In Hand Dental’s Chief Medical Officer, Dr. Kurt Hoffman, and our Chief Revenue Officer, Matt Quinn, recently appeared on the Raving Patients Podcast with host Dr. Len Tau.
They had a great conversation around engaging digital communication with patients, and it’s a must-listen for any practice owner or doctor.
You can take a listen here or read the transcription below:
Kurt: I’m orthodontist in KC Metro Area. UMKC Dental School – Graduated 1994. Been treating patients with fixed appliances since 1994 and with Invisilign since 2000. We developed a product for treating orthodontic patients remotely. It’s a software package called In Hand Dental.
Len: The product is similar to remote dental monitoring where the patients don’t have to spend time in the dental office. That’s really what it does, but just to break it down–your product remotely monitors patients’ progress so they don’t have to come into the office.
Matt: I’m the Chief Revenue Officer and I work with manufacturers and distributors and with the dental practices to help them migrate from traditional dental visits to being able to communicate with patients remotely with our app. It’s really about improving workflow and maximizing profits by communicating with patients through their phones. And it’s been very, very successful. Patients love it and practices love it because it frees up chair time and gives them time to focus on other aspects of the practice besides patient care.
Len: Great. So, there are a few direct-to-consumer models of clear aligners. In my practice we use Invisalign, but we don’t use the direct-to-consumer model. But it’s very common that patients come in and they’re getting work done through the direct-to-consumer model. So talk about how you fit in there. What is your space in the industry?
Kurt: We’re trying to bring the patients back to the dentist because that’s who we think should be treating patients. With direct-to-consumer aligner treatment there’s a market there, but we feel they should be monitored and followed by a dentist, before, during and after treatment and that’s where our application, In Hand Dental comes in. It treats patients the way they want to be treated.
Len: As you mentioned, it is a product that can be used for anything fixed or removable, not just orthodontics.
Kurt: Yes, it’s best suited for treatment methods like aligners that you can plan the treatment digitally and then put the process in motion and check it regularly and often if you have a good plan and good patient, they complete the series of aligners before they come back into the office. But yes it works well with products like Brius, which are fixed appliances, a lingual appliance where you put in the framework and you don’t need to remove it for five to eight months. As long as it’s being monitored that monitoring can be done at home, eliminating appointments while the movements you prescribed are occurring.
Len: Great. To clarify, you can work with any aligner company so if they’re doing it in the office or they’re doing the direct-to-consumer model, they can use this product to monitor patients.
Kurt: Absolutely.
Mike: The critical component is compliance. We’ve patented what we call Treatment MPH, so it has patient engagement that they have to use, answering specific questions on top of uploading pictures. We calculate an appliance score card that tells the practice who’s being compliant and who’s not. That is a key component because doctors don’t have to waste their time with patients who are above a score of about 80. On a scale of 1 to 100, doctors only spend time on patients who score below 80. Staff can reach out to them and tell them they need to come in.
Len: Gotcha! That makes sense. So let’s talk about one of the biggest advantages: saving chair time.
Kurt: Yes, that’s one of the biggest benefits for patients, but also for me. I appreciate the reduction in hours worked while increasing production. We see an aligner patient for the initial appointment, scan, explanation of treatment and cost. And on their second visit we deliver attachments, do our IPR, set them up on the app and give them all of their aligners. It saves huge amounts of time. All the patient does is send us three photos when they’re ready to change aligners: one with the exhausted aligner in, one without an aligner, and one with the new aligner, so I can compare the differences and check progress.
They also have to answer a random question or two every day, and record how many hours they wear the aligner each day. That data computes their MPH, so we can see how compliant they are while being able to see how the teeth are moving and working. And if things are on track they keep going. And if they’re not, we call them into the office, through the app, with the messaging feature.
Len: Does the dentist monitor or does someone else monitor for them?
Kurt: The dentist does the monitoring. It provides the level of in-office, personal treatment by their dentist that most patients want. They just don’t want to come in as often.
Len: Gotcha! Does the dentist get notification when the patient has uploaded their aligners?
Kurt: Yes, I’ll get a few types of messages on my phone. Some are from patients, such as “Hey, I lost my aligner.” Often they only had a few days left so we move them to the next aligner and update the tracking on the system.
