Achieving Measurable Outcomes: Understanding What’s Important in Practice Management Software

Jill Nesbitt, founder of Optimize Dental Consulting, on software implementation, change management, success metrics, and SOPs across DSO locations as well as her role at Revere Partners.

DSOPro: Tell us about your career and what you do.

I feel a bit Liam Neeson-esque by saying “I have a particular set of skills” – and that is implementing and optimizing enterprise-class dental software into DSOs. This is the work I do as an independent dental-software consultant. I also work with Revere Partners to support DSOs with technology evaluation services. 

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I came into dentistry through the business-side of private practice. Working full time in a different industry and going to school at night for my MBA, I was looking for some job flexibility so I had time to study. I shared my thoughts with my parents. At the time, my father, Dr. Charles Smith, who was an early visionary of dental group practice, owned a multi-doctor, multi-specialty group. This practice grew rapidly and needed some business structure, so he offered me the opportunity to join as a practice administrator to help organize the business side of the group while I completed my degree.

I managed HealthPark Dentistry for more than 15 years. At our height, we had more patients in the practice than we had citizens in our town! That’s how I built the foundation of my love for dentistry and my skillset. It was through my family’s practice where we took care of our community and our team.

It became time for a new adventure, and I moved to Nashville. I did some independent consulting to help structure the business-side of dentistry for multi-location group practices. This seemed to be going well until a client with four offices asked, “I have two offices on Dentrix, one on Eaglesoft, and one on PracticeWorks. Hygienists can’t move between offices because they don’t know the software. I can’t get consolidated reporting. This isn’t working. You’re the consultant, what software should we use? How are we going to make this work?” So, I did some research and found Dentrix Ascend, Henry Schein’s cloud-based, dental practice-management software (PMS). I had a friend who had founded a specialty DSO and was an early adopter of Ascend. So, I went to work for him to see if this system would work for my client.

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This was in 2017 when cloud-based dental systems were new, and although it was bumpy, it was so much better than trying to manage with shared documents in Google Drive. While I worked for the DSO supporting integrations after acquisition, I had gotten to know the Dentrix Ascend team at Henry Schein One. When I told them I was planning a return to independent consulting, they said, “We want to create a role for you called Customer Success. We want you to do what you’ve been doing for that DSO for all of our customers.”

So, I built the Dentrix Ascend Customer Success program for Henry Schein One, focusing on figuring out how to use Dentrix Ascend to achieve measurable outcomes. It wasn’t a training role where you “click-by-click” show how the buttons work. It was more of an, all right, so you want to pay your doctors. Here’s how you can do it. Or if you want to reconcile your bank statement, here’s how. We created best practices that our clients could use.

I loved being part of the Dentrix Ascend startup team under the larger umbrella of Henry Schein. I always worked with the largest groups, which started out as three to five locations and after 5 years, we celebrated having our first DSO with 100 locations on the software. Thanks to working with the largest DSOs across the United States as they moved to cloud-based software, I found that they didn’t have anyone who deeply understood how each of their different software products worked in order to deliver a standardized workflow.

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I decided it was time for me to start Optimize Dental Consulting to provide professional software implementation services for DSOs. I see that DSOs buy software to gain efficiency and standardize, but they do not always successfully roll it out and the team doesn’t actually gain the benefit. So, I lead the initiative. I combine my knowledge of dentistry with software expertise to run the project, incorporating change management, establishing best practices for the software set up, defining the success metrics and, finally, I create the standard operating procedures (SOPs) so we can scale and implement across all locations.

Around this same time, I joined Revere Partners to support investors, tech startups, and DSOs. It’s been fun to learn about how venture capital works to elevate dental technology software companies so they can help dental practices improve patient care and increase efficiency. I’ve found that the investors are often dentists or DSO leaders who want to invest in what they know – and they appreciate discovering new software they can use in their practices as well!

DSOPro: What types of software do you work with in your consulting firm?

Primarily, PMS. I am well versed in both Dentrix Ascend and Denticon as well as Jarvis Analytics. The fun of cloud-based PMS is that they include almost every type of software, from patient engagement to RCM systems to online booking and reporting. Plus, at least quarterly, they add new features, so I am constantly learning new systems.

When DSOs approach me, they’re usually looking to implement a new PMS across all locations and want someone experienced to lead the project. I’ve also worked with DSOs that want to optimize their dental software particularly around improving revenue cycle. They want to make sure they’re using all the highest-value features in their existing software plus be open to new technologies that may add value.

DSOPro: How do you approach these projects?

I start with a workflow assessment of current state and benchmark against the software to look for gaps and opportunities. I present recommendations to the DSO leadership and then I lead the project to implement each one. I create change management communications to update the teams on why we’re tackling these projects, define the metrics so we know when we are successful, set up the software, and write up the SOPs. All to support the teams, so they can use the software successfully – but not be pulled away from their full-time jobs.

I also coordinate with the software vendor to arrange training and gather utilization data to measure our progress. Next, I monitor our metrics to confirm success. Are people using it, and using it correctly? Are we starting to get outcomes? It takes time for people to become comfortable with a new system. It is important to have someone who follows through to make sure the software is successfully adopted.

