Who Really Owns Your Dental Data? (E.288)

“What if your software vendor is holding your patient records hostage—and you didn’t even know it?” ~Dr. Bryan Laskin

In this explosive episode, Regan Robertson, Dr. Maggie Augustyn, and Dr. Chad Johnson sit down with tech visionary and dentist Dr. Bryan Laskin to unpack one of dentistry’s most urgent but ignored threats: data access, ownership, and abuse.

What starts as a conversation on HIPAA quickly escalates into a systemic unraveling of how most practice management systems violate the spirit of patient rights—and what that means for the future of dentistry.

You’ll learn:

• Why dental software is stuck in the 1990s—and who benefits from keeping it that way
• How the CURES Act changed the game (but most dentists don’t even know it)
• The legal difference between a tooth scan and a crown design
• What “information blocking” means—and how your practice might be doing it illegally
• How vendors use access fees and obfuscation to profit off your patient relationships
• The dangers of staying silent—and the movement that’s fighting back

From the ethics of interoperability to lawsuits over access, this episode gives you the tools, questions, and next steps to take control of your patient data and protect your practice from hidden threats.

Key Reflection Questions for Listeners:

• Could I give a patient their complete records today—quickly and securely?
• Am I unknowingly violating HIPAA or the CURES Act?
• Is my current software partner helping or hurting my ability to grow and protect my patients?

Listen now to reclaim ownership of your practice—and your future.

TRANSCRIPT

[00:00:00] Dr. Maggie Augustyn: Hi listeners. This is Maggie Augustyn, along with your co-host Regan Robertson and Chad Johnson on Everyday Practices Dental Podcasts. We are here and we are hosting a very special guest, someone that I admire greatly and have the honor of introducing to you, Dr. Brian Laskin, who is an eternal entrepreneur. Um, he is a Minnesota-based dentist whose mind just does not stop. He is an innovator, um, and he is an entrepreneur. He is a genius and he knows a lot about technology and how technology applies in the area of dentistry, but more so he is fascinated with data. Um, he’s fascinated with the protection of data. He understands who owns data in, in the space of dentistry. I could go on about all of his inventions. We’d probably spend half the podcast talking about that. Currently he is in the role of, um owning, I believe he is the CEO if I understand that correctly, of tooth apps, which I would like for him to talk a little bit more about throughout this podcast but, uh, hello everybody. Um, and Dr. Laskin or, or Brian, tell me just a little bit more about who 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.

[00:01:51] Dr. Bryan Laskin: Well, thank you very much and thanks. I, I don’t wanna say anything ’cause there’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, starting off, I’m a dentist, right? Like you mentioned, I practiced dentistry for over 20 years. Did a lot with C/CAM, CT imaging as we were talking a little bit about, uh, but then I started developing technology of our own, and, and the first product we created was a patient engagement solution that 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 scaling the products called opera, DDS, uh. As we were scaling that recognized some fundamental flaws in how our technology is handled in dentistry. I don’t think it’s a controversial thing to say that technology and dentistry, particularly the, I’m, I’m not talking about the clinical technology, but the, the systems that run our practices are essentially archaic garbage, right, and there’s reasons why, the reasons I, you know, and I wrote a book about why that happens, but I, I saw it firsthand as I was developing technology in the space and what happens is that we have these systems that, uh, were typically developed by a software engineer in the eighties or nineties called practice management softwares that essentially tried to take a paper chart put it on a computer and then add some functions but essentially that’s all they do still to this day, and they’re all proprietary meaning that, you know, if you, if, if you have that information in there, there’s no way to get it out. And so what, what we’ve been working on for the last few years is developing a connecting, uh, connector that can connect to any system in dentistry. Then we’ve written standards through the a DA and through a organization that would help lead the creation of Dental Standards Institute to normalize data and then make it available to those people that that. So, uh, you know, at Opera DDS we had a very popular paperless forms product, and in the, the most popular practice management software, they wouldn’t let us write back to the medical history. Is we could not write back if somebody said that they had diabetes, we could not write it, write it back in the practice management software. Not because it wasn’t technically possible, because they made a business decision that their forms were so bad that the only way that they could sell them was by blocking other people out of their software, right, that put millions and millions of patients at risk. Okay. That’s why I’m focused on, that’s why I’ve been focused on this and if you, you know, we can unpeel this onion as much as you want today, but when you get down to it, the, the dental record information, the electronic dental record information is legally owned by patients and, and, us, we as dentists are stewards of this data, and we can’t even do our job as dentists to protect our patients because we don’t have access to this information, let alone patients having access to it. Now what we’ve done is we’ve built a whole bunch of features and stuff on top of the fact that we can get access and normalize this data, data analytics, new ways to do patient engagement, but at our core, what we’re doing is solving the problem of data access and interoperability, uh, connecting dentistry to medicine, connecting to different systems, and, uh, so that’s, that’s a little bit kind of how I got on this journey.

