May 21, 2025 • 52 mins
Dr. Bryan Laskin joins hosts Dr. Maggie Augustyn, Dr. Chad Johnson, and Regan Robertson to expose the truth about dental data. From HIPAA misunderstandings to unethical software vendors, Bryan breaks down what every dentist must know about protecting their practice, empowering patients, and staying compliant in a post-CURES Act world.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Maggie Augustyn (00:00):
Hi listeners.
This is Maggie Augustine, along with yourco-host Reagan Robertson and Chad Johnson
on Everyday Practices Dental Podcasts.
We are here and we are hosting a veryspecial guest, someone that I admire
greatly and have the honor of introducingto you, Dr. Brian Laskin, who is an.
(00:25):
Eternal entrepreneur.
Um, he is a Minnesota based dentistwhose mind just does not stop.
He is an innovator, um, and he is.
An entrepreneur.
He is a genius and he knows a lotabout technology and how technology
(00:49):
applies in the area of dentistry, butmore so he is fascinated with data.
Um, he's fascinated with.
The protection of data.
He understands who owns datain, in the space of dentistry.
I could go on about all of his inventions.
(01:10):
We'd probably spend half thepodcast talking about that.
Currently he is in the role of, um.
Owning, I believe he is the CEOif I understand that correctly,
of tooth apps, which I would likefor him to talk a little bit more
about throughout this podcast.
But, uh, hello everybody.
Um, and Dr. Laskin or, or Brian.
(01:35):
Tell me just a little bit more aboutwho you are and how you've ended up
in this role of being a leader in,in understanding data and how it
applies in, in the world of dentistry.
Dr. Bryan Laskin (01:51):
Well, thank you very much and thanks.
I, I don't wanna say anything 'causethere's, I just much as you keep going on.
That's right.
Well, and I, and I can, yeah.
Thank you.
Yes.
That was, uh, appreciate that.
Uh, well, I'll, you know, startingoff, I'm a dentist, right?
Like you mentioned, I. Practiceddentistry for over 20 years.
Did a lot with c camm CT imaging as wewere talking a little bit about, uh, but.
(02:11):
Then I started developing technology ofour own, and, and the first product we
created was a patient engagement solutionthat ended up in, uh, over 30,000 dental
practices when I sold it a few years ago.
And I like to say that that system,we were, I basically built to
solve problems in my practices.
And, and then as we were scalingthe products called opera, DDS, uh.
(02:34):
As we were scaling that recognizedsome fundamental flaws in how our
technology is handled in dentistry.
I don't think it's a controversial thingto say that technology and dentistry,
particularly the, I'm, I'm not talkingabout the clinical technology, but the.
The systems that run our practicesare essentially archaic garbage.
Right.
(02:54):
And there's reasons why.
The reasons I, you know, and Iwrote a book about why that happens,
but I, I saw it firsthand as I wasdeveloping technology in the space.
And what happens is that we havethese systems that, uh, were typically
developed by a software engineerin the eighties or nineties called
practice management softwares thatessentially tried to take a paper chart.
(03:18):
Put it on a computer andthen add some functions.
But essentially that's all they dostill to this day, and they're all.
Proprietary meaning that, you know, ifyou, if, if you have that information
in there, there's no way to get it out.
And so what, what we've been workingon for the last few years is developing
a connecting, uh, connector that canconnect to any system in dentistry.
(03:42):
Then we've written standards through thea DA and through a organization that would
help lead the creation of dental StandardsInstitute to normalize data and then make
it available to those people that that.
So, uh, you know, at Opera DDS we hada very popular paperless forms product,
and in the, the most popular practicemanagement software, they wouldn't let
(04:05):
us write back to the medical history.
Is we could not write back if somebodysaid that they had diabetes, we
could not write it, write it backin the practice management software.
Not because it wasn't technicallypossible, because they made a
business decision that their formswere so bad that the only way that
they could sell them was by blockingother people out of their software.
Right.
(04:26):
That put millions andmillions of patients at risk.
Okay.
That's why I'm focused on, that'swhy I've been focused on this
and if you, you know, we can.
Unpeel this onion as much as you wanttoday, but when you get down to it,
the, the dental record information, theelectronic dental record information
is legally owned by patients and, and.
(04:48):
Us.
We as dentists are stewards of thisdata, and we can't even do our job as
dentists to protect our patients becausewe don't have access to this information,
let alone patients having access to it.
Now what we've done is we've built awhole bunch of features and stuff on
top of the fact that we can get accessand normalize this data, data analytics,
(05:09):
new ways to do patient engagement, but.
At our core, what we're doing issolving the problem of data access
and interoperability, uh, connectingdentistry to medicine, connecting
to different systems, and, uh, sothat's, that's a little bit kind
of how I got on this journey.
Dr. Maggie Augustyn (05:26):
I was completely ignorant about many, many of these things
when I first met you and serendipitously,I sat next to you at a Smile ro, a
smile source meeting, and started toshare with you some of the issues that
I was having, uh, with a company thatI was working with, and I was trying
to get out of a relationship with them.
And we'll talk a littlebit more about that later.
(05:47):
But I had no idea that these werethe things that we were dealing
with, that I was dealing with.
Within my practice.
Um, and, and that they werethings that were going unsolved.
I also had forgotten, um, and wasreminded of not too long ago really
what HIPAA stood for, because I justunderstood HIPAA as being unable to
(06:12):
disclose information about a patient.
Right.
But so.
Then I needed to speak to an attorneyabout this particular issue that I
was having, and then I was remindedwhat HIPAA actually stood for.
Chad, do you remember exactlywhat HIPAA stands for?
I don't mean to like put you in display.
(06:33):
No, I'll give it
Dr. Chad Johnson (06:34):
a go.
Health Information Portabilityand Accountability Act.
Dr. Maggie Augustyn (06:39):
Yes,
Dr. Chad Johnson (06:39):
you're the top 1% my friend, but there,
Dr. Maggie Augustyn (06:42):
but do you know what that means?
Dr. Chad Johnson (06:45):
Yes and no.
I mean, it's a, it's a large volume ofinformation and I think we boil it down
to a one sheet synopsis for people tounderstand, but do like at the same time.
Do I understand all of its implications?
No.
Um, no.
I mean, the biggestest answer is no,because Yeah, I think I could, if someone
(07:05):
said, well, what about page 1,998?
And they, and I'd be like, ohyeah, I don't know that one.
Ha ha caught you.
You don't actually know it.
No, I don't.
Brian,
Dr. Maggie Augustyn (07:15):
take us home.
What does, yeah, what does HIPAA mean?
Dr. Bryan Laskin (07:18):
So I, I totally hear where you're coming from
about the complexities, right?
But we're not, this is howbad this is to meaning.
How, how much under our nosethis pervasive problem has
been that we've ignored.
You don't have to read hipaa, youhave to do exactly what you just did
was read the what the acronym standsfor health information, meaning
(07:41):
information about your health.
Portability, meaning it can go with you.
Accountability act, right?
So all we're doing is can we getinformation to follow along with the
patient, wherever that patient goes?
That's what the, that's what it'sabout now, according to their desires.
Yeah.
No, not just your desires, justwhat, regardless of what the
patient wants, it goes aroundwherever the patient needs it to be.
(08:04):
Patient should do anything.
Dr. Chad Johnson (08:06):
My only point being, you know, like before
that, if one doctor said, Hey.
I want to, you know, likesend this information over.
But then the patientsaid, whoa, whoa, whoa.
That's my uncle.
You know, who's that podiatrist?
And I didn't tell you that you hadpermission to send that data over.
I'm the one who owns that data.
And so this, the hipaa, in onesense, reclaimed who was the owner
(08:28):
of that information and who got toassign the portability accessibility.
Dr. Bryan Laskin (08:35):
Well, I'm, I'm, I'm not an attorney.
Right.
So, yeah.
No, I was just thinking so on tv.
Well, but I, so my next, my nextsentence, you know, there, there, you
know, you could be, there could, or wecould have a disagree, we could have
some disagreement about, however, what.
What now?
With, with hipaa, you're correct,but there's another regulation that
(08:56):
came later called the CURES Act,which has the information blocking
rule, which actually bars patientsfrom doing what you just said.
If you as a, as as a healthcareprovider need that information
to provide the best care.
Nobody can block access to thatinformation, including patients.
So, so, uh, so that's, youknow, it's not part of hipaa.
(09:18):
It's, it is a later regulationthat was passed in 2022.
Uh, interesting.
Okay.
But, or went into effectin 2022 is passed in 2016.
But, but that's, that was my point, isthat it's like this is all about data
getting to, to people to provide care now.
HIPAA includes two rules becausewe, we don't want to just like.
(09:43):
Patient's information to go everywhere.
So there's a privacy rule and a securityrule that as we share information,
we keep it secure and private.
That's the only thing that any HIPAAtrainer I've ever TA heard talk
about in dentistry talks about.
Right.
All of us have HIPAA trainers cometo Yammer at us for a. Of the most
boring hours of our life every year.
Right?
To talk about about hipaa.
(10:05):
Uh, and I say that becausewe actually created a meeting
'cause I was so bored in hipaa.
We created a day called the Get It DoneDay, where I just would tell people, okay,
come in, get all your regulation stuffdone, and just make sure it doesn't suck.
Right?
Because most of this is like watchingpaint dry, but they don't even
talk about what the title means.
That's how bad it isin dentistry right now.
(10:26):
So, sorry.
It's a little bit of a soapbox,but No, it's fantastic.
And, and those of us, everybodyon this call are not alone.
The actual HIPAA trainers don'teven talk about the intent.
The original intent that's in the titleof the, of the regulation, because we
get mired down in these little detailsof like, oh my gosh, if I send an x-ray
(10:48):
and I, you know, and I take a screenshot.
So there's no, like, isthat patient information?
You know, it's like the, we get miredin these little details, uh, that, that
we forget the fact that the whole pointof this is that patients have access
to their data, that we as dentistscan get access to the information to
provide the level of care that we need.
We act like a new patient comes in andwe get a a, a print off of four bite
(11:10):
wings from six months ago, and we thinkthat we can provide the best level care.
Whereas when we have a dentist, when,when we have a patient in our practices
and they, they present with an issue,the first thing we do is we look at
the history of that tooth, right?
So,
Dr. Maggie Augustyn (11:25):
and, and so we do, we, we collect so much
data now, and back in the dayit was just paper charts, right?
And then there were impressions,and then maybe, maybe we took,
um, and we kept the stone models.
Maybe we didn't, right?
Today everything is digital.
The scans are digital.
Um, but then there's more.
There is, um.
There's phone calls and youcommunicate with the patient.
(11:49):
It's a record of an appointment.
It's not an appointment, but it's arecord of communication and, and giving
advice that is on that phone call.
There's, there's text messages.
Um, I. There's CT scans, there is,there's, there's lab information.
I mean, data about how you're treating apatient, how you're choosing to go, um,
(12:12):
in a certain direction is everywhere.
And the question is,you know, who owns that?
Who owns that data?
Who owns the scan?
That you take on a patient who ownsthe SDL file for, for the, you know,
(12:32):
um, uh, for the implant surgical guide.
Uh, who, who owns?
Any of that, can the patient request that?
And I, I, I heard you record a, apodcast a, about, um, the projects that
you're working on, and your desire isfor the patient to be able to get this
(12:57):
information and to take it from dentist.
To dentists right?
From provider to provider, because howincredible would life be to, for them
to be able to take a, a, a file of theirlast crown, um, or even to have a scan of
their last crown available for us to see?
And gosh, what did that prep look like?
(13:20):
You know, if we have to replace a crownon that patient, what was that prep like?
