see how well your patients are actually doing in terms of their oral health. So that's kind of where our starting point was. And, you know, we have various metrics. I think one of the things that we just released was this white paper on trends in patient experience.
We do collect NPS as a metric, mostly because it's a helpful metric at the top level of like, hey, if you're just going to kind of keep a pulse on things, sure, like that's a fine metric to look at. But if you really want to make changes in your office, if your NPS is, let's say 30, right, what do you actually do? What are the spaces where you can actually improve? And unless you're asking more things other than just, would you recommend us, you're probably not going to have those individual granular areas for improvement. And so what we saw in that data from all of our customers is that the things that tend to drive NPS the most are things that offices might not be thinking about. So active listening, shared decision-making, which involves patients in their decision-making, and what we call patient consideration, which is they were gentle, and sensitive to my comfort level. They didn't talk with things in my mouth, right? They let me know before they were going to lean me back instead of just pushing a button. Some of those pieces that I think tend to get minimized or just not thought of as we think about systems change within these dental groups and dental practices. So those are the kinds of things that we're really passionate about helping offices improve because they actually do really matter.
Alec Goldman:
Yeah. I mean, even as you're going through those line items, like, wow, like those are the things that, at least for me, like I really do care about. Like I love it when my hygienist or dentist lets me know about certain procedures that are happening just moments before to make me feel kind of just like mentally prepared. Right. Um, so inevitably my, I think the next question here is like, those are the things that I, I'd agree with personally that matter to my patient experience. How are you recommending practices to actually measure that? so that they can learn from metrics at scale.
Matt Allen:
Yeah, for sure. So the way that we do that is we collect that data for offices after the patient leaves the office. And so, you know, there's some good research here. So we use survey technology to do this. Our platform is built using NexHealth as, you know, using the synchronizer, which has been super helpful, allowed us to really get to scale a lot more quickly than we could have otherwise. So thank you for that. Um, and you know, we collect data 24 hours, at least about 24 hours after the experience. Some people are like, why don't you collect it right when the patient leaves the office? And this is an interesting thing from the perspective of just thinking about dentistry specifically, if you were a medical person, maybe coming to dentistry, you might not think about this, right? But people are leaving the office and they're still numb generally in dentistry, right? If you've had a procedure and I just don't think that's the right time to measure patient experience at all. is when you're kind of still in the procedure technically, right? You're still experiencing the effects of the procedure. We had someone recently tell us that their daughter went to the oral surgeon, got her wisdom teeth removed, obviously super groggy on the way home and whatever, and they got a text and it was like, will you leave us a review? And so, you know, he's like, I don't really want to respond to this right now. So yeah, we measure that the day after. It's all anonymous and private unless the patient chooses to be contacted, which I think is really important as well. Because I think there's something kind of, you know, obviously Google reviews are important for marketing data and being visible on the internet. Like that's just the reality of where we're at in the world. But I also think that it's probably not the best and right way to measure the quality of healthcare in general, right? It's a different kind of data. And so what we hope to actually give people is that kind of quality data from a patient perspective that says, hey, like, you know, you really might be struggling with listening. Right. And so we're giving that back to them at both the provider level, the office level, and the organization level and saying, Hey, here are some changes that you could actually make if you're a provider, let's say, um, to help you be perceived as a better listener, or if you're an organization and you're scoring low on cultural sensitivity, let's say, right, what are the steps that you could take to actually change that within your organization? So those are the kinds of insights that we're trying to drive, uh, you know, at various different levels.
Alec Goldman:
Can you share any success stories of companies that are practices that are working with DifferentKind and how changing probably what was just a very generic NPS score when a patient would leave the office changed it so that not only that they were doing NPS, but were really collecting all of the data, all these tiny little touch points
Matt Allen:
Mm-hmm.
Alec Goldman:
to improve their patient experience?
Matt Allen:
Yeah, 100%. The customer that we've actually worked with the longest, it's a fun story, right? They started with us. They have three practices. They're up in Oregon. They started with us and we've been working together for about three years now. We started doing this in our alpha days, right? We were collecting the data on paper and putting together graphs and Google Sheets, right? It's like the perfect startup story. But it's been really fun. We actually just talked with one of their staff members and they said, for the first time ever, um, you know, in, in her clinic, right? All of the dentists within their clinic had met their productivity goals for four months in a row. Um, which, you know, I think in any dental business, right? You start talking about that, like, what's the ROI of this? And what do we think about that? Right. And we all want to, you know, be meeting our productivity measures. Uh, so that's great, right?
