1. Increase treatment acceptance by improving the patient experience Patient journey in the practice GMT 45250 © Nobel Biocare Services AG, 2016. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Please refer to nobelbiocare.com/trademarks for more information. Product images are not necessarily to scale. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability. For prescription use only. Caution: Federal (United States) law restricts this device to sale by or on the order of a licensed dentist. See Instructions for Use for full prescribing information, including indications, contraindications, warnings and precautions.

2. Speaker Note: Slides 2 is hidden and do not appear when you begin your slide show. This template is designed to run on a PC (PowerPoint 2007 or 2010), or a Macintosh (PowerPoint 2011 ). Insert and adapt the content. Replace proposed pictures and logo The proposed flow of the presentation is: 1)Background – why is treatment acceptance important 2)Barriers to treatment acceptance – list and explain the barriers that stop the patient to accept a treatment proposal 3)Strategies to detect & address the barriers – advises on identifying and dealing with the barriers 2

3. Content Background Patient journey Next step 3

4. Treatment acceptance starts at home  The decision by the patient to accept a treatment considers more than just the treatment proposal.  Other key factors related to the overall patient experience are:  before being in contact with the practice – website, other patient opinion  at the first contact with the dental team  during the pre-consultation with the assistant  during the consultation with the clinician  at home, after having received the treatment proposal  … 4

5. Treatment acceptance starts at home 5 Patient ignores problem Patient recognizes problem Independent information search Support Information by dentist Pre-treatment Post-treatment Advocacy AwarenessAcceptanceSatisfactionVisit

6. Increase patient acceptance systematically High acceptance rate goes with an effective communication with the patient and their handling by the team during their journey before and in the practice. The patient flow offers the opportunity to learn about patients’ situation, to address their needs, and educate them on what’s to come. To make the most out of the clinician available resources, the objective is to handle the patient with the active support of the team. This is done by empowering the dental team. 6 1. Initial contact by reception 2. Dental examination by surgeon 3. Discussing treatment options 4. Discussing fees and insurance 4. Concluding the visit 0. Information search

7. Agenda Background Patient journey Next step 7

8. Steps of the patient journey in the practice 0. Before the visit 1.Take the call 2.Pre-consultation 3.Greeting 4.Medical history 5.Practice tour 6.Meet the dentist 7.Give fees & information on the treatment 8.Follow up and book the treatment 8 1 3 4 5 6 7 2 8

9. 0. Before the visit - Everything starts before the patient arrives Channels to build relationship before the patient is in contact with the practices:  Marketing  Website  Referral  Stationary  Location  Opening hours  Office, facility, signage, entrance, … Convenient access to the practice helps, in particular  Enough parking in the area  Dedicated parking for the practice  Easy drop-off space  Public transport connection nearby 9 9

10. 0. Before the visit  Free download on MyNobel the booklet: The digital age of patient communication 10 Before / After

11. 1. Take the call - The patient calls and the receptionist …listens actively When the patient calls, the objective is:  about to collect as much information possible, not to keep calls short.  to build value during the call, feel the patient listened to (capture their name immediately, …) On the phone the receptionist: 1.Starts with greeting and repeating the patient name “ Good morning Mr Smith, how can I help you?” 2.Encourage dialogue with open question. Focus on where the patients want to go rather than where they have been. 3.Confirm patient's needs e.g. “Mr Smith, you would like to eat apple again?” 11 1

12. 1. Take the call - The patient calls and the receptionist …listens actively 4.Mentions the possible solutions the practice offers which might suit the patient's need. Be careful not to set high expectations. E.g. same day treatment, appointment time… 5.!! Price request on call must be handled carefully !! Before providing the fee, the receptionist:  makes sure to have the details of the patient needs  provides a single price point, mentioning that this is based on the short discussion  agrees that a consultation is needed to confirm the treatment options & fees. 6.Closes by defining the next consultation 12  Good morning, here is Mrs Smith  Good morning Mrs Smith, I am Julie the treatment coordinator... …  What are your dental health objective?  One of my most important objective is to be less embarrassed when I smile.  What makes you feel more comfortable when you envision your perfect smile? 1

13. 1. Take the call - Avoid miscommunication during calls The dental professional seeks to avoid miscommunication by: -repeating or summarizing the information helps to check that the correct message was understood -systematically recording the most relevant conversations and agreements -capturing the patient information in a way that it can be shared within the practice team -avoiding promise on any treatment result which can not be achieved -formulating in a positive way objections and arguments 13 "You failed to say!" just mention "Perhaps this was not stated.“ "You're wrong!” say rather "Permit me to clarify." "You don't understand!" say rather "Let me explain.“ 1