[00:05:26] Dr. Maggie Augustyn: 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 to share with you some of the issues that I was having, uh, with a company that I was working with, and I was trying to get out of a relationship with them and we’ll talk a little bit more about that later. But I had no idea that these were the things that we were dealing with, that I was dealing with within my practice, um, and, and that they were things that were going [00:06:00] unsolved. I also had forgotten, um, and was reminded of not too long ago really what HIPAA stood for, because I just understood HIPAA as being unable to disclose information about a patient. Right, but so, then I needed to speak to an attorney about this particular issue that I was having, and then I was reminded what HIPAA actually stood for. Chad, do you remember exactly what HIPAA stands for? I don’t mean to like put you in display. No,

[00:06:34] Dr. Chad Johnson: I’ll give it a go. Health Information Portability and Accountability Act.

[00:06:39] Dr. Maggie Augustyn: Yes,

[00:06:39] Dr. Chad Johnson: you’re the top 1% my friend, but there,

[00:06:42] Dr. Maggie Augustyn: but do you know what that means?

[00:06:45] Dr. Chad Johnson: Yes and no. I mean, it’s a, it’s a large volume of information and I think we boil it down to a one sheet synopsis for people to understand, 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 said, well, what about page 1,998? And they, and I’d be like, oh yeah, I don’t know that one. Ha ha caught you. You don’t actually know it. No, I don’t.

[00:07:15] Dr. Maggie Augustyn: Brian, take us home. What does, yeah, what does HIPAA mean?

[00:07:18] Dr. Bryan Laskin: So I, I totally hear where you’re coming from about the complexities, right? But we’re not, this is how bad this is to meaning. How, how much under our nose this pervasive problem has been that we’ve ignored. You don’t have to read HIPPA, you have to do exactly what you just did was read the what the acronym stands for health information, meaning information about your health. Portability, meaning it can go with you. Accountability act, right? So all we’re doing is can we get information to follow along with the patient, wherever that patient goes? That’s what the, that’s what it’s about now, according to their desires. Yeah. No, not just your desires, just what, regardless of what the patient wants, it goes around wherever the patient needs it to be. Patient should do anything.

[00:08:06] Dr. Chad Johnson: My only point being, you know, like before that, if one doctor said, “Hey. I want to, you know, like send this information over,” but then the patient said, “Whoa, whoa, whoa. That’s my uncle. You know, who’s that podiatrist and I didn’t tell you that you had permission to send that data over. I’m the one who owns that data,” and so this, the HIPPA, in one sense, reclaimed who was the owner of that information and who got to assign the portability accessibility.

[00:08:35] Dr. Bryan Laskin: Well, I’m, I’m, I’m not an attorney. Right. So,

[00:08:40] Dr. Chad Johnson: Yeah. No, I was just thinking so on tv.

[00:08:42] Dr. Bryan Laskin: Well, but I, so my next, my next sentence, you know, there, there, you know, you could be, there could, or we could have a disagree, we could have some disagreement about, however, what. What now? With, with HIPPA, you’re correct, but there’s another regulation that came later called the CURES Act, which has the information blocking rule, which actually bars patients from doing what you just said. If you as a, as as a healthcare provider need that information to provide the best care, nobody can block access to that information, including patients. So, so, uh, so that’s, you know, it’s not part of HIPPA. It’s, it is a later regulation that was passed in 2022. Uh, interesting. Okay, but, or went into effect in 2022 is passed in 2016. But, but that’s, that was my point, is that it’s like this is all about data getting to, to people to provide care now. HIPAA includes two rules because we, we don’t want to just like. Patient’s information to go everywhere. So there’s a privacy rule and a security rule that as we share information, we keep it secure and private. That’s the only thing that any HIPAA trainer I’ve ever taught heard talk about in dentistry talks about. Right. All of us have HIPAA trainers come to Yammer at us for of the most boring hours of our life every year. Right? To talk about about hipaa. Uh, and I say that because we actually created a meeting ’cause I was so bored in HIPPA. We created a day called the Get It Done Day, where I just would tell people, okay, come in, get all your regulation stuff done, and just make sure it doesn’t suck. Right? Because most of this is like watching paint dry, but they don’t even talk about what the title means. That’s how bad it is in dentistry right now. So, sorry. It’s a little bit of a soapbox, but No, it’s fantastic and, and those of us, everybody on this call are not alone. The actual HIPAA trainers don’t even talk about the intent. The original intent that’s in the title of the, of the regulation, because we get mired down in these little details of like, “Oh my gosh, if I send an x-ray and I, you know, and I take a screenshot. So there’s no, like, is that patient information?” You know, it’s like the, we get mired in these little details, uh, that, that we forget the fact that the whole point of this is that patients have access to their data, that we as dentists can get access to the information to provide the level of care that we need. We act like a new patient comes in and we get a a, a print off of four bite wings from six months ago, and we think that 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,