Why did that crown come up?
You know, the, there's a lot ofinformation that could be available
to us at our fingertips as we'retreatment planning This patient.
Yeah.
All that data.
Who, who owns the SDL files?
Dr. Bryan Laskin (13:39):
I mean, the, so when we're talk about STL files,
it is a little nuanced because, youknow, and, and I should start off by
saying when we answer these questions,uh, how we answer them is important.
Right.
If, if, if I just tell youmy opinion, it's my opinion.
If I codify it into.
Our application, then it'sproprietary information that
(14:00):
nobody else can get access to.
And we're just another problem, frankly.
Right.
So what we've decided to do is gothrough the open forum of standard
development, which means that you goassemble people in the room who, who
hopefully know what they're talking about.
And we discuss this andwe come up with answers.
Not saying we're right, but atleast it's an open form that
anybody can give insight into.
(14:20):
And then there's a voting processand then that gets published and we
develop standards and we actually.
One of the things we talked about, uh,Maggie, is exactly what you talked about
when it comes to an STL file, what ispart of the electronic dental record?
Because the electronic dentalrecord is owned by the patient.
You know, there's no disputingthat that's the patient's data,
(14:40):
and we as dentists have rights andresponsibilities associated with
that electronic dental record.
Mm-hmm.
So what we came up with, I happen to agreewith, but we could always go back and
have more discussion about it, is thatthat prep tooth that you mentioned, that
scan is actually property of the patient.
It's a, it's the scanof the patient's tooth.
(15:00):
However, the restoration that getsdesigned is not property of the patient.
So the dentist.
Can have that in themiddle of the laboratory.
Right.
But that does not need to be part ofthe electronic dental record because
what you've done then is you've actuallycreated something new based on this STL
Dr. Maggie Augustyn (15:17):
file.
That's like your artwork.
Dr. Bryan Laskin (15:19):
Yeah.
Yeah.
And so that you as a dentist don't need togive patients their, their crown design.
But you know, legally, ethically, andnot morally, I would say you do have
to give them access to their prepped.
And this, this isn't piein the sky technology.
Someday you can do, we've actuallybuilt this out so that there is a mobile
(15:42):
application for patients to download andyou can actually export and import, and
in many cases, automate this workflow.
So what we're trying todo is basically help.
These companies that aren't complying withthe, with the regulations and the, and the
way the world works where patients haveaccess to the data to be able to make it
(16:02):
easy for them to plug in and give patientsaccess and, and dental practices access.
Regan Robertson (16:08):
I, Brian, I've been asking for this for 27 years, so I
was in, I was around a group of reallywhat would be like an incubator,
startup kind of tech world, um,what we would call it to that today.
And, and that was a problem that gotkicked around as something to solve.
I figured by now, 27years later, it would be.
(16:29):
It would be completely resolved,and I'm shocked to hear why not.
Um, but also in a ignorant sortof way, you just kinda make
me like the light bulb go on.
Is this why it can take so long whenyou request your medical records?
Like, to me it's, it, it would be easy.
You've got a file, you've gotmy, my information in there in a
week, you know, I would expect toget it and that's not the case.
(16:51):
Or at least it hasn't been been for me.
So is that, is that part of thatIt's not sure what to exactly give,
there's no standard for it and maybefragmented systems on how it's stored?
I mean, I just, I guess I justexpected after that, anytime that
we would be beyond this problem.
Dr. Bryan Laskin (17:09):
You mentioned me are, are you talking about the
medical record or general record?
Yeah.
Well,
Regan Robertson (17:12):
medical, yeah, medical records specifically comes
to mind, but just in general, whenyou request records, I guess I would
imagine it in most practices to besomething that would be electronic and
instantaneous, and in some cases itis, but then in other cases it is not.
Dr. Bryan Laskin (17:26):
Yeah, I think, you know, medical, I like to say
medicine and dentistry are messedup in different ways, right?
And, and, and because I'm, I talkwith a lot of, in fact, that's
gonna be a big focus in my folk.
My, my, uh, podcast going forwardis we bring on physicians to
talk about this because, uh, as.
Right now there's a big, it's calledMDI, medical Dental Integration,
(17:47):
or Medical Dental Connection,and it's called different things.
But there's a big push withindentistry to to work more closely
with our medical colleagues,which I totally agree with Me too.
But we need to do it ina meaningful way, right?
Because they're messed up, right?
We're messed up, butthey're also messed up.
And if we take our industryand put it on the medical.
Machine.
It's not gonna go go.
(18:08):
It's not gonna go well for dentalpatients, dental practices.
This could be, I mean, uh, we ha wehave to do this meaningfully in my mind.
So let's talk about whatthose differences are.
And so when we're talking aboutthe medical record access by
patients and the dental recordaccess, it's two different worlds.
They've been working on medicalinteroperability or data exchange.
For the last 20 years, and there's allsorts of problems with it regionality.
(18:32):
There's massive companies likeEpic and Oracle that are fighting
battles and all sorts of stuffgoing on that lead to the problems
that you're discussing, which hold
Dr. Chad Johnson (18:41):
up, those aren't even medical companies proper, right?
I mean, those are just data companies.
Correct.
Dr. Bryan Laskin (18:49):
Those are software companies Yep.
That, that have data.
You're right.
Yep.
Which, which is its own problem.
Right.
Meanwhile, on the dental side,nobody's done anything except for
us for the last three years, right?
Uh, and not, these aren'tsoftware companies.
These are typically distributioncompanies or some company
that bought another company.
It's a PE group that just bought asoftware company and is, doesn't even
(19:12):
know how to do, innovate and do anything.
So all they're trying to do is milkthis cash cow until it dies, right?
Two totally different, twototally different problems, but
at the end result is Im patient.
You're getting hose in both instances.
I would argue today, worse on thedental side, but it's so much easier
to fix because nobody's done anything.
(19:34):
So what we've tried to do is come in,write standards, learning from the medical
mistakes, second mouse gets the cheese andcreate technology that can, we can solve
the problem holistically in dentistry.
Then we can actually apply to medicineand help solve some of their problems too.
That's, that's in a nutshell, that'swhat the mission for Tooth APS is.
Regan Robertson (19:54):
Brian, what fuels your passion for this?
Why does this matter to you otherthan it's a fun problem to solve?
Dr. Bryan Laskin (20:01):
I've been called an impact junkie, and so
I, the bigger impact, the better.
The harder the problem, the more I likeit, and if it involves a fight, then
I'm really down and this checked allthe boxes for me, so I, it's something
I could not, I. Go away from, right?
Mm-hmm.
Then we're fighting against somethings that I just think are
philosophically wrong, frankly.
(20:22):
You know, I, I sold my dental practicesafter 20 years of 25% year over year
growth was the, was the, was the least.
We grew, I sold my software, my lasttechnology partner company, and so I
was like, when I was looking at thisproblem, I, I literally thought, what's
the biggest problem I can help solve?
I'm in a unique position to solve,and then I couldn't think of
anybody else that would do it.
(20:43):
Frankly, that's why I'mreally passionate about it.
I don't know.
I mean, now there might be, but,but back three years ago, I don't, I
couldn't think of anybody else that wasactually gonna work on this problem.
Mm-hmm.
That's, that's, that's whyI'm passionate about it.
Regan Robertson (20:55):
So let's talk, go.
Go ahead.
I was just gonna ask, what isthe, the biggest, uh, frustration
that you've hit your head againstthe wall in this particular, um,
quest that you've undertaken?
You're gonna get
Dr. Bryan Laskin (21:08):
me, I get, I'm gonna get, I'm gonna get mad talking
about that, but, uh, the best you, uh,I'll, I'll, so I can't just pick one.
The biggest one is software vendorswho just want to just clearly violating
the information blocking rule.
And, and, and every time you say no togiving one instance of data, there's
(21:32):
a fine of up to a million dollars.
So we're talking software companiesthat could have paid half a billion
dollar or a billion dollars of finesto the federal government, and that's
happening to me on a weekly basis.
The other instance is dental practices.
When I talk to them and they say,Brian, we don't want to give patients
their treatment plans because then theymight go somewhere else, and I think.
(21:54):
Do you suck so bad at your job thatyou think they're gonna go somewhere
else if you actually tell patientswhat you are planning to do for them?
And, uh, I don't know which isworse, but I hear, I literally,
every week I hear both.
And so that's been my biggest frustration.
Regan Robertson (22:10):
I appreciate you sharing that because I really, I mean, I
genuinely was super, super curious aboutthat and I'm glad you brought it up.
You know, Dennis being afraid or fearfulto give away that information, and I've
requested my own records in the past,um, dental, medical, otherwise I'll
leave it anonymous, but, um, I could tellin the response back to me, it's not.
(22:32):
They never said no, but it was, well, why?
And it was just a really curious,but also tinged with that,
are you leaving me feeling?
Mm-hmm.
And, and I thought, ohgosh, no, of course not.
But there was that human element to it.
Um, but I didn't think youwere, you, you have to, right?
You have to legally give someonetheir information if they ask for it.
Dr. Bryan Laskin (22:50):
You don't have to, but there, but there
are consequences if you do.
Okay.
Okay.
Well said.
Well said.
Yeah.
Yeah.
You know, it's that becauseI, the reason I say, people
say, well, where are the flow?
What, what, where are the fines?
I said, they say, well, I don't thinkI wanted, I'm gonna, I'm gonna do this.
I go, that's fine.
You can steal a car.
As long as nobody comes after you, youknow, you, you didn't get in trouble.
Doesn't mean it wasn't illegal.
(23:11):
Right?
Yeah.
Uh, the.
And, and one of my favorite quotes is by,uh, Rick Rubin, the music producer who
says The best art divides the audience.
When I talk about this, oneof two things happens, right?
Dentists come up to me, theygo, oh, thank you so much.
My aunt just had a knee replacementand we couldn't figure out that.
We couldn't get her records to go see.
(23:32):
And they understand theproblem in healthcare.
They see it from the patient'sperspective, or they start saying,
what are you talking about?
My software platform?
My practice management software, peoplecould leave me and go to another one.
To which I say, youhave 1% of the industry.
Are you worried about losing your1% or getting part of the other 99?
And very often, clearly the answeris they're worried about losing their
(23:54):
1% 'cause their software is so bad.
And so, you know, that'skind of what's going on.
The, uh, there's not, nobody goes this.
Nobody feels well.
Okay, this is kind of going on.
It, it definitely divides the audiencewhen you tell them that patients should
have access to their data for sure.
Mm.
Dr. Maggie Augustyn (24:12):
Let, let's talk about a fight and let's talk about
fueling that fire, because recentlywhen you and I met I, um, there's a fire
in me and there's still a fire in me.
And, um.
I, I had a relationship with acompany that was working with
our phones and I, and I startedthis relationship in 2017, 2016.
(24:39):
And it, it was a great solution.
Um, it was a way for us to get ourphones connected to Eaglesoft and, um.
You know, the calls were recorded, wecould go back and we can listen to them.
There was a lot of information there.
Um, and, and it, and it was a reallygreat solution and we were in a
(25:00):
relationship with them up until this year.
But then there came other companiesonto the market that provided a
similar system, and I wanted toinvestigate that because they, they
had a different way of communicatingwith some of the other, um, uh.
Technologies that we were using inthe office and they were also less
(25:24):
expensive, but I could not get outof my relationship with this company.
Um, and they, they, they rhyme withsleeve, um, or yeah, sleeve or sleeves
or what, what, whatever you have, right?
And, um, that was bad, but, butlet's leave it in there, uh, because.
(25:48):
They, they refuse to give me my data.
