Dr Cindy V Roark: Revolutionizing Dentistry by Fusing Clinical and Technological Developments Together

Sage Dental Group of Florida and Sage Dental Group of Georgia PLLC have provided dental care at 70 locations to over 1 million patients through its broad practice network, which offers general, specialty, and cosmetic dental care, including restorative, prosthodontic, endodontic, oral surgery, periodontics, pediatric, and orthodontic treatment. With Dr. Cindy driving clinical innovation, Sage has become both a national and international leader in the deployment of AI-driven solutions to improve the quality of care, accuracy of diagnosis, and overall patient experience. Dr. Cindy serves as Senior Vice President and Chief Clinical Officer at Sage Dental Management, LLC, where she is responsible for overall clinical leadership and enterprise-wide clinical strategic planning, with a heavy emphasis on research and development.

A Multi-Talented Leader

As a special area of interest, Cindy is one of the preeminent global leaders in the adoption of Artificial Intelligence to improve dentistry diagnosis and outcomes. She brings 20 years of private practice, non-profit, and DSO experience to Sage Dental Management. Sage Dental is a national leader in the dental services industry, recently highlighted for innovative performance during the COVID-19 Pandemic. In addition to owning a successful private practice in Massachusetts, she served as Clinical Officer at two national Dental Service Organizations and was formerly the Director of General Dentistry and Associate Professor at the Vanderbilt University Medical Center. Additionally, Cindy has vast experience in international supply chain and product development. Other recent roles include Clinical Advisor to Replicate Natural Dental Implants, a German dental implant start-up, and DSO Advisor to Dental Monitoring, an Artificial Intelligence orthodontic services provider. She received her Master of Science in Health Care Management degree from Harvard University and earned a dental degree Magna Cum Laude from the Henry M. Goldman School of Dental Medicine at Boston University.

Opting for a Confronting Professional Shift

Cindy admits, "The transition from practicing clinician to healthcare management and leadership role was the single most important shift I have made professionally. Once I had a seat at the C-suite table, I realized that I needed to be bilingual in business and dentistry." Later, she decided to pursue a Master's in Health Care Management degree from Harvard University. The skills she took away from that program shaped her overall strategic philosophy in terms of embracing information technology to improve health outcomes. Moving from clinician to leader allowed Cindy to have a greater impact on population health, an effect that far exceeds a single patient in a single dental chair. This shift helped her become a true change agent.

Overcoming the Obstacle by Gaining Patient's Trust

Cindy opines that dentistry, unlike many areas of medicine still has a subjective component.  Typically, people don't see this as medicine. Mainstream medicine today involves electronic health records with clinical decision-making built into the platform. For instance, if a suspected stroke patient enters an emergency department, they are treated virtually the same way in New Hampshire as they are in Los Angeles. The clinical software algorithm provides both diagnostic and treatment consistency across medical providers. Yet, in dentistry, a patient can see 10 dentists and receive 10 different treatment plans. This makes it easy to see why 'trust is a huge issue among patients.' Medico-legally, inconsistency of diagnosis and treatment is a real concern.

Cindy recalls that initially when she looked to improve consistency across providers, there was no leading mechanism to assess the exam data and provide clinical insight or support.  It is impossible to avail consistency of care by doing post-treatment chart reviews. At that point, it is too late to impact the diagnostic direction. Dentistry lags behind medicine by about 15 years in terms of healthcare IT adoptions.  Existing systems and infrastructure made it extremely tough to pull and aggregate data. She adds that she thought there had to be a better way.

Cindy asserts that another challenging matter was the inherent skepticism of long-term dentists.  No one likes change. Many dentists are certain that their naked eyes can detect caries better than an artificial intelligence solution. Statistics and studies refute this all day long.  Nevertheless, building an ecosystem to drive lasting digital transformation required quite a bit of change management. It became almost a sales job to get dentists to understand the value of migrating to a smarter type of diagnostic solution. She highlights that managing through unfounded fears that jobs would be replaced or that poor work would be exposed, definitely slowed down the initial adoption phase.