[00:11:25] Dr. Maggie Augustyn: and, and so we do, we, we collect so much data now, and back in the day it 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 you communicate with the patient. It’s a record of an appointment. It’s not an appointment, but it’s a record 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 a patient, how you’re choosing to go, um, 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 owns the SDL file for, for the, you know, 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, a podcast a, about, um, the projects that you’re working on, and your desire is for the patient to be able to get this information and to take it from dentist to dentists right? From provider to provider, because how incredible would life be to, for them to be able to take a, a, a file of their last 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? You know, if we have to replace a crown on that patient, what was that prep like? Why did that crown come up? You know, the, there’s a lot of information that could be available to us at our fingertips as we’re treatment planning this patient. Yeah. All that data. Who, who owns the SDL files?

[00:13:39] Dr. Bryan Laskin: I mean, the, so when we’re talk about SDL files, it is a little nuanced because, you know, 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 you my opinion, it’s my opinion. If I codify it into our application, then it’s proprietary information that nobody else can get access to and we’re just another problem, frankly. Right. So what we’ve decided to do is go through the open forum of standard development, which means that you go assemble people in the room who, who hopefully know what they’re talking about and we discuss this and we come up with answers. Not saying we’re right, but at least it’s an open form that anybody can give insight into and then there’s a voting process and 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 SDL file, what is part of the electronic dental record? Because the electronic dental record is owned by the patient. You know, there’s no disputing that that’s the patient’s data, and we as dentists have rights and responsibilities associated with that electronic dental record. Mm-hmm. So what we came up with, I happen to agree with, but we could always go back and have more discussion about it, is that that prep tooth that you mentioned, that scan is actually property of the patient. It’s a, it’s the scan of the patient’s tooth. However, the restoration that gets designed is not property of the patient. So the dentist can have that in the middle of the laboratory right, but that does not need to be part of the electronic dental record because what you’ve done then is you’ve actually created something new based on this SDL file

[00:15:17] Dr. Maggie Augustyn: That’s like your artwork.

[00:15:19] Dr. Bryan Laskin: Yeah. Yeah. And so that you as a dentist don’t need to give patients their, their crown design but you know, legally, ethically, and not morally, I would say you do have to give them access to their prepped and this, this isn’t pie in the sky technology. Someday you can do, we’ve actually built this out so that there is a mobile application for patients to download and you can actually export and import, and in many cases, automate this workflow. So what we’re trying to do is basically help these companies that aren’t complying with the, with the regulations and the, and the way the world works where patients have access to the data to be able to make it easy for them to plug in and give patients access and, and dental practices access.

[00:16:08] Regan Robertson: I, Brian, I’ve been asking for this for 27 years, so I was in, I was around a group of really what 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 got kicked around as something to solve. I figured by now, 27 years later, it would be, it would be completely resolved, and I’m shocked to hear why not. Um, but also in a ignorant sort of way, you just kinda make me like the light bulb go on. Is this why it can take so long when you request your medical records? Like, to me it’s, it, it would be easy. You’ve got a file, you’ve got my, my information in there in a week, you know, I would expect to get it and that’s not the case or at least it hasn’t been been for me. So is that, is that part of that It’s not sure what to exactly give, there’s no standard for it and maybe fragmented systems on how it’s stored? I mean, I just, I guess I just expected after that, anytime that we would be beyond this problem.

[00:17:09] Dr. Bryan Laskin: You mentioned me are, are you talking about the medical record or general record?

[00:17:12] Regan Robertson: Yeah. Well, medical, yeah, medical records specifically comes to mind, but just in general, when you request records, I guess I would imagine it in most practices to be something that would be electronic and instantaneous, and in some cases it is, but then in other cases it is not.