Um, yes, you can leave, but there's noway for us to give you to, there's no way
for us to give you the call recordings orthe text messages or anything like that.
You, you could leave, but youcould leave without your data
and, and I stayed because.
(26:09):
I, I really wanted to hangonto those call recordings.
There's a lot of information there.
There's the mood of the patient.
There is the threats of I'm going to, youknow, Sue, you there, there, there's a
lot of information on there that I didn'twant to lose that I felt was in some way
protecting me until finally this year.
Um.
(26:30):
I went to them and I, and I hadtalked to you and, and they said,
we will give you your information,including your call recordings.
Um, but every time I would talk toa representative of this company,
every other sentence, maybe notsentence, but paragraph, was,
could you please stay with us?
(26:51):
Even after my very, very longmonologues of there is nothing.
In this world that you could do to keepme because of the unethical practices that
you have been, you know, because of theway that you have interacted with me for
the last almost 10 years, I just don't,I don't work with companies like yours,
(27:14):
and so through this very, very long.
Process of separating myself with them andthem promising to give me back my data.
Unfortunately, I was always ontheir Zoom call, so none of this was
recorded other than, you know, metaking some notes, uh, or my office
(27:35):
manager having a recollection of this.
Uh, we ended up signing a contract withMango to, to move into their services.
And then finally, when it came time to,to sever our relationship, they said,
we can't give you your recorded calls.
Um, and, and I said, what do you mean?
But you, but you said that you would.
(27:56):
And they said, yeah, no,you must have misheard that.
So I ended up posting something onsocial media presenting this information,
um, and they, they posted on socialmedia, don't wor don't, don't worry.
We'll take care of you.
And they ended up sending meanother email saying We will
give you your recorded data.
(28:18):
And I ended up talking to an attorney.
And, uh, trying to figure out whetheror not I can get my recorded data
and, and kind of went back and forthto, to find out that, um, that it's
probably the only way for me to dothat is through a lawsuit that would
probably cost me anything, anywhere.
Bet up up to a million dollars.
(28:41):
Um.
And as soon as we kind of made any moremovement after that email where they said
that they would give me my recorded dataonce more, they, they came back, um, and
they gave me a link to download the data.
Of course, there were norecorded calls on that data.
And then, you know, again, Isaid, can I have my recorded data?
(29:03):
And then they said, that is unfeasible.
And then I said, but thisis information blocking.
And they said, it's not informationblocking if it is not feasible.
I talked to another company thatdoes the exact same thing, which
is PBM Practice by numbers.
They do exact same thing.
They record calls, they offerphones, and I said, do you release?
(29:26):
Recorded calls to the clientsthat are leaving your company.
She said, absolutely.
That's, uh, Aditi Al, who's also adentist that invented that company.
I absolutely release data.
I said, how hard is it?
It's not hard at all.
You go on the server, you hirean engineer to, to get your
data, and we release that to you.
And so it, it's made me extremely angry.
(29:49):
But, but, but the entire timethey kept offering, please,
will you stay with sleeve?
You can keep, you can keep yourdata for a monthly fee of this much.
We just can't.
It is unfeasible for us to release thisdata from me, which bottles my mind.
(30:11):
How is it possible for you to notbe able to, to give me a recording?
I mean, at first it was like,oh, the data's too large.
What I mean, what world do you live in?
That data is too largefor you to transfer.
Dr. Chad Johnson (30:25):
Right.
Dr. Maggie Augustyn (30:25):
Have you not heard of Dropbox?
I mean, and so, um, so, so, soI was given a choice, right?
To stay with sleeve and pay a monthlypayment to get ahold of my data, which
my integrity just prevents me from givingthem a single penny, um, to, to possibly.
(30:47):
Soothe them and go and, and take awhole bunch of my retirement savings
and, and try and wrestle that awayfrom them or to walk away, um, with
this fire that's still burning thisincredible anger at this unethical
company that, that does this to me.
And they have done it to many, many, manydentists because I've heard from many
(31:12):
dentists that they have done this to, um.
I don't know what the solution here isbecause this company goes to dentists
and just flat out lies about what theycan have and, and what they're willing to
give on the back end as they're severingthe relationship as they did to me.
Dr. Bryan Laskin (31:33):
Yeah, I, I, uh.
I do know what the solution is.
I, I mean, and we'reworking on the solution.
We're working on a, we're developinga coalition of software vendors that
believe in open data and dentistry.
We're going, doing a conveningthis summer in Washington to
push for some certain things.
Getting, you know, high onmy mind is getting patients
access to their data 'cause.
(31:54):
Like you mentioned, the, the recordings,I don't know, depending on the
recordings, if, if that's part ofthe electronic dental record or not.
Certainly some of those text messagemessages probably are, uh, I would
argue that it's the patient'sdata and patients should have
access to it, and unless they're.
Delivering that through a secure mobileapplication, which they're probably not.
Those, all the companies who are,who believe in open access don't even
(32:16):
fully understand what that means.
Right.
So we're putting together a coalitionto kind of educate the industry and,
and we're gonna be coming out withcertifications and things to kind
of like, so that, 'cause right now.
Let's face it, the, the, the,the software landscape is in,
dentistry is the wild West.
It's just lawlessness completely.
(32:37):
And we are like a weird, in the weirdposition of being a disruptor by trying
to lay laws down versus break them.
Right?
We are trying to like, createstandards and, and laws that.
By all accounts should already be inplace, but nobody's following them.
So it kind of puts us in a weird positionto be the sheriff in town and trying to
(33:00):
get these behemoths who, I mean, thereare some massive companies that are
just illegally stealing and resellingdata and what no dentist says when they
sign up for a phone system, a patientengagement solution, they don't ask how
do you get the patient's information?
Nobody asked that because nobodyeven knows about the problem of, of
(33:22):
companies hacking into integratorsillegally stealing the patient's
information and reselling it.
Uh, so there's, there's so many I. Wecould go deep into a, in, in a nerdom
of like a, a wizard, wizarding world oflawlessness, of nerdom that, uh, that,
that probably would put people to sleep.
But the reality, tell me about me.
Dr. Chad Johnson (33:43):
Hold on.
Um, our, our dentists implicitly gettingdata that has been procured illegally.
Oh,
Dr. Bryan Laskin (33:51):
a hundred percent.
Yes.
There's companies out there doingthat right now, and they have big.
Booth trade shows, and nobody asks,oh gee, are you actually, how are
you obtaining this information?
Right, because you have to,
Dr. Maggie Augustyn (34:03):
you have to provide other patients.
Dr. Bryan Laskin (34:05):
Could you
Dr. Maggie Augustyn (34:06):
explain that?
Because I, I don't even, yeah,
Dr. Bryan Laskin (34:08):
so here's, here's the common practice of how.
The average technology company integrateswith the practice management software.
Okay.
There's a couple different ways.
One is you can go to the company andsay, Hey, I wanna integrate with your,
with your practice management software.
And then they say, great, here'sour API that you can plug into.
And they then they chargeyour company for that.
(34:29):
Okay?
The X amount or whatever, and, and.
Most of them don't ask thequestion, do you have a medical nece
necessity to have that information?
They just say, how muchdo you wanna pay us?
And, and the more you pay us,the more information you get.
That's it.
So that's, that's, that's the mostlawful way that tends to be going on now.
(34:50):
Then there's companies that are like,well, this is a, or, and, and by the
way, these are large companies and ifyou're a small technology company, they
probably, you don't, probably will,won't pay them enough for them to even.
Talk to you right.
Then on the other side, becausethere's a bunch of companies that they
won't talk to, the companies have,have, have sprung up that say they
built their own roads who'll get intothe practice management data, pull
(35:14):
it out and resell it to companies.
And nobody talks about this in dentistry.
Uh, you know who, uh, but, butthat's kind of what's going on.
So it's either, uh, uh, knowingand, uh, and unknowingly illegally
blocking information or it's.
Getting it in sketchy formats andreselling it and what we're trying
(35:35):
to do, because every, if you.
When you plug into thesesystems, everyone's unique.
You know, if you look at somethinglike Dentrix that's had hype,
God knows how many iterations.
That alone probably has 10 differentconnectors for the 10 different versions
of it, of that have been throughoutthe years of, of Dentrix, right?
So if you're a small developer to getto integrate with people's practice
(35:56):
management software, you have to build15, 20, 30 connectors that all suck.
By the way, these are all.
Bad connections that don't comply withthat, that, that, that aren't very good,
and that you have to, as a small company,a big part of your job is connecting
to these piles of garbage, right?
Mm-hmm.
What we're trying to do is replace allof that with a standard called API or
(36:17):
programmic in interface for any companythat that needs to have the information
that can show, they have the inform,they need to have the information
to plug in and get it with a singleconnection for all of dentistry, right?
And so.
It's not directly what the, uh, the,the sleeve company, but it, but, but
it, but it's, but it, but if they hadadhered to the standards and regulations
(36:42):
that are, you know, some are mandatedby the federal government for all of
health healthcare in including dentistry.
And some are new ones and someare just ones that we should do
because it kind of makes sense.
Right.
Um, and what's been the
Dr. Maggie Augustyn (36:55):
response?
Dr. Bryan Laskin (36:57):
It depends who you talk to, right?
I mean, software vendors thinkit's great, but they're kind of
are like, can you actually do this?
And because we're, we haven't solvedevery prob problem, but what I can
tell you is we're the only one reallysolving the problem in, in this way.
So we have, I. Made a ton of progress.
Nobody, I hadn't heard the terminteroperability in dentistry.
(37:19):
And when I started is when I wrote abook about it, uh, three years ago.
Right?
But now, now it's becoming a thing.
You know, we're great peoplelike you recognize the problem.
Have me on the podcasttalking about it sort.
We're spreading the worddoing convening in Washington.
We're putting pressure.
Our next step as a company is we'regonna go directly to patients.
So patients are gonna be able to requesttheir records di directly, and then
(37:43):
dental, then dentists will get, they'llget educated pretty quick when you get
a, when you get 10 patients request theirrecords through a mobile application.
Right.
You'll probably figurethis out pretty fast.
So that's what we're doing as a companyto try to move the tide, uh, you know,
standards and regulation, talking todentists, uh, you know, through the
podcast, through books, whatever.
And then, uh, and then.
(38:04):
Than going to, going directly to patient.
And, uh, there's large companiesthat, you know, one of the large
PMS vendors has a list approvedapproval pending unauthorized
slash dangerous on their website.
Okay.
And I, and so I, I bet you can guess.
(38:25):
What gets you on the dangerous listand how you go to be authorized?
There's one criteria, it involvesa pen and a check, right?
So I mean, so companies who are onthe danger list are calling me up
going, we need to solve this problem'cause they're on the danger list
because they don't want to pay it.
Right?
So we are having momentum, uh,but you know, I'm an impatient
(38:48):
guy, so I want it to go faster.
Hmm.
Regan Robertson (38:53):
Have you had difficulty yourself?
Is that, is that part of thereason other than it being a great
injustice and, uh, and being avery enticing problem to solve?
Dr. Bryan Laskin (39:04):
Yeah.
That's how I identified this problemis was, um, through scaling the patient
engagement solution, had talking to thePMS vendors, uh, it was just, I mean.
Problematic, but we were able tosolve for it in most instances.
But, but you know, when I sold thatplatform, and even before I was
(39:25):
sold that I was trying to think oflike, what's the next big challenge?
And I was like, this is just a mess.
Right?
Uh, so I have had experience, uh,uh, from, from the perspective
of a technology developer.
Also, I'm involved in alot of different startups.
I'm, you know, I, I am apart of about 15 different
technology startups in dentistry.
And so if you're gonna be doing something.