We're seeing that kind of information, but I think hearing from their staff just on like, Hey, this actually really helps me on a day-to-day basis. to better interact with patients. And they see that in the feedback then too. So one of the ways they use the data is they're actually taking the narrative feedback that we collect and using that on a relatively regular basis. Our hope is that you know, it would even be daily, right? To be able to say, hey, we're having a huddle. Here are some things that went really well. You know, Susie at the front desk, you crushed it the other day. You know, Tom, you were awesome. Jose, you were amazing, right? That kind of, hey, we are recognizing a lot of people on the team. Lots of good data out there from this patient experience work that shows that it actually does improve staff retention, it increases treatment adherence, those kinds of things. So we have some of those anecdotes and again as we collect more and more data working to kind of prove out those things, which again I think is a little silly because it's kind of like, hey it's already been shown in medical to like work again and again, but you know we want to make sure that in our data everything looks the exact same. So it's cool to hear anecdotes like that from our customers.
Alec Goldman:
Yeah, congrats. I mean, that's again, selfishly hearing it from, uh, thinking about my own experience, like these are definitely the touch points that matter.
Alec Goldman:
Is your recommendation from a process perspective to take the report that you're sharing with these practices and then have dental practices kind of meet regularly on a daily basis, almost do what lots of, I feel like technology companies do, I know a lot of hotels do this. It's called just like a daily standup
Matt Allen:
Mm-hmm.
Alec Goldman:
where they go around the room and say, like delivering feedback. Or is it more of a, you know, each of your, the, uh, employees of the practice would receive an email, like what's, what's your recommendation, how to actually deliver the feedback that DifferentKind is collecting.
Matt Allen:
Yeah, so we, I mean, we have the dashboards for each of those individual levels in our hope, right? And the way that we try to onboard, you know, customers, and, you know, I'm sure you all know this, right, is the desired behavior, right? Like, how do we continue to help drive towards that? Um, you know, is that they are in there at least on a weekly basis, but hopefully on a daily basis, right? To be able to say, Hey, what did I do well? And how can I make changes, right? To your idea of a daily standup, um, that kind of continual quality improvement. Um, so we're working on different ways of doing that, both from like, you know, Hey, here's. We don't want to bombard people with emails. They've got a lot of stuff going on in the morning, right? Some of that stuff, but we do send out, you know, some kind of monthly highlights.
We're happy to jump on, you know, calls with offices and just have a 15-minute data review to kind of look at that and say, Hey, you know, how are things going? Where do you need support? Um, we're building some interesting tools. I think that will provide coaching, you know, in a tech-enabled way. Um, that should be coming out relatively soon, which I'm super excited about as well because our goal is to have it be actionable. We're collecting this data in real-time, which I think is helpful, right? To what you guys do, it's super frustrating to have to call a place, leave a message, and wait for a callback. They don't call you back.
You're just trying to make an appointment, right? You just want to be able to do that quickly. And in the same way, if you're getting feedback from patients, there are plenty of groups out there that will do that. And it takes a month six weeks or a quarter to actually get that feedback returned. And at that point, it's kind of useless because you're like, I don't remember what happened today or two days ago, much less a quarter ago. And so having that in relatively real time is super important. And so, yeah, we just hope that the way that practices think about this is with that kind of continual quality improvement in mind and that they would say, yeah, we wanna look at this as an office, as an organization, at relatively regular levels. We think it's helpful for board discussions, those kinds of things as well, for comp discussions, for... reviews, right, on if you're doing any kind of onboarding and doing a 90-day review or whatever that looks like, you're finding different ways to include the patient voice essentially into how you think about managing your practice.
Alec Goldman:
Yeah, I mean, I had all those thoughts before in regards to how it lets a dentist kind of provide real-time feedback to all the staff there. Obviously, the patient experience is their product,
Matt Allen:
Mm-hmm.
Alec Goldman:
and it's not something that they can just so closely hold to themselves. It has to be something that's delivered across the practice. So what better way than to provide pretty much what sounds like real-time feedback daily? at the very granular level so that a dentist can make changes, not just saying, hey, how do we get more five-star reviews, but how do we make changes in the seat? How do we make changes pre-appointment, and post-appointment? So I really see the value in what DifferentKind is doing.