[00:17:26] Dr. Bryan Laskin: Yeah, I think, you know, medical, I like to say medicine and dentistry are messed up in different ways, right, and, and, and because I’m, I talk with a lot of, in fact, that’s gonna be a big focus in my folk. My, my, uh, podcast going forward is we bring on physicians to talk about this because, uh, as right now there’s a big, it’s called MDI, medical Dental Integration, or Medical Dental Connection, and it’s called different things but there’s a big push within dentistry to to work more closely with our medical colleagues, which I totally agree with but we need to do it in a meaningful way, right? Because they’re messed up, right? We’re messed up, but they’re also messed up. And if we take our industry and put it on the medical. Machine. It’s not gonna go go. It’s not gonna go well for dental patients, dental practices. This could be, I mean, uh, we ha we have to do this meaningfully in my mind. So let’s talk about what those differences are. And so when we’re talking about the medical record access by patients and the dental record access, it’s two different worlds. They’ve been working on medical interoperability or data exchange for the last 20 years, and there’s all sorts of problems with it regionality. There’s massive companies like Epic and Oracle that are fighting battles and all sorts of stuff going on that lead to the problems that you’re discussing, which,

[00:18:41] Dr. Chad Johnson: Hold up, those aren’t even medical companies proper, right? I mean, those are just data companies.

[00:18:49] Dr. Bryan Laskin: Correct. 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’t software companies. These are typically distribution companies or some company that bought another company. It’s a PE group that just bought a software company and is, doesn’t even know how to do, innovate and do anything. So all they’re trying to do is milk this cash cow until it dies, right? Two totally different, two totally different problems, but at the end result is as the patient, you’re getting hose in both instances. I would argue today, worse on the dental side, but it’s so much easier to fix because nobody’s done anything. So what we’ve tried to do is come in, write standards, learning from the medical mistakes, second mouse gets the cheese and create technology that can, we can solve the problem holistically in dentistry. Then we can actually apply to medicine and help solve some of their problems too. That’s, that’s in a nutshell, that’s what the mission for Tooth APS is.

[00:19:54] Regan Robertson: Brian, what fuels your passion for this? Why does this matter to you other than it’s a fun problem to solve?

[00:20:01] Dr. Bryan Laskin: I’ve been called an impact junkie, and so I, the bigger impact, the better. The harder the problem, the more I like it, and if it involves a fight, then I’m really down and this checked all the boxes for me, so I, it’s something I could not go away from, right? Mm-hmm. Then we’re fighting against some things that I just think are philosophically wrong, frankly. You know, I, I sold my dental practices after 20 years of 25% year over year growth was the, was the, was the least. We grew, I sold my software, my last technology partner company, and so I was like, when I was looking at this problem, 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. Frankly, that’s why I’m really 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 was actually gonna work on this problem. Mm-hmm. That’s, that’s, that’s why I’m passionate about it.

[00:20:55] Regan Robertson: So let’s talk, go. Go ahead. I was just gonna ask, what is the, the biggest, uh, frustration that you’ve hit your head against the wall in this particular, um, quest that you’ve undertaken?

[00:21:08] Dr. Bryan Laskin: You’re gonna get 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 vendors who just want to just clearly violating the information blocking rule and, and, and every time you say no to giving one instance of data, there’s a fine of up to a million dollars. So we’re talking software companies that could have paid half a billion dollar or a billion dollars of fines to 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 they might go somewhere else,” and I think,” do you suck so bad at your job that you think they’re gonna go somewhere else if you actually tell patients what you are planning to do for them?” And, uh, I don’t know which is worse, but I hear, I literally, every week I hear both. And so that’s been my biggest frustration.

[00:22:10] Regan Robertson: I appreciate you sharing that because I really, I mean, I genuinely was super, super curious about that and I’m glad you brought it up. You know, dentists being afraid or fearful to 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 tell in the response back to me, it’s not. 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, oh gosh, no, of course not but there was that human element to it. Um, but I didn’t think you were, you, you have to, right? You have to legally give someone their information if they ask for it.

[00:22:50] Dr. Bryan Laskin: You don’t have to, but there, but there are consequences if you do. Okay. Okay.

[00:22:53] Regan Robertson: Well said. Well said.

[00:22:55] Dr. Bryan Laskin: Yeah. Yeah. You know, it’s that because I, 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 think I 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, you know, you, you didn’t get in trouble. Doesn’t mean it wasn’t illegal. 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, one of two things happens, right? Dentists come up to me, they go, “Oh, thank you so much. My aunt just had a knee replacement and we couldn’t figure out that. We couldn’t get her records to go see,” and they understand the problem in healthcare. They see it from the patient’s perspective, or they start saying, what are you talking about? My software platform? My practice management software, people could leave me and go to another one. To which I say, “You have 1% of the industry, are you worried about losing your 1% or getting part of the other 99?” And very often, clearly the answer is they’re worried about losing their 1% ’cause their software is so bad and so, you know, that’s kind 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 audience when you tell them that patients should have access to their data for sure. Mm.