(39:46):
In dentistry, and you want, this is abig problem for every company that's
trying to solve problems in dentistryand not, not everyone, you know, if
you're creating the next generation ofcomposite, you don't need to have access
to the patient's information necessarily.
But, uh, but for, but for, youknow, if you're an AI company,
if you're, you know, doing.
(40:07):
Anything that's a data shining patient.
Yeah.
Data, any, any research.
Right.
This is, it's a big deal.
And so, uh, so yeah, that's a longanswer to your short question.
Regan Robertson (40:17):
It, but it feels like a volcano.
No, you answered it great.
It feels like a volcano that'ssitting somewhat dormant.
And, and think back to like thehousing crisis in 2008, you know?
Right.
Leading up to that.
The big surge.
The big wave, the lava, whatever.
Metaphor you wanna share?
I remember being approved for an enormousmortgage, and I think I was making like,
(40:37):
I don't know, it was like 11 bucks anhour, something crazy small and thinking
how this doesn't, like, even on on themost basic level, make financial sense,
like why am I getting approved for that?
But everybody was doing it and I cansee how this sort of lawlessness or
maybe the lack of attention from lawon these things, how this happens
(40:58):
if I am a dentist, since I've got.
Three dentists here.
Uh, what is the first step thata, that a dentist needs to take?
Because likely there's a level ofignorance of not being fully aware
other than experiencing it likeyourself and the frustration from it.
Um, where does one start?
Dr. Bryan Laskin (41:16):
I'm, I'm a little biased, right?
Obviously a little right.
Yeah.
So I, I would say making sure yourpatients can get access through
their, to their data througha secure mobile application.
Because here's, here's the reality isthat that's where your liability lies.
The, the what, what, what happened.
Because if a patient requeststheir records, and you cannot give
(41:37):
it to them through a secure, ifthey say, I'd like my, you know.
Again, it's only if thepatient complains, right?
But if they know their rights,which is that if they request their.
Through a secure mobile application,you need to be able to deliver
that in a machine readable format.
Again, there's, there's alot of detail here, right?
(41:58):
So, uh, uh, I would, you know, and bythe way, the patient doesn't care that
it's the practice management system.
That's the problem.
They're gonna come to you and specificallythe person behind the front desk that's
overwhelmed complaining about this.
Right?
And so that's where I would startmaking sure that my patients aren't
(42:18):
going to be pissed, that I can'tgive them their information when
they start learning about this.
Dr. Maggie Augustyn (42:24):
So are you saying that the data that they request
has to be them, has to be, that ithas to be requested via an app, or
it has to be delivered via an app?
Dr. Bryan Laskin (42:35):
It has to be delivered in the format that the patient wants,
including a secure mobile application.
So if they say, I want to have a bunchof PDFs printed off and a thousand
pieces of paper, which they won'tright, then, then that's, then, then
you have to deliver it in that form.
And I, that you probably could just dois through a secure mobile application.
(42:58):
But, but it specifically states, uh,let me, let me, let me describe why
I. The reason why this, the 20, the21st Century Cures Act, which includes
the information blocking rule cameto be patients were looking to, you
know, to get their medical records.
And physicians said, well, we can't do it.
(43:19):
They're all locked up in Epic.
And, and Epic said, well, toobad we're not covered under
hipaa, which they were, right?
So the federal government wrote.
A piece of legislation, the 21stCentury Cures Act to fix that issue
such that that is why MyChart exists.
If you know the product MyChart,MyChart was not created because
(43:42):
Epic loves people and wants them tohave access to their data, epic was,
or MyChart was created because thefederal government forced them to.
The problem is nobody's beenpaying attention in dentistry.
We have the same mandates to have aMyChart, and that's what we've built.
Uh, it's now called Care, CAIR.
(44:03):
Uh, we're rebranding it, uh, that, that,uh, is going, that the way that patients
get access to their data and then patientscan, but the, but the reality is, is that
this really isn't about the stick, right?
It's not about the it.
You know, if you've used MyChart orif you've used these records, you're
gonna be way more informed as a patient.
(44:24):
And I think it's gonna be thebiggest increase in case acceptance
since the interval camera.
When patients can see their intervalphotos, they can see they can get
third party financing, do onlinescheduling all through a secure mobile
application, they can message you, youknow, instead of that being through
a phone system, it'll be through.
The secure mobile application.
And by the way, it doesn't matter whichsystems you're using, if you use like
(44:46):
a Mango voice, they're a partner ofours, you can do your text messaging
and it can show up in our, in ourplatform securely, stuff like that.
So that's, that's where I, I wouldstart, is making sure, because
that's where you're likely to get
dinged as a, as a practice, isif a patient says, I'd like my
(45:07):
complete records, making sure thatyou can actually deliver that.
Dr. Maggie Augustyn (45:12):
Except you can no longer start writing.
Patient was a complete jerk,was totally disrespectful.
Like you, you can't put thatin a patient chart anymore.
Sure you can.
And
Dr. Bryan Laskin (45:21):
not in the progress.
No, no, you can.
I wouldn't do it.
But eh, you know, if the patient's,then you're just telling the truth.
Right?
Dr. Chad Johnson (45:29):
But darn right.
Yeah.
Regan Robertson (45:30):
I, I'm seeing the, I understand now the B2C connection, why
you wanna go straight to the patient andempower the patient to drive the change.
Uh, your episode, I think your podcastcalled Patient First Podcast, right?
And, uh, you have a recentepisode with Frank Lo.
I'm only like 15 minutes into theinterview, but it's incredible.
And Frank is talking, um,insurance and, and healthcare.
(45:52):
And, and there's so much about thatworld that I am not aware of myself,
that I feel, and I've asked, um,multiple like providers, I've been
like, it would be so cool, you know,if you had a, if you had a class on it
and, and you could help empower people.
But what if, like, follow me here.
What if we were able to take that kindof fear mindset of I don't want people
(46:13):
to leave and switch it around so thatit's an empowerment, like, because you
are with me, you get this access, Ihave put in the work for you because
you know why we are in this together.
Like, to me, that's true advocacy.
Like I think of myhealthcare people as my team.
I, you know, I have a chiropractor.
I, I had a therapist for a long time.
I have my medical doctor.
(46:34):
I have my dentist like that.
They should all be talking.
Maybe it's all about me.
Maybe that's a selfish thing, but,but shouldn't they all be talking
because there's, there's riskfactors and things that, that some
practitioners look at that others aren't.
It's just, it just makes sense.
And, and so for me, I wouldfeel empowered as a patient and
I know where I would be going.
(46:55):
If, if we can take down thesesilos, I would feel like my
health really does matter.
Dr. Bryan Laskin (47:02):
Yeah.
And, and that's what, that'swhat we're focused on, right?
You can't do every, Rome wasn't builtin a day, but I do believe oral health
is the gateway to overall health.
And so I think it makessense for us to, to go there.
Yeah, absolutely.
Dr. Maggie Augustyn (47:13):
As unexciting as HIPAA is the idea that we could
have something similar to to MyChartfor our patients and our ability to
communicate with them would be safeand protected and under our control as
opposed to the control of whatever whim.
The company that we're working with andwhomever, you know, and then there's the
(47:35):
idea of who owns this company today andwhat whim, you know, what whim and what
mood are they in to release those, thoserecords or the reigns or control onto us.
Um,
Dr. Bryan Laskin (47:51):
well, I, I, I, let me interrupt you there if you don't mind.
'cause it's not an idea, it's reality.
We've already done it.
It's called care.
Uh, and it's not.
It's not who it, you know, obviously I'm,I'm a co-owner, so I'm 50% of the company.
It's not a private equity group.
You know, my co-founder andI have in multiple exits.
This is self-funded, so we'renot looking to get another round
and jack up the prices on people.
(48:13):
Right.
Uh, which is kind of what all thosecompanies are doing right now.
And estimate
Regan Robertson (48:17):
quality.
Dr. Bryan Laskin (48:18):
Yeah.
And, and, and, and we actually have,how this information is handled is all.
Public is part of the standardsthat we've written, right?
The one how patients getaccess through dental.
Dental records are called Thor Trans.
It's called Thor, transferableHolistic Oral Records.
How we manage dentistry, uh, withindentistry is called Odin, the Oral
(48:38):
Data Interoperability Network.
I'm based in Minnesota, like you said.
So we like our north.
There you go.
So, so here we have onecoming up right now.
So we're, we're, you know, if youwanna get involved, let me hit me up.
You know, we're working right now, I'mmapping and filtering medical histories.
'cause you look at the medicalhistory in your practice management
software, it makes no sense.
So what we're doing is we're takingthe medical, medical history and then.
(49:00):
Doing what they do in medicine isthey actually take that comprehensive
medical record and then look at whatare you doing as a provider and then
having you work with that medicalhistory for the patient so it's not
onerous for you or overwhelming.
And so that's what we'redoing for dentistry.
So instead of just having a radiobutton about allergies, if you're.
Sedating patients in your practice, he'llfollow the same levels of medical history.
(49:22):
Uh uh.
So, so I'm going down to the rabbithole, but that one's called hild.
It's another, it's anothernorth theme, right?
So if you wanna get involved then withstandard development or open data,
uh, I'm the right guy to reach out to.
Dr. Chad Johnson (49:36):
Hmm.
That PMS that I use has ahealth history question.
Venereal disease, yes or no.
And I'm like, who calls it that anymore?
I, it's just like, I'mjust, but I can't change it.
It's just, it's just like, nope.
That's what we call it, you know, whenwe made it and we're not changing it.
And that's what's it's gonna say.
(49:57):
And you can't, you know,keep things updated.
It's so frustrating.
What do you do?
Dr. Bryan Laskin (50:03):
Yeah.
And so what we're trying to do is.
Develop, get the right people in the roomto develop a medical history that, you
know, nothing's perfect, but at leastthat's published, that people had a public
form that they could give feedback to,and then we can adjust it as necessary.
Yes.
Dr. Maggie Augustyn (50:22):
Brian, every time I talk to you or see you, I am just
in awe of everything that you are.
I, I don't know how your brain works.
It, it makes my brain hurt, but I'm reallyglad that your brain works this way.
Mm-hmm.
Um, I just want to offer youa heartfelt thank you for, um.
For making this world spinin the right direction.
(50:44):
Um,
Dr. Bryan Laskin (50:45):
well, right.
You're, you're doing amazing things too.
And so it's Right.
You know, the respect is mutualand, and, uh, and so thank you.
Thank you very much.
I.
Dr. Maggie Augustyn (50:54):
Thank you for joining us today.
Thank you for this, uh, incredibleamount of knowledge and I mean, I, I
think we are all looking forward to thefuture that you are helping us create.
Uh, check out tooth apps and, uh, let,let's see what the next two, three
years will bring for our patients.
Dr. Bryan Laskin (51:15):
Appreciate it.
Thank you very much,
Dr. Chad Johnson (51:16):
Dr. Maggie.
In conclusion, I wrote apoem while we were in this.
It's only three lines.
We do rhyme with sleeve, but you cannotretrieve your patient data when you leave
the end.
Dr. Maggie Augustyn (51:34):
That's lovely.
Dr. Bryan Laskin (51:37):
I love, I love how you weaved all that together.
It was pretty good.
Dr. Chad Johnson (51:41):
No, you didn't.
What.
Regan Robertson (51:50):
Thank you everyone.
I'm gonna hit stop.
Hi listeners.
This is Maggie Augustine, along with yourco-host Reagan Robertson and Chad Johnson
on Everyday Practices Dental Podcasts.
We are here and we are hosting a veryspecial guest, someone that I admire
greatly and have the honor of introducingto you, Dr. Brian Laskin, who is an.