Passion and Persistence Makes a Perfect Leader

Cindy thinks that the innate ability to pivot on the fly is critical to leading through a digital transformation. Things can and will go wrong. Systems might react one way in a testing environment, and another way entirely in a pilot launch, absent a controlled situation.   Without passionate leaders, organizations find it easy to 'quit.' So, organizational commitment is the very first thing a technology leader must have to integrate both short-term and then sustain those changes long-term. She adds that as far as attributes are concerned, every technology leader should adopt a continuous learning mindset. In this case, leaders must know more about the subject than any person hopes to persuade. There will be an inevitably healthy amount of scepticism.

Cindy states, "One can't possibly hope to bring about change if he, himself, doesn't fully understand the objective. If anyone has ever attended a professional continuing education event, then he is aware that the speaker ALWAYS gets questioned."

Right Technology as the Catalyst of Innovation

Cindy advises leaders to pick nimble partners. The choice of technology partners is crucial in terms of innovating the solutions.  By partnering with healthcare AI early innovators, Sage has been able to pilot and troubleshoot in order to help create Sage-specific solutions. For instance, Dental Monitoring, a company that provides AI-based remote orthodontics solutions, and Hello Pearl, a company that provides an AI-based X-ray co-diagnostic software, worked with Sage every step of the way to improve and enhance capabilities. In fact, they have gotten together to collaborate based on synergies that Sage helped identify. She highlights, "Business school 101, still applies today. Pick the right partner and pilot, pilot, pilot until you have an awesome product. Good is not good enough when trying to introduce change."

Extensive Use of Emerging Trends

Cindy remarks that while dental care delivery remains a manual task, the field is certainly ripe for health care IT innovation and disruptive technology solutions. The COVID-19 Pandemic certainly identified the need for digital transformation and remote capabilities to continue to provide care. Additionally, there are also emerging technologies that are ready for primetime.

Cindy insists, "Imagine a world where dental radiographs are assessed through an artificial intelligence platform and annotated for both doctor and patient prior to even looking in the patient's mouth." Disruptive technologies exist in the areas of claim adjudication, practice data mining, virtual assistants to schedule appointments, chatbots, remote monitoring of orthodontics via smartphone, and Natural Language Processing for team training.  Levering these technologies to both improve patient care and patient experience is the job of every healthcare leader. Dentistry and technology are changing at warp speed. She adds that previous generations of dentists learned the bulk of what they needed to know in dental school.  That simply isn't the case any longer. The dental office and the delivery of dental care will look completely different 10 years from now.

The Future of Dentistry Lies in Technical solutions

Cindy mentions that she views dentistry as an industry standing at the verge of complete transformation. At Sage, the employees differentiate themselves by consistently providing the most innovative technology and patient care platform in the industry.  As more dentists adopt these important technology solutions, consistency will become more of the norm.  She truly believes that all dental schools need to be on board with AI-based solutions, given the ability to deliver on the consistency of diagnosis and treatment planning. As the dental industry continues to consolidate in the Dental Services Organization (DSO) space, she sees these information technology solutions as vital. DSO's will need to be able to data-mine in order to control costs with virtual assistants and chatbots, auto-adjudicate claims to provide a more accurate bill at treatment time, and provide more accurate care based on radiographic disease indications. Dr. Cindy highlights that those who do not embrace these solutions will clearly be left behind.

An Advisory Note for Next-Generation Leaders

Cindy insists that all leaders, healthcare or not, need to retain an attitude of lifelong learning. It sounds simple but often isn't. In order to effectively lead through a move in the direction of augmented intelligence, leaders at a bare minimum need to understand the concept of a neural network. If some people are the leaders who feel they learned all they need to know in either business school or dental school, eventually they will fail. Technology is improving at warp-speed. To harness the potential, re-education is the key. AI can and will streamline and improve dental diagnostic work, and play a huge part in how people reengage existing patients and attract new ones. Cindy concludes by saying, "Educate yourself, so that you and the organization you lead will be ready."