We can also get a message like “Kasey just changed her aligners.” Then at my leisure I can go look at those pictures and then respond with either “Good job. Keep going!” or “Use your chewies. It looks like a front tooth is not seating.” Or “I think you need to come in for a refinement scheme.”
So we get a note that pops like a text. There’s a red number on the icon on my phone and that’s how I know there are messages.
Matt: One thing I want to add is that we also have live virtual call capability built into the app as well so it’s not just strictly text. So Dr. Hoffman can request a live virtual call straight to the patient’s phone, and vice versa. Either party can say “Not now. Let’s schedule something.” Dr. Hoffman can also send a personal video to them or say “Can you send a video so I can see the molars in a mirror?”
Kurt: And it’s all HIPAA-compliant.
Len: So if I have a patient who’s doing Invisalign, you recommend that they come in at the beginning and get all their IPR then?
Kurt: Yes. We do have patients with overlapped incisors and I won’t get good contour. So if we need an interim appt to add an attachment or do some IPR, we try to do that somewhere at the midpoint. That will add one appointment.
Len: David Gates, Orthodontist in Las Vegas, at Invisalign says “It’s hard to hack your way out of the jungle” with all those front teeth overlapped. I was taught to do posterior IPR rather than anterior later in treatment.
Kurt: We’re not trying to change the way doctors do treatment. We’re adding a tool. One frustration patients have is when they come in and everything is fine and they say, “What did I come in for?” And I say, “Because I only gave you four aligners and it’s been eight weeks. Here’s four more.” So you still need in-person appointments, but do them efficiently and group those kinds of things together to minimize in-office visits.
Len: Things have changed a lot with aligners. 10 years ago remote monitoring would have looked crazy. But now it makes sense to limit the amount of time someone’s in the chair which reduces costs.
Kurt: Over the years, aligners have improved so much you don’t need patients to come to the office as much any more. I’ve found myself trying to justify a visit because things were going so well.
Matt: Between 2019 and 2022 Kurt’s treatment plan close rate has gone from 58% to 75%, primarily because his office has gotten so good at having the conversation with the patient: “What’s your lifestyle? What do you do? What’s more efficient for you? How can my treatment be more convenient for you? By the way, we have this opportunity to do things remotely. We can download the app right now, take the first pictures and get going.” That has changed how often Kurt closes business. Kurt would you agree?
Kurt: I would agree. Our biggest growth is among patients’ parents once they see how the process is going. They see their kids’ teeth getting straight. And parents hate appointments even more than kids.
Len: I see patients come in for a fifth or sixth consultation and I ask, “Why aren’t you making a decision?” I think if you tell patients that if you do this, you’ll limit the number of times you come into the office from every six weeks to two or three times the entire time. I think this is a very intriguing aspect to something like this.
Kurt: Our product is designed by orthodontists and dentists for orthodontists and dentists, and one thing we didn’t foresee changing things was the messaging feature feels very much like text messaging, but patients can message either me or my staff and we’ll respond up until bedtime the same day or first thing the next morning. And that changes perceived intimacy with the person. You’ve having a conversation with them and learning things about them. They might be talking about their kids or something that happened, building the relationship. And that is huge for building your practice. The other thing is the Resources tab because after you’ve given them their aligners you give them instructions, but a lot of people are checked out at that point. But you can point out the Resources tab and say “Here’s everything you need to know.” Now they don’t have a piece of paper they can lose, and I know my patients will get consistent information from any assistant in any office.
Len: Matt, anything you want to add there?
Matt:Yes! It’s also great for recall. You now have real estate on their phone. When they’re done with aligner treatment you can say “You say you have a problem with TMJ. Come in and let’s talk about it.” They’re not going to delete your app. This is how you tell them it’s time for them to come in for a check-up.
Kurt: A lot of dentists are using the app also to send messages for six-month recall appointments and it’s boosted compliance for that.
Len: Can you talk about the revenue model?
Kurt: Yes. Dental Monitoring charges per patient per month between $10 and $12 depending on volume. Plus there’s the box you inventory. We charge each office a low fee per month for the software subscription. So if it’s a software subscription, use the heck out of it and you won’t be overcharged.