14. 2. Pre-consultation - Help the patient to get to the practice On the phone, depending on the patient profile, some information can be sent:  If referred, the treatment coordinator can send some information abut the discussed needs. E.g. missing tooth  If new patient – the practice can send a simple letter incl. address, parking, contact, time. 14 2

15. 3. Greeting at the practice - At the door step of the practice  Use signage for patients inside and outside the practice e.g parking, entrance  Treatment Coordinator (TC) / Dental assistant welcome the patient near the entrance.  The coordinator calls the patient by his name.  The TC immediately define and present his role as coordinator.  The TC outlines what the patient can expect during his visit. E.g. 15 “I will present our practice, discuss your Medical Record, then you will meet the doctor,…” “ I am here to guide you and as your main point of contact. “Mr Smith, welcome to our practice” 3

16. 4. Medical and dental history - Get to know the patient Collect patient medical history and additional information that will be useful for the diagnostic and to support the best approach to get the patient acceptance Tips:  The assistant should not just give the patient a form and let him complete it in the waiting room. This is the opportunity to get the patient information through dialogue.  This is a chance to learn about their ‘barriers’. Fill out medical history together.  Key is to ask open questions on previous experiences, expectations, … Footer16 4

17. 4. Medical and dental history - Get to know the patient A structured patient risk assessment form can help to make sure that all aspects of the patient are captured 17 Source: John Kois (2012) Personal History Gum and Bone Tooth Structure Bite and Jaw Joint Smile Charactrristics Dental History Name____________________________________________________________ Age _________ Referred by ___________________________________ How would you rate the condition of your mouth? Excellent / Good / Fair / Poor Previous Dentist _______________________________ How long have you been a patient? ___________ Months/Years Date of most recent dental exam _____ / _____/ _____ Date of most recent x-rays _____ 7_____ / _____ Date of most recent treatment (other than a cleaning) _____ / _____ /_____ I routinely see my dentist every: 3 mon / 4 mo. / 6 mon. / 12 mo. / 18 mo. / Not routinely WHAT IS YOUR IMMEDIATE CONCERN? ______________________________________________ PLEASE ANSWER YES OR NO TO THE FOLLOWING: YES NO 1.Are you fearful of dental treatment? (How fearful on a scale 1 (least) to 10 (most) 2.Have you had an unfavorable dental experience? 3.Have you ever had complications from past dental treatment? 4.Have you ever had trouble getting numb or had any reactions to local anesthetic? 5.Did you ever have braces, orthodontic treatment or had your bite adjusted? 6.Have you had any teeth removed? 1.Do your gums bleed or are they painful when brushing or flossing? 2.Have you ever been treated for gum disease or been told you have lost bone around your teeth? 3.Have you ever noticed an unpleasant taste or odor in your mouth? 4.Is there anyone with a history of periodontal disease in your family? 5.Have you ever experienced gum recession? 6.Have you ever had any teeth become loose on their own (without an injury), or do you have difficulty eating an apple? 7.Have you experienced a burning sensation in your mouth? 1.Is there anything about the appearance of your teeth that you would like to change? 2.Have you ever whitened (bleached) your teeth? 3.Have you feld uncomfortable or self conscious about the appearance of your teeth? 4.Have you been disappointed with the appearance of previous dental work? Patient’s Signature_______________________________________________________________Date__________ Doctor’s Signature_______________________________________________________________Date__________ 1.Have you had any cavities within the past 3 years? 2.Does the amount of saliva in your mouth seem too little or do you have difficulty swallowing any food? 3.Do you feel or notice any holes (i.e. pitting, craters) on the biting surface of your teeth? 4.Are any teeth sensitive to hot, cold, biting, sweets, or avoid brushing any part of your mouth? 5.Do you have grooves or notches on your teeth near the gum line? 6.Have you ever broken teeth, chipped teeth, or had a toothache or cracked filling? 7.Do you frequently get food caught between any teeth? 1.Do you have problems with your jaw joint? (pain, sounds, limited opening, locking, popping) 2.Do you feel like your lower jaw is being pushed back when you bite your teeth together? 3.Do you avoid or have difficulty chewing gum, carrots, nuts, baguettes, protein bars, or other hard dry foods? 4.Have your teeth changed in the last 5 years, become shorter, thinner or worn? 5.Are your teeth becoming more crooked, crowded, or overlapped? 6.Are your teeth developing spaces or becoming more loose? 7.Do you have more than one bite, squeeze, or shift your jaw to make your teeth fit together? 8.Do you place your tongue between your teeth or rest your teeth against your tongue? 9.Do you chew ice, bite your nails, use your teeth to hold objects or have any other oral habits? 10.Do you clench your teeth in the daytime or make them sore? 11.Do you have any problems with sleep (i.e. restlessness), wake up with a headache or an awareness of your teeth? 12.Do you wear or have you ever worn a bite appliance?

