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The Challenge In Standardizing Electronic Healthcare Records (EHR). Where Is Progress Being Made?


Many industries face a similar challenge when it comes to data. Where to store it, how to keep it secure, and how to learn from it to optimize their business and evolve their industry. Healthcare is no exception, and one could argue that the data issue is even more important in this sector; it is both an asset and an obstacle. While many healthcare providers have made moves to standardize their data, in part because of federal regulations, one vertical that often gets left out of the greater healthcare conversation is dental, which has yet to fully standardize its data.

There are a few key players who are working on this challenge currently, one of which is tab32, the cloud technology platform founded ten years ago, which is now the first in the industry to standardize electronic healthcare record (EHR) data by offering a cloud-based open data warehouse that allows for a standardized taxonomy for data collection, curation, and processing. Kiltesh Patel, CEO and co-founder, argues that this standardization has the potential to evolve the dental industry and potentially leapfrog over medical, allowing for the data to be used to inform business decisions, progress technological advances, and even allow for legislation to be written to support the dental industry in general, something that has been missing up until now.

I had a conversation with Kiltesh Patel of tab32 regarding the platform’s role as the first to standardize EHR data in dental, what this means for dental outcomes, and the wider-reaching implications of how innovative technologies with a data-driven approach are impacting healthcare providers and health outcomes.

Rhett Power: First of all, thanks so much for taking the time to speak with me. I first want to know a bit about your background, how did you find your way into dental data and founding tab32?

Kiltesh Patel: Thank you for having me! My background is primarily in managing big data in various forms since my graduation. Since back when there was a lack of internet speed bandwidth, you had to dial in to get on the internet! I have spent a long time working in healthcare, partially at the San Diego Super Computer Center researching big data and genomics, and also serving as the Director Of Technology and Medical Informatics in Health Sciences at UC San Diego, where I utilized data for health informatics and translational scientific research. I realized quickly that there are amazing possibilities for dentistry and the dental market. Medical has had so much history with tech and data, and I realized that dental had the ability to overpass them if the data was used in the right way. In general, I’ve always been interested in data, we depend on it so much today. Without data we are literally blindsided, making decisions with no information. Early on, data was undiscoverable or basically very difficult to pull out from a provider’s system. That’s where my journey, and tab32’s journey started, was figuring out how to pull that data out and thinking about how we can create a meaningful context to it to leverage it and eventually create a meaningful care journey for our patients and peers.

RP: What drew you to dental specifically?

KP: I’ve worked with the broader healthcare inpatient ambulatory side of the businesses and at the time when I was pursuing my business degree, I felt there could be more meaningful impact and care for our patients. I was looking into where I could personally make more of an impact, and I found 3 or 4 things that I won’t go into here, but I realized the dental is so often looked over and this would be somewhere I could find solutions and help them progress.

RP: Has federal regulation been something that has helped progress dental in recent years? There’s a federal law that says all health information needs to be easy to exchange by the end of this year, does this stand for dental as well?

KP: Unfortunately, no, because priorities for dental are a bit different. I wish the situation was different, but our healthcare leaders and lawmakers have forgotten that our mouth is connected to the body and oral health has a direct impact on overall health. There have not been many initiatives to really make a strong appeal for the dental market to move in that direction, which is very unfortunate because they’re facing the same types of problems, but it is even more pronounced in dental because dental markets tend to be seen as retail healthcare. It’s because of the overall lack of understanding of dental by government that causes them to not be supportive of the industry evolving. An example is that of the Affordable Care Act, because of the lack of understanding of the industry, only less than a thousand dentists qualified to participate out of a country that has over 200,000 dentists. The key to this is for people like me to voice our opinions out loud and push for standardization so that we can learn and evolve from the data.

RP: How exactly will the standardization of data, the work that tab32 is doing, impact this issue?

KP: If data is not discoverable how can you build solutions around it? Dental data up to this point is just unavailable. We must standardize across the industry and create a shared model that you can manage operationally and clinically across all different practice management systems. And there are so many disparate silos of systems, so we need to work to integrate all of those together. The outcome of this is something that would help stakeholders, patients, providers, and payers in a variety of ways. That’s where tab32 is taking the lead and pushing out a model. Then if we’re able to pull this data altogether from one standardized system and harmonize it with larger healthcare data, an opportunity exists that the industry will evolve and potentially leapfrog over medical. An example is heart-related diseases. All the academic papers say the first signs of any heart-related disease comes from bacteria within your mouth. How can we leverage that information to not just wait for it to show up but to do preventative care to avoid it completely. These are some of the larger questions that we will be able to address at a macro level, delivering the value-based care that people are still conceptualizing through various healthcare models.

RP: Why cloud-computing to achieve this?

KP: Cloud is just an enabler, not so much a technology that is solving the problem. Cloud is helping enable us to see the problem and resolve the problem through this whole technology platform we have built out.

RP: What exactly does tab32 do?

KP: Great question! One of our first solutions was the practice management platform, which allows a provider to migrate to the cloud and liberate their data. The second part of that technology was creating modules around it to make sure that day-to-day activities that happen within the context of the practice can be delivered through the practice management platform. Then it becomes a platform where we allow them to customize and build out their stack of features from engagement practices, reputation, radiology, billing components, all of it. So, we created the entire platform stack for them to roll that out into the product and give them an entire solution which we felt was necessary to really realize the power of liberating that data. Once you’ve liberated the data, how can you make it widely available? How can you automate or centralize a lot of functions, creating more efficiencies for the providers or the offices we work with? That was part two of our journey. What we are now solving is the big data and pulling all the information into our data warehouse and data lake.

RP: Are you going to solve this issue alone?

KP: No! Everyone needs to come together for this to be achieved. I hope this message can be spread out far and wide with the standard model I am proposing. We (tech companies, managing platforms, providers, etc.) need to come together to combine and pull the data and take the industry to the next level. There is an opportunity for all of us together because it’s a huge market and there is a lot to be accomplished.

RP: What’s your projection for how long this evolution will take and dental can “leapfrog” medical as you said?

KP: If you asked me pre-covid, I would say 20 years, but now I feel like it will take less than 10 years. People have started realizing the potential and have already accelerated the process itself. Many incentives came out because we have a shortage of workforce and the labor costs are escalating tremendously and really, we are in a controlled industry. A gas station can put a sticker saying that gas is 10 cents higher, but a provider is not allowed to, you have to stick to the contracted prices that have been negotiated. So instead, the industry needs to create efficiencies. I feel like in the next five years you will see significant changes.

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