[00:24:12] Dr. Maggie Augustyn: Let, let’s talk about a fight and let’s talk about fueling that fire, because recently when 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 a company that was working with our phones and I, and I started this relationship in 2017, 2016 and it, it was a great solution. Um, it was a way for us to get our phones connected to Eaglesoft and, um, you know, the calls were recorded, we could go back and we can listen to them. There was a lot of information there. Um, and, and it, and it was a really great solution and we were in a relationship with them up until this year but then there came other companies onto the market that provided a similar system, and I wanted to investigate that because they, they had a different way of communicating with some of the other, um, uh, technologies that we were using in the office and they were also less expensive, but I could not get out of my relationship with this company. Um, and they, they, they rhyme with sleeve, um, or yeah, sleeve or sleeves or what, what, whatever you have, right? And, um, that was bad, but, but let’s leave it in there, uh, because they, they refuse to give me my data. Um, yes, you can leave, but there’s no way for us to give you to, there’s no way for us to give you the call recordings or the text messages or anything like that. You, you could leave, but you could leave without your data and, and I stayed because I, I really wanted to hang onto 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, you know, sue, you there, there, there’s a lot of information on there that I didn’t want to lose that I felt was in some way protecting me until finally this year, um, I went to them and I, and I had talked to you and, and they said, we will give you your information, including your call recordings. Um, but every time I would talk to a representative of this company, every other sentence, maybe not sentence, but paragraph, was, “Could you please stay with us?” Even after my very, very long monologues of there is nothing. In this world that you could do to keep me because of the unethical practices that you have been, you know, because of the way that you have interacted with me for the last almost 10 years, I just don’t, I don’t work with companies like yours, and so through this very, very long process of separating myself with them and them promising to give me back my data, unfortunately, I was always on their Zoom call, so none of this was recorded other than, you know, me taking some notes, uh, or my office manager having a recollection of this. Uh, we ended up signing a contract with Mango 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,” and they said, “Yeah, no, you must have misheard that.” So I ended up posting something on social media presenting this information, um, and they, they posted on social media, “Don’t worry don’t, don’t worry. We’ll take care of you,” and they ended up sending me another email saying we will give you your recorded data and I ended up talking to an attorney and, uh, trying to figure out whether or not I can get my recorded data and, and kind of went back and forth to, to find out that, um, that it’s probably the only way for me to do that is through a lawsuit that would probably cost me anything, anywhere bet up up to a million dollars, um, and as soon as we kind of made any more movement after that email where they said that they would give me my recorded data once more, they, they came back, um, and they gave me a link to download the data. Of course, there were no recorded calls on that data and then, you know, again, I said, “Can I have my recorded data?” And then they said, “That is unfeasible,” and then I said, “But this is information blocking,” and they said, “It’s not information blocking if it is not feasible.” I talked to another company that does the exact same thing, which is PBM Practice by numbers. They do exact same thing. They record calls, they offer phones, and I said, “Do you release recorded calls to the clients that are leaving your company.” She said, “Absolutely. That’s, uh, Aditi Al, who’s also a dentist 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 hire an engineer to, to get your data, and we release that to you,” and so it, it’s made me extremely angry but, but, but the entire time they kept offering, please, will you stay with sleeve? You can keep, you can keep your data for a monthly fee of this much. We just can’t. It is unfeasible for us to release this data from me, which bottles my mind. How is it possible for you to not be 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 large for you to transfer.

[00:30:25] Dr. Chad Johnson: Right.

[00:30:25] Dr. Maggie Augustyn: Have you not heard of Dropbox? I mean, and so, um, so, so, so I was given a choice, right, to stay with sleeve and pay a monthly payment to get ahold of my data, which my integrity just prevents me from giving them a single penny, um, to, to possibly. Soothe them and go and, and take a whole bunch of my retirement savings and, and try and wrestle that away from them or to walk away, um, with this fire that’s still burning this incredible anger at this unethical company that, that does this to me and they have done it to many, many, many dentists because I’ve heard from many dentists that they have done this to, um. I don’t know what the solution here is because this company goes to dentists and just flat out lies about what they can have and, and what they’re willing to give on the back end as they’re severing the relationship as they did to me.