Matt: We have 3 tiers from 4 logins with up to 100 active patients to 25 logins with up to 700 active patients. And those tiers cost monthly between $249 and $699. We can get a practice installed and up and running in an hour and half and we charge a one-time fee for that of $699.
We customize the templates, resources and who has access to which “care group.” Not everyone uses it for aligners. It might be teeth whitening or sleep apnea, so you assign different staff to different patients. The really cool thing is GPs are starting to look at them, but they’re not sure what’s a good case or bad case. I can set Kurt up as a third party consultant. So for GPs they don’t have to outsource that consulting. Huge revenue boost for them.
Len: How is tracking patient compliance? For how many hours a day they’re wearing the aligners.
Kurt: Each day they’re prompted to put in a number. They report how much they wore them in the previous 24 hour period. We also have a patent on a device that monitors temperature. As soon as the technology is small enough, we hope to have this installed in each aligner and know how long it’s at a temperature of 98.6 degrees each day.
Matt: We’ve gamified the process. If you open this up and see how you’re doing and see that your score is at 45, you’re embarrassed. And you go, “What the heck is going on? Oh, crap. I haven’t answered anything for four or five days.” It’s self-motivating because who wants to have a bad score and get scolded by the practice?” Plus, as a parent, I spent money on this. I went through this with my daughter. I spent five grand and I was mad that I wasn’t more part of the process. Because the parents get the same data, and if I’m going to spend five or six grand I want to make sure my child is being compliant.
Kurt: Great point. We’re putting parents on the app as well. We get messages from Mom and Dad. Mom and Dad see our instructions to their child. They reinforce compliance. If you miss some days, your score comes back up. Then you take three pictures which is five minutes every two weeks and five seconds every day to keep your score above 80 and give me the data I need to make sure I’m treating my patients well.
Len: Have you had practices give rewards for hitting high scores for compliance?
Kurt: We’re working on that to where we’ll have trophies and stars among the people in my office.
Len: It’s free for the patients. Do you white label it?
Kurt: Yes. Every time they get a message or open the home screen or when they download the app, they’ll see your logo. It’s like you have an app.
Matt: It has a lead generation component, too. If someone downloads your app who you’ve never met and registers, you can start communicating with them. So it’s not just for current patients, it’s for potential patients.
Len: That sounds really cool. Talk about ways listeners can save money.
Matt: We’ll offer a discount on our subscription rate of 20%. We have no contracts. It’s very easy. We do a demonstration for the practice which takes about 20 to 30 minutes, and then we set up an onboarding call which takes about an hour and a half and you’re up and running. We follow up every two weeks to see how things are going. We monitor how many active patients are on there and give tips and ideas on how to increase that number.
Kurt: We do have excellent support. I love helping out colleagues. My dad was an orthodontist. My son’s one. It doesn’t matter where you are. Reach out to me.
Len: Do you want them to use a code or do something to let you know they listened to the Raving Patients podcast?
Matt: They can go on https://inhanddental.com/ and hit a demo button and they can put in the message “Heard this on the Raving podcast.” Or they can call me directly at 913-827-1603.
Len: Anything else you want listeners to know?
Kurt: It’s super easy to set patients up on this app. I just need to enter their first name, last name and email. The fourth thing is select what type of treatment, aligners, and then it populates everything else across the platform on my app and theirs. It’s not a big time addition. It will save you so much time and appointments and won’t add any time to the process of getting a patient started.
Len: Matt, any final thoughts from you?
Matt: Kurt has taken his practice from being open 38 hours a week to 31, and he’s doubled his revenue. And he’s moved his whole base of customers from about 50% aligners to 80%. Is that right, Kurt?
Kurt: Probably for starts, but I’m still finishing up, so I’m probably in the 50-50 range for my current practice. As those people get their braces off and we do more aligners with digital treatment it’ll get higher. The pressure on me and my staff is lower. My office is a happier place. People can smell stress when they walk in and we have less of it. We’re seeing more patients and spending less time making more money.
Len: This is very enlightening. Matt and Kurt, thank you so much!
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