(00:25):
Eternal entrepreneur.
Um, he is a Minnesota based dentistwhose mind just does not stop.
He is an innovator, um, and he is.
An entrepreneur.
He is a genius and he knows a lotabout technology and how technology
(00:49):
applies in the area of dentistry, butmore so he is fascinated with data.
Um, he's fascinated with.
The protection of data.
He understands who owns datain, in the space of dentistry.
I could go on about all of his inventions.
(01:10):
We'd probably spend half thepodcast talking about that.
Currently he is in the role of, um.
Owning, I believe he is the CEOif I understand that correctly,
of tooth apps, which I would likefor him to talk a little bit more
about throughout this podcast.
But, uh, hello everybody.
Um, and Dr. Laskin or, or Brian.
(01:35):
Tell me just a little bit more aboutwho you are and how you've ended up
in this role of being a leader in,in understanding data and how it
applies in, in the world of dentistry.
Dr. Bryan Laskin (01:51):
Well, thank you very much and thanks.
I, I don't wanna say anything 'causethere's, I just much as you keep going on.
That's right.
Well, and I, and I can, yeah.
Thank you.
Yes.
That was, uh, appreciate that.
Uh, well, I'll, you know, startingoff, I'm a dentist, right?
Like you mentioned, I. Practiceddentistry for over 20 years.
Did a lot with c camm CT imaging as wewere talking a little bit about, uh, but.
(02:11):
Then I started developing technology ofour own, and, and the first product we
created was a patient engagement solutionthat ended up in, uh, over 30,000 dental
practices when I sold it a few years ago.
And I like to say that that system,we were, I basically built to
solve problems in my practices.
And, and then as we were scalingthe products called opera, DDS, uh.
(02:34):
As we were scaling that recognizedsome fundamental flaws in how our
technology is handled in dentistry.
I don't think it's a controversial thingto say that technology and dentistry,
particularly the, I'm, I'm not talkingabout the clinical technology, but the.
The systems that run our practicesare essentially archaic garbage.
Right.
(02:54):
And there's reasons why.
The reasons I, you know, and Iwrote a book about why that happens,
but I, I saw it firsthand as I wasdeveloping technology in the space.
And what happens is that we havethese systems that, uh, were typically
developed by a software engineerin the eighties or nineties called
practice management softwares thatessentially tried to take a paper chart.
(03:18):
Put it on a computer andthen add some functions.
But essentially that's all they dostill to this day, and they're all.
Proprietary meaning that, you know, ifyou, if, if you have that information
in there, there's no way to get it out.
And so what, what we've been workingon for the last few years is developing
a connecting, uh, connector that canconnect to any system in dentistry.
(03:42):
Then we've written standards through thea DA and through a organization that would
help lead the creation of dental StandardsInstitute to normalize data and then make
it available to those people that that.
So, uh, you know, at Opera DDS we hada very popular paperless forms product,
and in the, the most popular practicemanagement software, they wouldn't let
(04:05):
us write back to the medical history.
Is we could not write back if somebodysaid that they had diabetes, we
could not write it, write it backin the practice management software.
Not because it wasn't technicallypossible, because they made a
business decision that their formswere so bad that the only way that
they could sell them was by blockingother people out of their software.
Right.
(04:26):
That put millions andmillions of patients at risk.
Okay.
That's why I'm focused on, that'swhy I've been focused on this
and if you, you know, we can.
Unpeel this onion as much as you wanttoday, but when you get down to it,
the, the dental record information, theelectronic dental record information
is legally owned by patients and, and.
(04:48):
Us.
We as dentists are stewards of thisdata, and we can't even do our job as
dentists to protect our patients becausewe don't have access to this information,
let alone patients having access to it.
Now what we've done is we've built awhole bunch of features and stuff on
top of the fact that we can get accessand normalize this data, data analytics,
(05:09):
new ways to do patient engagement, but.
At our core, what we're doing issolving the problem of data access
and interoperability, uh, connectingdentistry to medicine, connecting
to different systems, and, uh, sothat's, that's a little bit kind
of how I got on this journey.
Dr. Maggie Augustyn (05:26):
I was completely ignorant about many, many of these things
when I first met you and serendipitously,I sat next to you at a Smile ro, a
smile source meeting, and started toshare with you some of the issues that
I was having, uh, with a company thatI was working with, and I was trying
to get out of a relationship with them.
And we'll talk a littlebit more about that later.
(05:47):
But I had no idea that these werethe things that we were dealing
with, that I was dealing with.
Within my practice.
Um, and, and that they werethings that were going unsolved.
I also had forgotten, um, and wasreminded of not too long ago really
what HIPAA stood for, because I justunderstood HIPAA as being unable to
(06:12):
disclose information about a patient.
Right.
But so.
Then I needed to speak to an attorneyabout this particular issue that I
was having, and then I was remindedwhat HIPAA actually stood for.
Chad, do you remember exactlywhat HIPAA stands for?
I don't mean to like put you in display.
(06:33):
No, I'll give it
Dr. Chad Johnson (06:34):
a go.
Health Information Portabilityand Accountability Act.
Dr. Maggie Augustyn (06:39):
Yes,
Dr. Chad Johnson (06:39):
you're the top 1% my friend, but there,
Dr. Maggie Augustyn (06:42):
but do you know what that means?
Dr. Chad Johnson (06:45):
Yes and no.
I mean, it's a, it's a large volume ofinformation and I think we boil it down
to a one sheet synopsis for people tounderstand, but do like at the same time.
Do I understand all of its implications?
No.
Um, no.
I mean, the biggestest answer is no,because Yeah, I think I could, if someone
(07:05):
said, well, what about page 1,998?
And they, and I'd be like, ohyeah, I don't know that one.
Ha ha caught you.
You don't actually know it.
No, I don't.
Brian,
Dr. Maggie Augustyn (07:15):
take us home.
What does, yeah, what does HIPAA mean?
Dr. Bryan Laskin (07:18):
So I, I totally hear where you're coming from
about the complexities, right?
But we're not, this is howbad this is to meaning.
How, how much under our nosethis pervasive problem has
been that we've ignored.
You don't have to read hipaa, youhave to do exactly what you just did
was read the what the acronym standsfor health information, meaning
(07:41):
information about your health.
Portability, meaning it can go with you.
Accountability act, right?
So all we're doing is can we getinformation to follow along with the
patient, wherever that patient goes?
That's what the, that's what it'sabout now, according to their desires.
Yeah.
No, not just your desires, justwhat, regardless of what the
patient wants, it goes aroundwherever the patient needs it to be.
(08:04):
Patient should do anything.
Dr. Chad Johnson (08:06):
My only point being, you know, like before
that, if one doctor said, Hey.
I want to, you know, likesend this information over.
But then the patientsaid, whoa, whoa, whoa.
That's my uncle.
You know, who's that podiatrist?
And I didn't tell you that you hadpermission to send that data over.
I'm the one who owns that data.
And so this, the hipaa, in onesense, reclaimed who was the owner
(08:28):
of that information and who got toassign the portability accessibility.
Dr. Bryan Laskin (08:35):
Well, I'm, I'm, I'm not an attorney.
Right.
So, yeah.
No, I was just thinking so on tv.
Well, but I, so my next, my nextsentence, you know, there, there, you
know, you could be, there could, or wecould have a disagree, we could have
some disagreement about, however, what.
What now?
With, with hipaa, you're correct,but there's another regulation that
(08:56):
came later called the CURES Act,which has the information blocking
rule, which actually bars patientsfrom doing what you just said.
If you as a, as as a healthcareprovider need that information
to provide the best care.
Nobody can block access to thatinformation, including patients.
So, so, uh, so that's, youknow, it's not part of hipaa.
(09:18):
It's, it is a later regulationthat was passed in 2022.
Uh, interesting.
Okay.
But, or went into effectin 2022 is passed in 2016.
But, but that's, that was my point, isthat it's like this is all about data
getting to, to people to provide care now.
HIPAA includes two rules becausewe, we don't want to just like.
(09:43):
Patient's information to go everywhere.
So there's a privacy rule and a securityrule that as we share information,
we keep it secure and private.
That's the only thing that any HIPAAtrainer I've ever TA heard talk
about in dentistry talks about.
Right.
All of us have HIPAA trainers cometo Yammer at us for a. Of the most
boring hours of our life every year.
Right?
To talk about about hipaa.
(10:05):
Uh, and I say that becausewe actually created a meeting
'cause I was so bored in hipaa.
We created a day called the Get It DoneDay, where I just would tell people, okay,
come in, get all your regulation stuffdone, and just make sure it doesn't suck.
Right?
Because most of this is like watchingpaint dry, but they don't even
talk about what the title means.
That's how bad it isin dentistry right now.
(10:26):
So, sorry.
It's a little bit of a soapbox,but No, it's fantastic.
And, and those of us, everybodyon this call are not alone.
The actual HIPAA trainers don'teven talk about the intent.
The original intent that's in the titleof the, of the regulation, because we
get mired down in these little detailsof like, oh my gosh, if I send an x-ray
(10:48):
and I, you know, and I take a screenshot.
So there's no, like, isthat patient information?
You know, it's like the, we get miredin these little details, uh, that, that
we forget the fact that the whole pointof this is that patients have access
to their data, that we as dentistscan get access to the information to
provide the level of care that we need.
We act like a new patient comes in andwe get a a, a print off of four bite
(11:10):
wings from six months ago, and we thinkthat we can provide the best level care.
Whereas when we have a dentist, when,when we have a patient in our practices
and they, they present with an issue,the first thing we do is we look at
the history of that tooth, right?
So,
Dr. Maggie Augustyn (11:25):
and, and so we do, we, we collect so much
data now, and back in the dayit was just paper charts, right?
And then there were impressions,and then maybe, maybe we took,
um, and we kept the stone models.
Maybe we didn't, right?
Today everything is digital.
The scans are digital.
Um, but then there's more.
There is, um.
There's phone calls and youcommunicate with the patient.
(11:49):
It's a record of an appointment.
It's not an appointment, but it's arecord of communication and, and giving
advice that is on that phone call.
There's, there's text messages.
Um, I. There's CT scans, there is,there's, there's lab information.
I mean, data about how you're treating apatient, how you're choosing to go, um,
(12:12):
in a certain direction is everywhere.
And the question is,you know, who owns that?
Who owns that data?
Who owns the scan?
That you take on a patient who ownsthe SDL file for, for the, you know,
(12:32):
um, uh, for the implant surgical guide.
Uh, who, who owns?
Any of that, can the patient request that?
And I, I, I heard you record a, apodcast a, about, um, the projects that
you're working on, and your desire isfor the patient to be able to get this
(12:57):
information and to take it from dentist.
To dentists right?
From provider to provider, because howincredible would life be to, for them
to be able to take a, a, a file of theirlast crown, um, or even to have a scan of
their last crown available for us to see?
And gosh, what did that prep look like?
(13:20):
You know, if we have to replace a crownon that patient, what was that prep like?
Why did that crown come up?
You know, the, there's a lot ofinformation that could be available
to us at our fingertips as we'retreatment planning This patient.
Yeah.
All that data.
Who, who owns the SDL files?
Dr. Bryan Laskin (13:39):
I mean, the, so when we're talk about STL files,
it is a little nuanced because, youknow, and, and I should start off by
saying when we answer these questions,uh, how we answer them is important.
Right.
If, if, if I just tell youmy opinion, it's my opinion.
If I codify it into.
Our application, then it'sproprietary information that
(14:00):
nobody else can get access to.
And we're just another problem, frankly.
Right.