It has been interesting how many software vendors have reached out to say, “The service you’re offering is so needed.” From a vendor perspective, we know that DSO leadership wants to achieve outcomes. They want to buy technology to increase efficiency, especially to address staffing challenges. But it’s so much work to implement software across dozens of offices that sometimes the project fails because the team is just too busy and may not have the technical expertise to lead this type of project. This is painful for the DSO and the vendor.


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DSOPro: Do you want to add anything about your consultancy and where you see that going?

I’ll tell you a fun story. When I announced this new venture of mine in January, Ivoclar Vivadent invited me to the IDS meeting in Germany to speak at their partner-lab event. When I told them I’m not clinical, they said, “We know. Our customers know about our products, so you don’t need to talk about them. But when we host events for our DSO and dental lab partners, everyone is talking about standardization in dentistry and asking how they are supposed to make all this technology work together. We need a thought leader to share stories about how to be successful in making this happen.”

Talk about feeling like this was the right move at the right time! In my presentation, I shared tips to standardize – starting with establishing analytics and recognizing that technology initiatives are actually people projects. The third tip I shared was the value of building partnerships with your tech vendors.

I see that with Revere Partners. I think Revere does a beautiful job of developing partnerships between people who invest and believe in supporting new dental startups with DSOs and independent dentists who need technology solutions to address the problems or challenges they’re facing.

DSOPro: What are you seeing with technology initiatives today?

In the past, when interest rates were low, DSOs simply acquired offices to achieve their revenue and EBITDA targets. Now that the cost of capital has doubled, DSOs have slowed down acquisitions and are focusing on same-store growth. They are looking to technology to achieve these goals.

For DSOs already on cloud-based software, they can optimize their existing system. Like any software, it is likely they’re not even aware of some of the highest value features, or they’re aware, but haven’t had the time to implement them across the entire organization. So now is a great time to implement online scheduling, consolidated reporting and text to pay – each of these can result in measurable improvements in reaching financial targets.

For DSOs still using server-based systems, this is the opportunity to make the decision to select one cloud-based PMS across all locations. This allows leadership to support their practices and drive efficiency more effectively. I’ve been surprised at how many DSOs are still using 10+ different PMS systems across their organization. Their regional managers, executives, and revenue cycle leaders are struggling to implement processes when they have to explain things 10 different ways. It’s incredibly inefficient and frustrating. At the same time, private equity firms and lenders are expecting you to achieve your targets, so the best practice today is to move to one standard software platform.

DSOPro: Switching to your Revere Partners role, what trends are you seeing in venture capital?

I’m seeing the largest dental distributors, manufacturers, and associations recognizing that staying aware of new technologies is critical to their success – and they are reaching out to Revere Partners to serve as the venture arm for their organizations. This is a great fit because the analyst team already performs deep diligence on dozens of dental tech companies for our managing partners to make decisions on which ones we will fund. So, we can offer this diligence with these large companies as part of a corporate service.

Before I worked with Revere, I wasn’t familiar with the option of investing personally in venture capital. Now, I see that this can be a great way for individuals to diversify their personal investment portfolio with a long-term, higher potential return option. Most people don’t even know this exists.

To help people learn about venture capital, we have been hosting events, like the new tech discovery workshop at Dykema. I have facilitated discussions among DSOs to share the technology they’re using today and then I can share new technology solutions they may not be aware of. This has also led to the creation of a Technology Evaluation service. A DSO or independent practice can ask us to compare the technology they are currently using to new or emerging technologies we’re aware of as a result of doing due diligence on so many startups. This can help them to find the right technology for their unique needs.

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DSOPro: What types of technology trends are you seeing?

DSOs are selecting one cloud-based practice management platform for all locations. They want to implement quickly and successfully to achieve standardization. Often, they’ve grown quickly and have dozens of offices, so they know this is a significant project and are willing to invest to make sure the transition is a success.

DSOs are also feeling some level of “overwhelm” from the explosion of technology in dentistry. It’s difficult to sort through all the options and find which solutions will actually drive measurable outcomes. Especially in the category of revenue-cycle software solutions, groups are finding that they have to start with the KPI they need to move the needle on – and then select the software that can address that need.

And of course, everyone is talking about AI. There is a sense that caries-detection AI will become the standard of care, but again, this is yet another investment and decision to make. DSOs don’t want to back the wrong horse, so there is a lot of waiting to see what others choose.

Finally, DSOs acknowledge that the current staffing challenges are here to stay. So, they are looking to technology solutions to lighten the workload on teams and drive efficiency. That can work. I’ve seen it and I’ve led it. But it isn’t a quick fix. It requires technology leadership to handle the change management.


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About Jill Nesbitt

Jill Nesbitt headshot

Jill Nesbitt, MBA, has 20 years’ experience in dentistry, starting out managing a multi-specialty group practice. She then became an independent dental consultant working with multi-location dental groups to achieve measurable outcomes. Next, she worked for a DSO, helping onboard and train offices to use Dentrix Ascend, which led to working with the Henry Schein One team to build a customer success program for all Dentrix Ascend clients. Recognizing the need for professional software implementation for DSOs to optimize technology, she started Optimize Dental Consulting. Her expertise at the intersection of dentistry and technology also led to a collaboration with Revere Partners, the first venture capital firm targeting oral health, where Jill builds relationships with investors and provides a technology evaluation service for dental groups interested in comparing their tech stack against the newest technologies.

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