[00:31:33] Dr. Bryan Laskin: Yeah, I, I, uh. I do know what the solution is. I, I mean, and we’re working on the solution. We’re working on a, we’re developing a coalition of software vendors that believe in open data and dentistry. We’re going, doing a convening this summer in Washington to push for some certain things getting, you know, high on my mind is getting patients access to their data ’cause. Like you mentioned, the, the recordings, I don’t know, depending on the recordings, if, if that’s part of the electronic dental record or not, certainly some of those text message messages probably are, uh, I would argue that it’s the patient’s data and patients should have access to it, and unless they’re delivering that through a secure mobile application, which they’re probably not. Those, all the companies who are, who believe in open access don’t even fully understand what that means. Right. So we’re putting together a coalition to kind of educate the industry and, and we’re gonna be coming out with certifications 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 and we are like a weird, in the weird position of being a disruptor by trying to lay laws down versus break them. Right? We are trying to like, create standards and, and laws that by all accounts should already be in place, but nobody’s following them. So it kind of puts us in a weird position to be the sheriff in town and trying to get these behemoths who, I mean, there are some massive companies that are just illegally stealing and reselling data and what no dentist says when they sign up for a phone system, a patient engagement solution, they don’t ask how do you get the patient’s information? Nobody asked that because nobody even knows about the problem of, of companies hacking into integrators illegally stealing the patient’s information and reselling it. Uh, so there’s, there’s so many I. We could go deep into a, in, in a nerdom of like a, a wizard, wizarding world of lawlessness, of nerdom that, uh, that, that probably would put people to sleep but the reality, tell me about me.

[00:33:43] Dr. Chad Johnson: Hold on. Um, our, our dentists implicitly getting data that has been procured illegally.

[00:33:51] Dr. Bryan Laskin: Oh a hundred percent. Yes. There’s companies out there doing that 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, you have to provide other patients.

[00:34:06] Dr. Maggie Augustyn: Could you explain that? Because I, I don’t even, yeah,

[00:34:08] Dr. Bryan Laskin: So here’s, here’s the common practice of how. The average technology company integrates with the practice management software. Okay. There’s a couple different ways. One is you can go to the company and say, “Hey, I wanna integrate with your, with your practice management software,” and then they say, great, here’s our API that you can plug into and they then they charge your company for that. Okay? The X amount or whatever, and, and. Most of them don’t ask the question, “Do you have a medical nece necessity to have that information?” They just say, “How much do 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 most lawful way that tends to be going on now. Then there’s companies that are like, well, this is a, or, and, and by the way, these are large companies and if you’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, because there’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 into the practice management data, pull it out and resell it to companies and nobody talks about this in dentistry. Uh, you know who, uh, but, but that’s kind of what’s going on. So it’s either, uh, uh, knowing and, uh, and unknowingly illegally blocking information or it’s getting it in sketchy formats and reselling it and what we’re trying to do, because every, if you. When you plug into these systems, everyone’s unique. You know, if you look at something like Dentrix that’s had hype, God knows how many iterations. That alone probably has 10 different connectors for the 10 different versions of it, of that have been throughout the years of, of Dentrix, right? So if you’re a small developer to get to integrate with people’s practice management software, you have to build 15, 20, 30 connectors that all suck by the way These are all bad connections that don’t comply with that, 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 all of that with a standard called API or programmic in interface for any company that 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 single connection 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 had adhered to the standards and regulations that are, you know, some are mandated by the federal government for all of health healthcare in including dentistry and some are new ones and some are just ones that we should do because it kind of makes sense. Right. Um, and

[00:36:55] Dr. Maggie Augustyn: What’s been the response?

[00:36:57] Dr. Bryan Laskin: It depends who you talk to, right? I mean, software vendors think it’s great, but they’re kind of are like, can you actually do this? And because we’re, we haven’t solved every prob problem, but what I can tell you is we’re the only one really solving the problem in, in this way. So we have, I made a ton of progress. Nobody, I hadn’t heard the term interoperability in dentistry. And when I started is when I wrote a book about it, uh, three years ago. Right? But now, now it’s becoming a thing. You know, we’re great people like you recognize the problem. Have me on the podcast talking about it sort. We’re spreading the word doing convening in Washington. We’re putting pressure. Our next step as a company is we’re gonna go directly to patients. So patients are gonna be able to request their records di directly, and then dental, then dentists will get, they’ll get educated pretty quick when you get a, when you get 10 patients request their records through a mobile application. Right. You’ll probably figure this out pretty fast. So that’s what we’re doing as a company to try to move the tide, uh, you know, standards and regulation, talking to dentists, uh, you know, through the podcast, through books, whatever and then, uh, and then, than going to, going directly to patient and, uh, there’s large companies that, you know, one of the large PMS vendors has a list approved approval pending unauthorized slash dangerous on their website. Okay and I, and so I, I bet you can guess. What gets you on the dangerous list and how you go to be authorized? There’s one criteria, it involves a pen and a check, right? So I mean, so companies who are on the 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 guy, so I want it to go faster. Hmm.

[00:38:53] Regan Robertson: Have you had difficulty yourself? Is that, is that part of the reason other than it being a great injustice and, uh, and being a very enticing problem to solve?