So what we've decided to do is gothrough the open forum of standard
development, which means that you goassemble people in the room who, who
hopefully know what they're talking about.
And we discuss this andwe come up with answers.
Not saying we're right, but atleast it's an open form that
anybody can give insight into.
(14:20):
And then there's a voting processand then that gets published and we
develop standards and we actually.
One of the things we talked about, uh,Maggie, is exactly what you talked about
when it comes to an STL file, what ispart of the electronic dental record?
Because the electronic dentalrecord is owned by the patient.
You know, there's no disputingthat that's the patient's data,
(14:40):
and we as dentists have rights andresponsibilities associated with
that electronic dental record.
Mm-hmm.
So what we came up with, I happen to agreewith, but we could always go back and
have more discussion about it, is thatthat prep tooth that you mentioned, that
scan is actually property of the patient.
It's a, it's the scanof the patient's tooth.
(15:00):
However, the restoration that getsdesigned is not property of the patient.
So the dentist.
Can have that in themiddle of the laboratory.
Right.
But that does not need to be part ofthe electronic dental record because
what you've done then is you've actuallycreated something new based on this STL
Dr. Maggie Augustyn (15:17):
file.
That's like your artwork.
Dr. Bryan Laskin (15:19):
Yeah.
Yeah.
And so that you as a dentist don't need togive patients their, their crown design.
But you know, legally, ethically, andnot morally, I would say you do have
to give them access to their prepped.
And this, this isn't piein the sky technology.
Someday you can do, we've actuallybuilt this out so that there is a mobile
(15:42):
application for patients to download andyou can actually export and import, and
in many cases, automate this workflow.
So what we're trying todo is basically help.
These companies that aren't complying withthe, with the regulations and the, and the
way the world works where patients haveaccess to the data to be able to make it
(16:02):
easy for them to plug in and give patientsaccess and, and dental practices access.
Regan Robertson (16:08):
I, Brian, I've been asking for this for 27 years, so I
was in, I was around a group of reallywhat would be like an incubator,
startup kind of tech world, um,what we would call it to that today.
And, and that was a problem that gotkicked around as something to solve.
I figured by now, 27years later, it would be.
(16:29):
It would be completely resolved,and I'm shocked to hear why not.
Um, but also in a ignorant sortof way, you just kinda make
me like the light bulb go on.
Is this why it can take so long whenyou request your medical records?
Like, to me it's, it, it would be easy.
You've got a file, you've gotmy, my information in there in a
week, you know, I would expect toget it and that's not the case.
(16:51):
Or at least it hasn't been been for me.
So is that, is that part of thatIt's not sure what to exactly give,
there's no standard for it and maybefragmented systems on how it's stored?
I mean, I just, I guess I justexpected after that, anytime that
we would be beyond this problem.
Dr. Bryan Laskin (17:09):
You mentioned me are, are you talking about the
medical record or general record?
Yeah.
Well,
Regan Robertson (17:12):
medical, yeah, medical records specifically comes
to mind, but just in general, whenyou request records, I guess I would
imagine it in most practices to besomething that would be electronic and
instantaneous, and in some cases itis, but then in other cases it is not.
Dr. Bryan Laskin (17:26):
Yeah, I think, you know, medical, I like to say
medicine and dentistry are messedup in different ways, right?
And, and, and because I'm, I talkwith a lot of, in fact, that's
gonna be a big focus in my folk.
My, my, uh, podcast going forwardis we bring on physicians to
talk about this because, uh, as.
Right now there's a big, it's calledMDI, medical Dental Integration,
(17:47):
or Medical Dental Connection,and it's called different things.
But there's a big push withindentistry to to work more closely
with our medical colleagues,which I totally agree with Me too.
But we need to do it ina meaningful way, right?
Because they're messed up, right?
We're messed up, butthey're also messed up.
And if we take our industryand put it on the medical.
Machine.
It's not gonna go go.
(18:08):
It's not gonna go well for dentalpatients, dental practices.
This could be, I mean, uh, we ha wehave to do this meaningfully in my mind.
So let's talk about whatthose differences are.
And so when we're talking aboutthe medical record access by
patients and the dental recordaccess, it's two different worlds.
They've been working on medicalinteroperability or data exchange.
For the last 20 years, and there's allsorts of problems with it regionality.
(18:32):
There's massive companies likeEpic and Oracle that are fighting
battles and all sorts of stuffgoing on that lead to the problems
that you're discussing, which hold
Dr. Chad Johnson (18:41):
up, those aren't even medical companies proper, right?
I mean, those are just data companies.
Correct.
Dr. Bryan Laskin (18:49):
Those are software companies Yep.
That, that have data.
You're right.
Yep.
Which, which is its own problem.
Right.
Meanwhile, on the dental side,nobody's done anything except for
us for the last three years, right?
Uh, and not, these aren'tsoftware companies.
These are typically distributioncompanies or some company
that bought another company.
It's a PE group that just bought asoftware company and is, doesn't even
(19:12):
know how to do, innovate and do anything.
So all they're trying to do is milkthis cash cow until it dies, right?
Two totally different, twototally different problems, but
at the end result is Im patient.
You're getting hose in both instances.
I would argue today, worse on thedental side, but it's so much easier
to fix because nobody's done anything.
(19:34):
So what we've tried to do is come in,write standards, learning from the medical
mistakes, second mouse gets the cheese andcreate technology that can, we can solve
the problem holistically in dentistry.
Then we can actually apply to medicineand help solve some of their problems too.
That's, that's in a nutshell, that'swhat the mission for Tooth APS is.
Regan Robertson (19:54):
Brian, what fuels your passion for this?
Why does this matter to you otherthan it's a fun problem to solve?
Dr. Bryan Laskin (20:01):
I've been called an impact junkie, and so
I, the bigger impact, the better.
The harder the problem, the more I likeit, and if it involves a fight, then
I'm really down and this checked allthe boxes for me, so I, it's something
I could not, I. Go away from, right?
Mm-hmm.
Then we're fighting against somethings that I just think are
philosophically wrong, frankly.
(20:22):
You know, I, I sold my dental practicesafter 20 years of 25% year over year
growth was the, was the, was the least.
We grew, I sold my software, my lasttechnology partner company, and so I
was like, when I was looking at thisproblem, I, I literally thought, what's
the biggest problem I can help solve?
I'm in a unique position to solve,and then I couldn't think of
anybody else that would do it.
(20:43):
Frankly, that's why I'mreally passionate about it.
I don't know.
I mean, now there might be, but,but back three years ago, I don't, I
couldn't think of anybody else that wasactually gonna work on this problem.
Mm-hmm.
That's, that's, that's whyI'm passionate about it.
Regan Robertson (20:55):
So let's talk, go.
Go ahead.
I was just gonna ask, what isthe, the biggest, uh, frustration
that you've hit your head againstthe wall in this particular, um,
quest that you've undertaken?
You're gonna get
Dr. Bryan Laskin (21:08):
me, I get, I'm gonna get, I'm gonna get mad talking
about that, but, uh, the best you, uh,I'll, I'll, so I can't just pick one.
The biggest one is software vendorswho just want to just clearly violating
the information blocking rule.
And, and, and every time you say no togiving one instance of data, there's
(21:32):
a fine of up to a million dollars.
So we're talking software companiesthat could have paid half a billion
dollar or a billion dollars of finesto the federal government, and that's
happening to me on a weekly basis.
The other instance is dental practices.
When I talk to them and they say,Brian, we don't want to give patients
their treatment plans because then theymight go somewhere else, and I think.
(21:54):
Do you suck so bad at your job thatyou think they're gonna go somewhere
else if you actually tell patientswhat you are planning to do for them?
And, uh, I don't know which isworse, but I hear, I literally,
every week I hear both.
And so that's been my biggest frustration.
Regan Robertson (22:10):
I appreciate you sharing that because I really, I mean, I
genuinely was super, super curious aboutthat and I'm glad you brought it up.
You know, Dennis being afraid or fearfulto give away that information, and I've
requested my own records in the past,um, dental, medical, otherwise I'll
leave it anonymous, but, um, I could tellin the response back to me, it's not.
(22:32):
They never said no, but it was, well, why?
And it was just a really curious,but also tinged with that,
are you leaving me feeling?
Mm-hmm.
And, and I thought, ohgosh, no, of course not.
But there was that human element to it.
Um, but I didn't think youwere, you, you have to, right?
You have to legally give someonetheir information if they ask for it.
Dr. Bryan Laskin (22:50):
You don't have to, but there, but there
are consequences if you do.
Okay.
Okay.
Well said.
Well said.
Yeah.
Yeah.
You know, it's that becauseI, the reason I say, people
say, well, where are the flow?
What, what, where are the fines?
I said, they say, well, I don't thinkI wanted, I'm gonna, I'm gonna do this.
I go, that's fine.
You can steal a car.
As long as nobody comes after you, youknow, you, you didn't get in trouble.
Doesn't mean it wasn't illegal.
(23:11):
Right?
Yeah.
Uh, the.
And, and one of my favorite quotes is by,uh, Rick Rubin, the music producer who
says The best art divides the audience.
When I talk about this, oneof two things happens, right?
Dentists come up to me, theygo, oh, thank you so much.
My aunt just had a knee replacementand we couldn't figure out that.
We couldn't get her records to go see.
(23:32):
And they understand theproblem in healthcare.
They see it from the patient'sperspective, or they start saying,
what are you talking about?
My software platform?
My practice management software, peoplecould leave me and go to another one.
To which I say, youhave 1% of the industry.
Are you worried about losing your1% or getting part of the other 99?
And very often, clearly the answeris they're worried about losing their
(23:54):
1% 'cause their software is so bad.
And so, you know, that'skind of what's going on.
The, uh, there's not, nobody goes this.
Nobody feels well.
Okay, this is kind of going on.
It, it definitely divides the audiencewhen you tell them that patients should
have access to their data for sure.
Mm.
Dr. Maggie Augustyn (24:12):
Let, let's talk about a fight and let's talk about
fueling that fire, because recentlywhen you and I met I, um, there's a fire
in me and there's still a fire in me.
And, um.
I, I had a relationship with acompany that was working with
our phones and I, and I startedthis relationship in 2017, 2016.
(24:39):
And it, it was a great solution.
Um, it was a way for us to get ourphones connected to Eaglesoft and, um.
You know, the calls were recorded, wecould go back and we can listen to them.
There was a lot of information there.
Um, and, and it, and it was a reallygreat solution and we were in a
(25:00):
relationship with them up until this year.
But then there came other companiesonto the market that provided a
similar system, and I wanted toinvestigate that because they, they
had a different way of communicatingwith some of the other, um, uh.
Technologies that we were using inthe office and they were also less
(25:24):
expensive, but I could not get outof my relationship with this company.
Um, and they, they, they rhyme withsleeve, um, or yeah, sleeve or sleeves
or what, what, whatever you have, right?
And, um, that was bad, but, butlet's leave it in there, uh, because.
(25:48):
They, they refuse to give me my data.
Um, yes, you can leave, but there's noway for us to give you to, there's no way
for us to give you the call recordings orthe text messages or anything like that.
You, you could leave, but youcould leave without your data
and, and I stayed because.
(26:09):
I, I really wanted to hangonto those call recordings.
There's a lot of information there.
There's the mood of the patient.
There is the threats of I'm going to, youknow, Sue, you there, there, there's a
lot of information on there that I didn'twant to lose that I felt was in some way
protecting me until finally this year.
Um.
(26:30):
I went to them and I, and I hadtalked to you and, and they said,
we will give you your information,including your call recordings.
Um, but every time I would talk toa representative of this company,
every other sentence, maybe notsentence, but paragraph, was,
could you please stay with us?