18. 5. Practice tour Tour of the practice to strengthen the credibility, gather more patient information, show openness of the team, potentially reduce the anxiety related to the unknown. Tips:  Feature real patient pictures  Hang professional certificates and association membership for credibility purposes  Description of the different team member and roles  Have signage of the different room to support the communicative aspect of the team  When the tour is completed, seat the patient in the ‘exam room’. In case of delays, the exam room helps to reduce patients sitting in a waiting area.  Clean and tidy office 18 “Mrs Martin I would like to take this opportunity to show you around the office; to show you where our restroom is, our treatment room, …”

19. 5. Practice tour - At the end of the tour: waiting room, restroom,…  Other premises must reflect the service quality 19

20. 5. Practice tour - At the end of the tour: waiting room, restroom,…  Other premises must reflect the service quality 20

21. 5. Practice tour - At the end of the tour: waiting room, restroom,…  Other premises must reflect the service quality from a visual, smell and 21

22. 6. Meet the dentist Objective: Make sure the surgeon addresses the relevant patient needs When the patient is transferred to the surgeon, the team member:  Introduces the specialist taking care of the patient  Summarize what is important to the patient (objective, concerns, …) The consultation must be short and focused on the clinical needs 22 6

23. 6. Meet the dentist Key for positive patient interview is an open effective communication:  Active listening – give feedback to patient on what he just said to assure the understanding. Patient does most of the talking  Learn to know what motivates the patient  Being curious, clarify and avoid assuming  Seat next to patient (not behind desk)  Open body language leaning toward the patient 23 6

24. 6. Meet the dentist 6. Meet the surgeon (10 min)  Surgeon’s interactive examination follows this sequence:  Tell patient they’re going to be tipped back in his chair  Offer patient a mirror for a positive learning experience  Focus first on positive aspect in the mouth and then on the concerns  The assistant is actively involved  Doctor explains what is going to be examined and why as well as what is not obvious  Once exam is complete, sit the patient up and briefly covers what concerns and findings  Recommendation on the next steps 24 6

25. 6. Meet the dentist Tips:  Communication oriented towards patients involves:  Use right word avoid pain, expansive, blood,…  Use tangible, visual material to explain the situation and treatment options  The surgeon should close with brief overview of the information gathered, the patient’s concerns, the options and the next steps  On next slide, there is a talk track the specialist can use to help the patient to understand the value on Nobel Biocare treatment 25 6

26. 6. Meet the dentist – Partnering with Nobel Biocare gives you the right arguments 26 Tell the story… How is the clinician convincing patient to go for a premium restoration. Are your patients increasingly shopping and looking for low prices? How is the science from Nobel Biocare helping you to convince your patients? Are your patients thinking long term when they get a treatment? Are your patients thinking potential treatment needs when the travel or move? Are your patients thinking about the way the treatment evolves over time? 6

27. 6. Meet the dentist – Partnering with Nobel Biocare gives you the right arguments 27 The exceptional QUALITY of original products is based on Medical Device standards. ASSURANCE of life- long follow-up on products Designing for quality of life WIDE RANGE of evolutive product and solutions Leader in INNOVATION and continual investment in research and development Solutions for all indications EXPERIENCED clinicians all over the world Assurance for patients to get HIGH QUALITY FOLLOW ups Wherever the patient is in the WORLD Worldwide network of experts DISCOVERY of osseointegration in 1952 and the first edentulous patient treated by the Prof. Brånemark in 1965. The implant will be an integral part of the patient’s body and are designed for LIFE-LONG USE. Pioneer in dental implants The largest scientific HERITAGE Over 40 years of documented EXPERIENCE Predictable and SAFE solutions Scientifically proven Tell the story… How is the clinician convincing patient to go for a premium restoration.

28. 7. Treatment plan and fees Visual plan  Provide personal letter with detailed treatment for the patient to take home  Nothing to hide – the plan must show detailed cost for the treatment  To secure that the plan matches the patient’s key questions, the dental team must be sure that all key questions are addressed before doing the planning Communication with patient  Body language - move forward and don’t lean back & cross arms  Should not mention “lowest prices” and the dental team must NEVER apologize for the fees  Should NOT negotiate prices. The service is too good to compromise Tips:  Train the dental team recording them when handling patients / role play 28 7

29. 8. Follow up Schedule before the patient leaves the practice: -follow up call to discuss the patient’s decision about the treatment -potential next consultation date Deliver what you promised 29 8

30. Agenda Background Patient journey Next step 30

31. What’s next Involve your dental team, and take a structured approach on how the patient journey can be improved. Increasing treatment acceptance is a continual improvement process 31 1. Measure your treatment acceptance rate 2. Map patient journey with your team 3. For each step, define patient’s expectations 4. List actions to improve patient’s experience at each step 5. Prioritize and plan the implementatio n of the selected actions

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