[00:39:04] Dr. Bryan Laskin: Yeah. That’s how I identified this problem is was, um, through scaling the patient engagement solution, had talking to the PMS vendors, uh, it was just, I mean problematic, but we were able to solve for it in most instances. But, but you know, when I sold that platform, and even before I was sold that I was trying to think of like, 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 a lot of different startups. I’m, you know, I, I am a part of about 15 different technology startups in dentistry and so if you’re gonna be doing something in dentistry, and you want, this is a big problem for every company that’s trying to solve problems in dentistry and not, not everyone, you know, if you’re creating the next generation of composite, you don’t need to have access to the patient’s information necessarily but, uh, but for, but for, you know, if you’re an AI company, if you’re, you know, doing 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 long answer to your short question.

[00:40:17] Regan Robertson: It, but it feels like a volcano. No, you answered it great. It feels like a volcano that’s sitting somewhat dormant and, and think back to like the housing 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 enormous mortgage, and I think I was making like, I don’t know, it was like 11 bucks an hour, something crazy small and thinking how this doesn’t, like, even on on the most basic level, make financial sense, like why am I getting approved for that but everybody was doing it and I can see how this sort of lawlessness or maybe the lack of attention from law on these things, how this happens if I am a dentist, since I’ve got three dentists here. Uh, what is the first step that a, that a dentist needs to take because likely there’s a level of ignorance of not being fully aware other than experiencing it like yourself and the frustration from it. Um, where does one start?

[00:41:16] Dr. Bryan Laskin: I’m, I’m a little biased, right? Obviously a little right. Yeah. So I, I would say making sure your patients can get access through their, to their data through a secure mobile application. Because here’s, here’s the reality is that that’s where your liability lies. The, the what, what, what happened, because if a patient requests their records, and you cannot give it to them through a secure, if they say, I’d like my, you know, again, it’s only if the patient 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 a lot of detail here, right? So, uh, uh, I would, you know, and by the way, the patient doesn’t care that it’s the practice management system that’s the problem. They’re gonna come to you and specifically the person behind the front desk that’s overwhelmed complaining about this. Right? And so that’s where I would start making sure that my patients aren’t going to be pissed, that I can’t give them their information when they start learning about this.

[00:42:24] Dr. Maggie Augustyn: So are you saying that the data that they request has to be them, has to be, that it has to be requested via an app, or it has to be delivered via an app?

[00:42:35] Dr. Bryan Laskin: 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 bunch of PDFs printed off and a thousand pieces of paper, which they won’t right, then, then that’s, then, then you have to deliver it in that form and I, that you probably could just do is through a secure mobile application, but, but it specifically states, uh, let me, let me, let me describe why. The reason why this, the 20, the 21st Century Cures Act, which includes the information blocking rule came to be patients were looking to, you know, to get their medical records and physicians said, “Well, we can’t do it. They’re all locked up in Epic,” and, and Epic said, “Well, too bad we’re not covered under HIPPA,” which they were, right. So the federal government wrote a piece of legislation, the 21st Century Cures Act to fix that issue such that that is why MyChart exists. If you know the product MyChart. MyChart was not created because Epic loves people and wants them to have access to their data, epic was, or MyChart was created because the federal government forced them to. The problem is nobody’s been paying attention in dentistry. We have the same mandates to have a MyChart, and that’s what we’ve built.  Uh, it’s now called Cair, CAIR. Uh, we’re rebranding it, uh, that, that, uh, is going, that the way that patients get access to their data and then patients can, 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 or if you’ve used these records, you’re gonna be way more informed as a patient and I think it’s gonna be the biggest increase in case acceptance since the interval camera. When patients can see their interval photos, they can see they can get third party financing, do online scheduling all through a secure mobile application, they can message you, you know, instead of that being through a phone system, it’ll be through the secure mobile application and by the way, it doesn’t matter which systems you’re using. If you use like a Mango voice, they’re a partner of ours, you can do your text messaging and it can show up in our, in our platform securely, stuff like that. So that’s, that’s where I, I would start, is making sure, because that’s where you’re likely to get dinged as a, as a practice, is if a patient says, I’d like my complete records, making sure that you can actually deliver that.

[00:45:12] Dr. Maggie Augustyn: Except you can no longer start writing patient was a complete jerk, was totally disrespectful. Like you, you can’t put that in a patient chart anymore. Sure you can. And

[00:45:21] Dr. Bryan Laskin: 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?

[00:45:29] Dr. Chad Johnson: But darn right. Yeah.