(26:51):
Even after my very, very longmonologues of there is nothing.
In this world that you could do to keepme because of the unethical practices that
you have been, you know, because of theway that you have interacted with me for
the last almost 10 years, I just don't,I don't work with companies like yours,
(27:14):
and so through this very, very long.
Process of separating myself with them andthem promising to give me back my data.
Unfortunately, I was always ontheir Zoom call, so none of this was
recorded other than, you know, metaking some notes, uh, or my office
(27:35):
manager having a recollection of this.
Uh, we ended up signing a contract withMango to, to move into their services.
And then finally, when it came time to,to sever our relationship, they said,
we can't give you your recorded calls.
Um, and, and I said, what do you mean?
But you, but you said that you would.
(27:56):
And they said, yeah, no,you must have misheard that.
So I ended up posting something onsocial media presenting this information,
um, and they, they posted on socialmedia, don't wor don't, don't worry.
We'll take care of you.
And they ended up sending meanother email saying We will
give you your recorded data.
(28:18):
And I ended up talking to an attorney.
And, uh, trying to figure out whetheror not I can get my recorded data
and, and kind of went back and forthto, to find out that, um, that it's
probably the only way for me to dothat is through a lawsuit that would
probably cost me anything, anywhere.
Bet up up to a million dollars.
(28:41):
Um.
And as soon as we kind of made any moremovement after that email where they said
that they would give me my recorded dataonce more, they, they came back, um, and
they gave me a link to download the data.
Of course, there were norecorded calls on that data.
And then, you know, again, Isaid, can I have my recorded data?
(29:03):
And then they said, that is unfeasible.
And then I said, but thisis information blocking.
And they said, it's not informationblocking if it is not feasible.
I talked to another company thatdoes the exact same thing, which
is PBM Practice by numbers.
They do exact same thing.
They record calls, they offerphones, and I said, do you release?
(29:26):
Recorded calls to the clientsthat are leaving your company.
She said, absolutely.
That's, uh, Aditi Al, who's also adentist that invented that company.
I absolutely release data.
I said, how hard is it?
It's not hard at all.
You go on the server, you hirean engineer to, to get your
data, and we release that to you.
And so it, it's made me extremely angry.
(29:49):
But, but, but the entire timethey kept offering, please,
will you stay with sleeve?
You can keep, you can keep yourdata for a monthly fee of this much.
We just can't.
It is unfeasible for us to release thisdata from me, which bottles my mind.
(30:11):
How is it possible for you to notbe able to, to give me a recording?
I mean, at first it was like,oh, the data's too large.
What I mean, what world do you live in?
That data is too largefor you to transfer.
Dr. Chad Johnson (30:25):
Right.
Dr. Maggie Augustyn (30:25):
Have you not heard of Dropbox?
I mean, and so, um, so, so, soI was given a choice, right?
To stay with sleeve and pay a monthlypayment to get ahold of my data, which
my integrity just prevents me from givingthem a single penny, um, to, to possibly.
(30:47):
Soothe them and go and, and take awhole bunch of my retirement savings
and, and try and wrestle that awayfrom them or to walk away, um, with
this fire that's still burning thisincredible anger at this unethical
company that, that does this to me.
And they have done it to many, many, manydentists because I've heard from many
(31:12):
dentists that they have done this to, um.
I don't know what the solution here isbecause this company goes to dentists
and just flat out lies about what theycan have and, and what they're willing to
give on the back end as they're severingthe relationship as they did to me.
Dr. Bryan Laskin (31:33):
Yeah, I, I, uh.
I do know what the solution is.
I, I mean, and we'reworking on the solution.
We're working on a, we're developinga coalition of software vendors that
believe in open data and dentistry.
We're going, doing a conveningthis summer in Washington to
push for some certain things.
Getting, you know, high onmy mind is getting patients
access to their data 'cause.
(31:54):
Like you mentioned, the, the recordings,I don't know, depending on the
recordings, if, if that's part ofthe electronic dental record or not.
Certainly some of those text messagemessages probably are, uh, I would
argue that it's the patient'sdata and patients should have
access to it, and unless they're.
Delivering that through a secure mobileapplication, which they're probably not.
Those, all the companies who are,who believe in open access don't even
(32:16):
fully understand what that means.
Right.
So we're putting together a coalitionto kind of educate the industry and,
and we're gonna be coming out withcertifications and things to kind
of like, so that, 'cause right now.
Let's face it, the, the, the,the software landscape is in,
dentistry is the wild West.
It's just lawlessness completely.
(32:37):
And we are like a weird, in the weirdposition of being a disruptor by trying
to lay laws down versus break them.
Right?
We are trying to like, createstandards and, and laws that.
By all accounts should already be inplace, but nobody's following them.
So it kind of puts us in a weird positionto be the sheriff in town and trying to
(33:00):
get these behemoths who, I mean, thereare some massive companies that are
just illegally stealing and resellingdata and what no dentist says when they
sign up for a phone system, a patientengagement solution, they don't ask how
do you get the patient's information?
Nobody asked that because nobodyeven knows about the problem of, of
(33:22):
companies hacking into integratorsillegally stealing the patient's
information and reselling it.
Uh, so there's, there's so many I. Wecould go deep into a, in, in a nerdom
of like a, a wizard, wizarding world oflawlessness, of nerdom that, uh, that,
that probably would put people to sleep.
But the reality, tell me about me.
Dr. Chad Johnson (33:43):
Hold on.
Um, our, our dentists implicitly gettingdata that has been procured illegally.
Oh,
Dr. Bryan Laskin (33:51):
a hundred percent.
Yes.
There's companies out there doingthat right now, and they have big.
Booth trade shows, and nobody asks,oh gee, are you actually, how are
you obtaining this information?
Right, because you have to,
Dr. Maggie Augustyn (34:03):
you have to provide other patients.
Dr. Bryan Laskin (34:05):
Could you
Dr. Maggie Augustyn (34:06):
explain that?
Because I, I don't even, yeah,
Dr. Bryan Laskin (34:08):
so here's, here's the common practice of how.
The average technology company integrateswith the practice management software.
Okay.
There's a couple different ways.
One is you can go to the company andsay, Hey, I wanna integrate with your,
with your practice management software.
And then they say, great, here'sour API that you can plug into.
And they then they chargeyour company for that.
(34:29):
Okay?
The X amount or whatever, and, and.
Most of them don't ask thequestion, do you have a medical nece
necessity to have that information?
They just say, how muchdo you wanna pay us?
And, and the more you pay us,the more information you get.
That's it.
So that's, that's, that's the mostlawful way that tends to be going on now.
(34:50):
Then there's companies that are like,well, this is a, or, and, and by the
way, these are large companies and ifyou're a small technology company, they
probably, you don't, probably will,won't pay them enough for them to even.
Talk to you right.
Then on the other side, becausethere's a bunch of companies that they
won't talk to, the companies have,have, have sprung up that say they
built their own roads who'll get intothe practice management data, pull
(35:14):
it out and resell it to companies.
And nobody talks about this in dentistry.
Uh, you know who, uh, but, butthat's kind of what's going on.
So it's either, uh, uh, knowingand, uh, and unknowingly illegally
blocking information or it's.
Getting it in sketchy formats andreselling it and what we're trying
(35:35):
to do, because every, if you.
When you plug into thesesystems, everyone's unique.
You know, if you look at somethinglike Dentrix that's had hype,
God knows how many iterations.
That alone probably has 10 differentconnectors for the 10 different versions
of it, of that have been throughoutthe years of, of Dentrix, right?
So if you're a small developer to getto integrate with people's practice
(35:56):
management software, you have to build15, 20, 30 connectors that all suck.
By the way, these are all.
Bad connections that don't comply withthat, that, that, that aren't very good,
and that you have to, as a small company,a big part of your job is connecting
to these piles of garbage, right?
Mm-hmm.
What we're trying to do is replace allof that with a standard called API or
(36:17):
programmic in interface for any companythat that needs to have the information
that can show, they have the inform,they need to have the information
to plug in and get it with a singleconnection for all of dentistry, right?
And so.
It's not directly what the, uh, the,the sleeve company, but it, but, but
it, but it's, but it, but if they hadadhered to the standards and regulations
(36:42):
that are, you know, some are mandatedby the federal government for all of
health healthcare in including dentistry.
And some are new ones and someare just ones that we should do
because it kind of makes sense.
Right.
Um, and what's been the
Dr. Maggie Augustyn (36:55):
response?
Dr. Bryan Laskin (36:57):
It depends who you talk to, right?
I mean, software vendors thinkit's great, but they're kind of
are like, can you actually do this?
And because we're, we haven't solvedevery prob problem, but what I can
tell you is we're the only one reallysolving the problem in, in this way.
So we have, I. Made a ton of progress.
Nobody, I hadn't heard the terminteroperability in dentistry.
(37:19):
And when I started is when I wrote abook about it, uh, three years ago.
Right?
But now, now it's becoming a thing.
You know, we're great peoplelike you recognize the problem.
Have me on the podcasttalking about it sort.
We're spreading the worddoing convening in Washington.
We're putting pressure.
Our next step as a company is we'regonna go directly to patients.
So patients are gonna be able to requesttheir records di directly, and then
(37:43):
dental, then dentists will get, they'llget educated pretty quick when you get
a, when you get 10 patients request theirrecords through a mobile application.
Right.
You'll probably figurethis out pretty fast.
So that's what we're doing as a companyto try to move the tide, uh, you know,
standards and regulation, talking todentists, uh, you know, through the
podcast, through books, whatever.
And then, uh, and then.
(38:04):
Than going to, going directly to patient.
And, uh, there's large companiesthat, you know, one of the large
PMS vendors has a list approvedapproval pending unauthorized
slash dangerous on their website.
Okay.
And I, and so I, I bet you can guess.
(38:25):
What gets you on the dangerous listand how you go to be authorized?
There's one criteria, it involvesa pen and a check, right?
So I mean, so companies who are onthe danger list are calling me up
going, we need to solve this problem'cause they're on the danger list
because they don't want to pay it.
Right?
So we are having momentum, uh,but you know, I'm an impatient
(38:48):
guy, so I want it to go faster.
Hmm.
Regan Robertson (38:53):
Have you had difficulty yourself?
Is that, is that part of thereason other than it being a great
injustice and, uh, and being avery enticing problem to solve?
Dr. Bryan Laskin (39:04):
Yeah.
That's how I identified this problemis was, um, through scaling the patient
engagement solution, had talking to thePMS vendors, uh, it was just, I mean.
Problematic, but we were able tosolve for it in most instances.
But, but you know, when I sold thatplatform, and even before I was
(39:25):
sold that I was trying to think oflike, what's the next big challenge?
And I was like, this is just a mess.
Right?
Uh, so I have had experience, uh,uh, from, from the perspective
of a technology developer.
Also, I'm involved in alot of different startups.
I'm, you know, I, I am apart of about 15 different
technology startups in dentistry.
And so if you're gonna be doing something.
(39:46):
In dentistry, and you want, this is abig problem for every company that's
trying to solve problems in dentistryand not, not everyone, you know, if
you're creating the next generation ofcomposite, you don't need to have access
to the patient's information necessarily.
But, uh, but for, but for, youknow, if you're an AI company,
if you're, you know, doing.
(40:07):
Anything that's a data shining patient.
Yeah.
Data, any, any research.
Right.
This is, it's a big deal.
And so, uh, so yeah, that's a longanswer to your short question.
Regan Robertson (40:17):
It, but it feels like a volcano.
No, you answered it great.
It feels like a volcano that'ssitting somewhat dormant.
