What a Trial Is Actually For

The email arrives near the end. Your trial ends tomorrow, it says, and would you like to continue. And the honest answer, in a lot of practices, is that nobody can say whether anyone used it.

Not whether anyone liked it. The office manager liked it. The rep was helpful. The demo was impressive. But if the question is whether the scheduling coordinator booked a single real appointment through it on a real afternoon while the phone was ringing, the practice does not know, because nobody decided at the start that this was the thing to find out.

That is the whole argument of this post. A trial is not for confirming that you like a product. It is for finding out, before the money is spent, whether anyone in your building will use it. Almost nobody runs one that way, and the industry's own advice does not tell you to.

The checklist that recommends the trial and forgets what it is for

Earlier this month this blog took apart the ADA's ten-point checklist for investing in technology, a New Dentist Blog piece written by Dr. Roger Levin of Levin Group, a practice-management consultancy, and found that it asks "will you and your staff actually use the new technology?" last, at question ten of ten.

Read the checklist again for the word trial and something else shows up. It appears twice. Question three, on cost-effectiveness, says that "if the manufacturer offers a 90-day trial period, take advantage of it," because the trial "will enable you to get an accurate picture of operating costs and the impact of profitability before you make a permanent commitment." Question seven, on whether the product is user-friendly, says "this is another area where trial usage can be very enlightening."

So the checklist recommends the trial for cost and for ease of use. Then it reaches question ten, the one about whether anyone will use it, and recommends something else entirely: "be honest with yourself and ask for frank appraisals from your staff." Ask people how they feel.

The one question a trial can answer with evidence rather than opinion is the one the checklist answers by asking for opinions. The trial is sitting three questions away, already recommended, never connected to the thing it is best at.

Adoption is the obstacle, and the industry says so

At an ADA Forsyth Institute event for dental investors and technology developers last October, the panel's conclusion was reported under the headline that adoption is the key challenge. One panelist, an emeritus professor of dentistry, said that "that behavioral change, which seems very simple, is actually a tremendous barrier in practices to adopt new technology." An executive from a large dental support organization said that "most of what we talk about with innovation is behavioral change of humans."

Those are people whose money depends on practices adopting what they fund, saying that the hard part is not whether the product works. It is whether the humans in the building change what they do. That is the developer's problem after the sale. Before the sale, it is yours, and the trial is the only instrument you have for it.

What the trial has to observe

A demo is the vendor's hands on the vendor's data. A trial is your team's hands on your patients' appointments, and it is only useful if you decided beforehand what to watch.

Before the first day, write down the one task the product is supposed to take over. Not the category, the task. Answering the phone at lunch. Sending the post-op instructions after an extraction. Booking the after-hours caller who is not yet a patient. If you cannot write the task in one sentence, you are not ready to trial anything, and there is an earlier post on this blog about writing that sentence.

Write down whose day changes. A person, not a role, and definitely not "the team." If it is a phone tool, it is the scheduling coordinator. If it is a documentation tool, it is the assistant who writes the notes. That person knows the trial is running and knows what she is being asked to do differently, because a trial the team does not know about is a demo with a longer clock.

Write down what "used" means in a way you can count. The appointment was booked in the tool rather than written on the sticky note and entered later. The instruction sheet went out from the tool rather than from the printer. The count is the whole point. "Everyone seems to like it" is what the checklist's question ten will get you, and it is not an answer.

And write down what happens to the old way while the trial runs. Keep it. Keep the sticky notes and the printed sheets and the clipboard, visibly, on purpose, because the most honest signal a trial gives you is whether the old way survives it. There is a post on this blog about the thing you are still doing by hand a year after buying the software that was supposed to replace it. A trial is your chance to catch that before the purchase. If the parallel process is still alive at the end of the trial, the product did not take, no matter what the appraisals say.

Running it and ending it

During the trial, look at the count, not the mood. Look at it on a rhythm the practice already has, the morning huddle or the team meeting, and the question each time is the same: did the task happen in the tool, how many times, and by whom. The mood is what the vendor's survey will collect, and it is not what you are paying for.

Find out what the last day does before the first day. Some trials end and stop. Some end and start billing. Know which, and know what you owe if you stop, so the decision at the end is about the count and not about the inconvenience of cancelling.

Then decide from the count. If the task happened in the tool, by the person whose day it was, and the old way withered, buy it. If the appraisals were warm and the count is thin, do not, and do not feel bad about it. The checklist itself says that many dentists "have made substantial investments in technologies that end up underutilized," and that for those investments the return "is nil." The trial existed so you would not be one of them.

What we do about this

We think the first weeks should be the trial in the sense above, so we do not lock anyone into a long-term contract and there is no onboarding fee. If the count says stop, you stop. The number a practice receives after signing up for Laine is an ordinary working number that is not published anywhere, so the first calls it takes can be your own team calling in as patients, which is the cheapest trial there is. And if the sentence you write before the trial describes a task neither Laine nor Saige takes on, we will say so, and you will have saved yourself the ninety days.

The email is going to arrive. Decide now what you want to be able to say when it does.

Deren Flesher, DDS. Founder, AiroDental.