Matt Allen:
Totally.
Alec Goldman:
Matt, you mentioned before the NexHealth  Synchronizer, that we typically have very few podcasts, folks who are joining, to talk about that. ask you personally, you know, how has, how are you, can you explain to the audience, what it means to build on top of the NexHealth  Synchronizer and how has that enabled your business to move with a little bit more speed?
Matt Allen:
Yeah, for sure. So for us, you know, before we kind of knew about the synchronizer, it was this process of saying, okay, it's going to take us X amount of time to build a specific integration. And it's going to, we're going to have to focus and prioritize which, which the one we should focus on, right? Which obviously excludes a whole bunch of other customers. And then once we kind of discovered, Hey, this is a solution that we can use to, uh, you know, essentially get all the data that we need for our product to run. Um, I mean, I think we were up in. for sure, I mean like a matter of hours probably, you know, and like fully operational in less than a week and including testing and all of that stuff, right? So, and that was with 18 different electronic data records and maybe there's more now 19 or 20 or something like that. So just a ton, you know, faster, right? In terms of how we were able to actually get the data that we need to help offices actually measure this. So for us, it was a total game changer and really allowed us to, yeah, just to move a ton faster and to feel like, hey, we can meet Most all of our customers exactly where they're at. Um, we no longer have to say, Oh, we don't integrate with your PMS. Sorry. Um, and that, that was, like I said, just a huge game changer for us.
Alec Goldman:
And so cool. I know that this might be the silliest question, but why is it so important for your business to be able to integrate with these EHRs?
Matt Allen:
Yeah, for sure. One of the things that we see sometimes in our world as you're getting this data from patients, right? If you don't integrate within the electronic dental record, then all of a sudden you're starting to have to ask patients for all this information. And so A, introduces errors, but B, takes them a lot longer. It's a lot more cumbersome, right? And to the point of, hey, let's make it as easy as possible for you. I love one of Cleveland Clinic's general kind of values in their system is like, We will make it easy for you. and what a great operational value for, you know, a healthcare organization or a dental organization. Say, we will make it easier for you. And so that obviously doesn't make it easier for the patient. And then we can actually get a lot more data, right? When we know specific codes that have been pulled, we can link those to parts of the patient experience.
That's one thing we do is we can say, hey, look, your patient experience in hygiene versus oral surgery, here's how it breaks out. Here's where it's not only a person, right? But it might be a type of appointment where you actually need to make changes or bring in some specialists or something like that, right? Because you're just, you know, maybe your patients aren't having a great experience when they come in for endo, and it might be worth bringing in an endodontist one day a week or something. So, you know, when we look at those kinds of data points, we just would not be able to have them, you know, if we weren't able to actually pull that data from the PMS.
Alec Goldman:
It's really remarkable, especially for you to be able to offer a DifferentKind across so many different EHRs so fast. But even to hear from your perspective, how it really allows for you to have so many more different types of insights, where it's not just based off of the moments that happen within the chair, but how that also kind of overlays with all of their historical data, the procedures, their birth date, where they're from, income,
Matt Allen:
Yep.
Alec Goldman:
all these different factors. and allows you to offer much more specific advice. So that's really cool. And I could probably speak on behalf of the entire NexHealth team, about how excited we are for you.
Matt Allen:
Yes, well thank you all for your support and helping that.
Alec Goldman:
Of course. Matt, we're coming up to time. I know you've got a 12 o'clock hard stop, but I want to give you one last opportunity if you have anything else to share just kind of on the black box of service delivery and measuring the patient experience.
Matt Allen:
Yeah, I would say I thought a lot about this, right? Just in general as a profession. I would say the first step is we just need to start moving beyond NPS. If that's all anyone got from these 20 minutes of, hey, like we capture NPS, but that's it, right? My encouragement to all of us would be to start moving beyond that using whatever tools are out there, right? Use whatever is at your disposal, but start moving beyond just NPS because I think you really will find data that surprises you, eh? and B allows you to actually become the kind of practice where patients really do want to come again and again.
Alec Goldman:
Matt, thank you so much for joining. For those listening in, if you care to download the thought leadership piece that Matt is talking about, it's called Trends in Patient Experience 2023. You can find it on the NexHealth podcast site for Matt. You can also find it on DifferentKind’s website. Matt, thank you so much for joining today. Enjoy the rest of your day.