And, and think back to like thehousing crisis in 2008, you know?
Right.
Leading up to that.
The big surge.
The big wave, the lava, whatever.
Metaphor you wanna share?
I remember being approved for an enormousmortgage, and I think I was making like,
(40:37):
I don't know, it was like 11 bucks anhour, something crazy small and thinking
how this doesn't, like, even on on themost basic level, make financial sense,
like why am I getting approved for that?
But everybody was doing it and I cansee how this sort of lawlessness or
maybe the lack of attention from lawon these things, how this happens
(40:58):
if I am a dentist, since I've got.
Three dentists here.
Uh, what is the first step thata, that a dentist needs to take?
Because likely there's a level ofignorance of not being fully aware
other than experiencing it likeyourself and the frustration from it.
Um, where does one start?
Dr. Bryan Laskin (41:16):
I'm, I'm a little biased, right?
Obviously a little right.
Yeah.
So I, I would say making sure yourpatients can get access through
their, to their data througha secure mobile application.
Because here's, here's the reality isthat that's where your liability lies.
The, the what, what, what happened.
Because if a patient requeststheir records, and you cannot give
(41:37):
it to them through a secure, ifthey say, I'd like my, you know.
Again, it's only if thepatient complains, right?
But if they know their rights,which is that if they request their.
Through a secure mobile application,you need to be able to deliver
that in a machine readable format.
Again, there's, there's alot of detail here, right?
(41:58):
So, uh, uh, I would, you know, and bythe way, the patient doesn't care that
it's the practice management system.
That's the problem.
They're gonna come to you and specificallythe person behind the front desk that's
overwhelmed complaining about this.
Right?
And so that's where I would startmaking sure that my patients aren't
(42:18):
going to be pissed, that I can'tgive them their information when
they start learning about this.
Dr. Maggie Augustyn (42:24):
So are you saying that the data that they request
has to be them, has to be, that ithas to be requested via an app, or
it has to be delivered via an app?
Dr. Bryan Laskin (42:35):
It has to be delivered in the format that the patient wants,
including a secure mobile application.
So if they say, I want to have a bunchof PDFs printed off and a thousand
pieces of paper, which they won'tright, then, then that's, then, then
you have to deliver it in that form.
And I, that you probably could just dois through a secure mobile application.
(42:58):
But, but it specifically states, uh,let me, let me, let me describe why
I. The reason why this, the 20, the21st Century Cures Act, which includes
the information blocking rule cameto be patients were looking to, you
know, to get their medical records.
And physicians said, well, we can't do it.
(43:19):
They're all locked up in Epic.
And, and Epic said, well, toobad we're not covered under
hipaa, which they were, right?
So the federal government wrote.
A piece of legislation, the 21stCentury Cures Act to fix that issue
such that that is why MyChart exists.
If you know the product MyChart,MyChart was not created because
(43:42):
Epic loves people and wants them tohave access to their data, epic was,
or MyChart was created because thefederal government forced them to.
The problem is nobody's beenpaying attention in dentistry.
We have the same mandates to have aMyChart, and that's what we've built.
Uh, it's now called Care, CAIR.
(44:03):
Uh, we're rebranding it, uh, that, that,uh, is going, that the way that patients
get access to their data and then patientscan, but the, but the reality is, is that
this really isn't about the stick, right?
It's not about the it.
You know, if you've used MyChart orif you've used these records, you're
gonna be way more informed as a patient.
(44:24):
And I think it's gonna be thebiggest increase in case acceptance
since the interval camera.
When patients can see their intervalphotos, they can see they can get
third party financing, do onlinescheduling all through a secure mobile
application, they can message you, youknow, instead of that being through
a phone system, it'll be through.
The secure mobile application.
And by the way, it doesn't matter whichsystems you're using, if you use like
(44:46):
a Mango voice, they're a partner ofours, you can do your text messaging
and it can show up in our, in ourplatform securely, stuff like that.
So that's, that's where I, I wouldstart, is making sure, because
that's where you're likely to get
dinged as a, as a practice, isif a patient says, I'd like my
(45:07):
complete records, making sure thatyou can actually deliver that.
Dr. Maggie Augustyn (45:12):
Except you can no longer start writing.
Patient was a complete jerk,was totally disrespectful.
Like you, you can't put thatin a patient chart anymore.
Sure you can.
And
Dr. Bryan Laskin (45:21):
not in the progress.
No, no, you can.
I wouldn't do it.
But eh, you know, if the patient's,then you're just telling the truth.
Right?
Dr. Chad Johnson (45:29):
But darn right.
Yeah.
Regan Robertson (45:30):
I, I'm seeing the, I understand now the B2C connection, why
you wanna go straight to the patient andempower the patient to drive the change.
Uh, your episode, I think your podcastcalled Patient First Podcast, right?
And, uh, you have a recentepisode with Frank Lo.
I'm only like 15 minutes into theinterview, but it's incredible.
And Frank is talking, um,insurance and, and healthcare.
(45:52):
And, and there's so much about thatworld that I am not aware of myself,
that I feel, and I've asked, um,multiple like providers, I've been
like, it would be so cool, you know,if you had a, if you had a class on it
and, and you could help empower people.
But what if, like, follow me here.
What if we were able to take that kindof fear mindset of I don't want people
(46:13):
to leave and switch it around so thatit's an empowerment, like, because you
are with me, you get this access, Ihave put in the work for you because
you know why we are in this together.
Like, to me, that's true advocacy.
Like I think of myhealthcare people as my team.
I, you know, I have a chiropractor.
I, I had a therapist for a long time.
I have my medical doctor.
(46:34):
I have my dentist like that.
They should all be talking.
Maybe it's all about me.
Maybe that's a selfish thing, but,but shouldn't they all be talking
because there's, there's riskfactors and things that, that some
practitioners look at that others aren't.
It's just, it just makes sense.
And, and so for me, I wouldfeel empowered as a patient and
I know where I would be going.
(46:55):
If, if we can take down thesesilos, I would feel like my
health really does matter.
Dr. Bryan Laskin (47:02):
Yeah.
And, and that's what, that'swhat we're focused on, right?
You can't do every, Rome wasn't builtin a day, but I do believe oral health
is the gateway to overall health.
And so I think it makessense for us to, to go there.
Yeah, absolutely.
Dr. Maggie Augustyn (47:13):
As unexciting as HIPAA is the idea that we could
have something similar to to MyChartfor our patients and our ability to
communicate with them would be safeand protected and under our control as
opposed to the control of whatever whim.
The company that we're working with andwhomever, you know, and then there's the
(47:35):
idea of who owns this company today andwhat whim, you know, what whim and what
mood are they in to release those, thoserecords or the reigns or control onto us.
Um,
Dr. Bryan Laskin (47:51):
well, I, I, I, let me interrupt you there if you don't mind.
'cause it's not an idea, it's reality.
We've already done it.
It's called care.
Uh, and it's not.
It's not who it, you know, obviously I'm,I'm a co-owner, so I'm 50% of the company.
It's not a private equity group.
You know, my co-founder andI have in multiple exits.
This is self-funded, so we'renot looking to get another round
and jack up the prices on people.
(48:13):
Right.
Uh, which is kind of what all thosecompanies are doing right now.
And estimate
Regan Robertson (48:17):
quality.
Dr. Bryan Laskin (48:18):
Yeah.
And, and, and, and we actually have,how this information is handled is all.
Public is part of the standardsthat we've written, right?
The one how patients getaccess through dental.
Dental records are called Thor Trans.
It's called Thor, transferableHolistic Oral Records.
How we manage dentistry, uh, withindentistry is called Odin, the Oral
(48:38):
Data Interoperability Network.
I'm based in Minnesota, like you said.
So we like our north.
There you go.
So, so here we have onecoming up right now.
So we're, we're, you know, if youwanna get involved, let me hit me up.
You know, we're working right now, I'mmapping and filtering medical histories.
'cause you look at the medicalhistory in your practice management
software, it makes no sense.
So what we're doing is we're takingthe medical, medical history and then.
(49:00):
Doing what they do in medicine isthey actually take that comprehensive
medical record and then look at whatare you doing as a provider and then
having you work with that medicalhistory for the patient so it's not
onerous for you or overwhelming.
And so that's what we'redoing for dentistry.
So instead of just having a radiobutton about allergies, if you're.
Sedating patients in your practice, he'llfollow the same levels of medical history.
(49:22):
Uh uh.
So, so I'm going down to the rabbithole, but that one's called hild.
It's another, it's anothernorth theme, right?
So if you wanna get involved then withstandard development or open data,
uh, I'm the right guy to reach out to.
Dr. Chad Johnson (49:36):
Hmm.
That PMS that I use has ahealth history question.
Venereal disease, yes or no.
And I'm like, who calls it that anymore?
I, it's just like, I'mjust, but I can't change it.
It's just, it's just like, nope.
That's what we call it, you know, whenwe made it and we're not changing it.
And that's what's it's gonna say.
(49:57):
And you can't, you know,keep things updated.
It's so frustrating.
What do you do?
Dr. Bryan Laskin (50:03):
Yeah.
And so what we're trying to do is.
Develop, get the right people in the roomto develop a medical history that, you
know, nothing's perfect, but at leastthat's published, that people had a public
form that they could give feedback to,and then we can adjust it as necessary.
Yes.
Dr. Maggie Augustyn (50:22):
Brian, every time I talk to you or see you, I am just
in awe of everything that you are.
I, I don't know how your brain works.
It, it makes my brain hurt, but I'm reallyglad that your brain works this way.
Mm-hmm.
Um, I just want to offer youa heartfelt thank you for, um.
For making this world spinin the right direction.
(50:44):
Um,
Dr. Bryan Laskin (50:45):
well, right.
You're, you're doing amazing things too.
And so it's Right.
You know, the respect is mutualand, and, uh, and so thank you.
Thank you very much.
I.
Dr. Maggie Augustyn (50:54):
Thank you for joining us today.
Thank you for this, uh, incredibleamount of knowledge and I mean, I, I
think we are all looking forward to thefuture that you are helping us create.
Uh, check out tooth apps and, uh, let,let's see what the next two, three
years will bring for our patients.
Dr. Bryan Laskin (51:15):
Appreciate it.
Thank you very much,
Dr. Chad Johnson (51:16):
Dr. Maggie.
In conclusion, I wrote apoem while we were in this.
It's only three lines.
We do rhyme with sleeve, but you cannotretrieve your patient data when you leave
the end.
Dr. Maggie Augustyn (51:34):
That's lovely.
Dr. Bryan Laskin (51:37):
I love, I love how you weaved all that together.
It was pretty good.
Dr. Chad Johnson (51:41):
No, you didn't.
What.
Regan Robertson (51:50):
Thank you everyone.
I'm gonna hit stop.
Popular Podcasts
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
The Clay Travis and Buck Sexton Show
The Clay Travis and Buck Sexton Show. Clay Travis and Buck Sexton tackle the biggest stories in news, politics and current events with intelligence and humor. From the border crisis, to the madness of cancel culture and far-left missteps, Clay and Buck guide listeners through the latest headlines and hot topics with fun and entertaining conversations and opinions.
The Charlie Kirk Show
Charlie is America's hardest working grassroots activist who has your inside scoop on the biggest news of the day and what's really going on behind the headlines. The founder of Turning Point USA and one of social media's most engaged personalities, Charlie is on the front lines of America’s culture war, mobilizing hundreds of thousands of students on over 3,500 college and high school campuses across the country, bringing you your daily dose of clarity in a sea of chaos all from his signature no-holds-barred, unapologetically conservative, freedom-loving point of view. You can also watch Charlie Kirk on Salem News Channel