[00:45:30] Regan Robertson: I, I’m seeing the, I understand now the B2C connection, why you wanna go straight to the patient and empower the patient to drive the change. Uh, your episode, I think your podcast called Patient First Podcast, right? And, uh, you have a recent episode with Frank Lo. I’m only like 15 minutes into the interview, but it’s incredible and Frank is talking, um, insurance and, and healthcare and, and there’s so much about that world 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 kind of fear mindset of I don’t want people to leave and switch it around so that it’s an empowerment, like, because you are with me, you get this access, I have 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 my healthcare 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. 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 risk factors 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 would feel empowered as a patient and I know where I would be going. If, if we can take down these silos, I would feel like my health really does matter.

[00:47:02] Dr. Bryan Laskin: Yeah, and, and that’s what, that’s what we’re focused on, right? You can’t do every, Rome wasn’t built in a day, but I do believe oral health is the gateway to overall health and so I think it makes sense for us to, to go there. Yeah, absolutely.

[00:47:13] Dr. Maggie Augustyn: As unexciting as HIPAA is the idea that we could have something similar to to MyChart for our patients and our ability to communicate with them would be safe and protected and under our control as opposed to the control of whatever whim the company that we’re working with and whomever, you know, and then there’s the idea of who owns this company today and what whim, you know, what whim and what mood are they in to release those, those records or the reigns or control onto us. Um,

[00:47:51] Dr. Bryan Laskin: 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 and I have in multiple exits. This is self-funded, so we’re not looking to get another round and jack up the prices on people. Right. Uh, which is kind of what all those companies are doing right now.

[00:48:17] Regan Robertson: And estimate quality.

[00:48:18] Dr. Bryan Laskin: Yeah. And, and, and, and we actually have, how this information is handled is all. Public is part of the standards that we’ve written, right? The one how patients get access through dental. Dental records are called Thor Trans. It’s called Thor, Transferable Holistic Oral Records. How we manage dentistry, uh, within dentistry is called Odin, the Oral Data Interoperability Network. I’m based in Minnesota, like you said. So we like our north. There you go. So, so here we have one coming up right now. So we’re, we’re, you know, if you wanna get involved, let me hit me up. You know, we’re working right now, I’m mapping and filtering medical histories. ’cause you look at the medical history in your practice management software, it makes no sense. So what we’re doing is we’re taking the medical, medical history and then doing what they do in medicine is they actually take that comprehensive medical record and then look at what are you doing as a provider and then having you work with that medical history for the patient so it’s not onerous for you or overwhelming and so that’s what we’re doing for dentistry. So instead of just having a radio button about allergies. If you’re sedating patients in your practice, he’ll follow the same levels of medical history. Uh uh. So, so I’m going down to the rabbit hole, but that one’s called hild. It’s another, it’s another north theme, right? So if you wanna get involved then with standard development or open data, uh, I’m the right guy to reach out to.

[00:49:36] Dr. Chad Johnson: Hmm. That PMS that I use has a health history question. Venereal disease, yes or no and I’m like, who calls it that anymore? I, it’s just like, I’m just, but I can’t change it. It’s just, it’s just like, nope. That’s what we call it, you know, when we made it and we’re not changing it and that’s what’s it’s gonna say and you can’t, you know, keep things updated. It’s so frustrating. What do you do?

[00:50:03] Dr. Bryan Laskin: Yeah. And so what we’re trying to do is develop, get the right people in the room to develop a medical history that, you know, nothing’s perfect, but at least that’s published, that people had a public form that they could give feedback to, and then we can adjust it as necessary.

[00:50:22] Dr. Chad Johnson: Yes.

[00:50:22] Dr. Maggie Augustyn: 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 really glad that your brain works this way. Mm-hmm. Um, I just want to offer you a heartfelt thank you for, um for making this world spin in the right direction.

[00:50:45] Dr. Bryan Laskin: Um, well, right. You’re, you’re doing amazing things too and so it’s Right. You know, the respect is mutual and, and, uh, and so thank you. Thank you very much. I.

[00:50:54] Dr. Maggie Augustyn: Thank you for joining us today. Thank you for this, uh, incredible amount of knowledge and I mean, I, I think we are all looking forward to the future 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.

[00:51:15] Dr. Bryan Laskin: Appreciate it. Thank you very much,

[00:51:18]Regan Robertson: Let’s, yes, let’s win. I cannot wait to see you in Texas. And doctor, if you’re listening, I hope to see you too. We are excited to help you grow. Thank you. Thank you for listening to another episode of Everyday Practices Podcast. It would mean the world if you can help spread the word by sharing this episode with a fellow dentist and leave us a review on iTunes or Spotify. Do you have an extraordinary story you’d like to share or feedback on how we can make this podcast even more awesome. Drop us an email at podcast@productivedentist.com, and don’t forget to check out our other podcasts from Productive Dentist Academy at productivedentist.com/podcasts. See you next week.