Episode 289 - Revamping Dental Tech with Melissa LuVisi
Max interviews Melissa Luvisi from tab32 as they dissect the intersection of dentistry and technology. They explore the software deficits plaguing the medical field, how dentistry is lagging, and how it can take a quantum leap forward. Luvisi shares her insights on harnessing health data, addressing security and privacy issues, and the promising future of dental tech.
Melissa LuVisi
Melissa LuVisi is an entrepreneur, advocate, and the Chief Strategy Officer at tab32, a cloud-based dental technology platform, where she drives corporate strategy across account management, sales, marketing, and R&D. She is the recipient of the 2022 Sacramento Business Journal’s Women Who Mean Business award. As a member of Newsweek Expert Forum and founder of a successful marketing agency, Melissa is regularly quoted as a marketing expert in top publications, contributing to conversations in the tech, AI, Future of Work, and sustainability verticals.
As CSO at tab 32, her innovative marketing strategies included the receipt of the Inc. 5000 2022 award, the Sacramento Business Journal’s runner-up award in MedTech Innovation, a 5-fold increase in revenues, and pioneering the YouTube campaign which highlights innovators in the dental industry. Early in her career, LuVisi served as one of the first executive team members at Tender Greens Restaurants, a $100M restaurant group with 25+ locations; from there, she spearheaded the launch of the tech-enabled auditing arm of FedEx Ground real estate department. In 2012 she co-founded Treading Art, a leading online cultural publication and events marketing company, and again in 2014, she founded Lu Curates Media, a boutique marketing firm that bridges tech, marketing, and public relations to facilitate and support businesses.
Links
Melissa LuVisi - Newsweek Profile | Linkedin
Newsweek - How Gaps in Pediatric Dental Care Fuel Cycles of Poverty and What We Can Do About It
Comstock’s Magazine - Women in Leadership: Melissa LuVisi
11News - Melissa LuVisi of tab32 Joins the Newsweek Expert Forum
Max Sklar’s Twitter Update on The Fourth Turning is Here
Related Episodes
Episode 269 - Image Recognition Technology for Health with Susan Conover
Transcript
Narration: You're listening to the Local Maximum, Episode 289. Time to expand your perspective. Welcome to the Local Maximum. Now here's your host, Max Sklar.
Max: Welcome, everyone. Welcome. You have reached another Local Maximum. We have a great interview for you today. I just want to start with a little update. On Friday, I just got back from France on a work trip from Nice. So that was really cool. With you know, these long plane rides always kind of knocked the wind out of me. But, but it was great. It was it was an amazing experience.
It was my first international trip for a while probably since Ukraine in 2019, which you might remember back from episodes, I don't know, 77, 78, I got a chance to read quite a bit on the plane. And not only that, but since I moved, I got a new bookshelf, not just that one, but there are others, the rooms, new books, so I'm hoping there's going to be a lot of fascinating materials to bring you in the near future.
One book that came out recently is Neil Howe’s new book on the fourth turning, called “The Fourth Turning is Here”. I posted on Twitter because I went to Barnes and Noble on the day it came out and and I was very excited to get it because the fourth turning and generational theory, if you're, if you're not familiar with it, definitely go back and listen to our previous episodes has been a big topic on the show. And it's it's topic that I can't stop thinking about some of our most popular shows. So I haven't started the book yet. I didn't want to bring the big book on the trip with me. And I can't find my Kindle.
But I brought a smaller book on the same subject on how technology is going to a theory and how technology is going to bring about the “The First Turning” by Carol Engler. Some of it is a little dated. And I think some of the predictions didn't quite pan out. But I think it was still worthwhile. And I'd love to review that on the show soon either on a solo show or with Aaron. And then I'll start the grand finale. “The Fourth Turning is Here”, Neil Howe, which I'm very excited about.
I also started a really cool book called “The Case Against Reality” by Donald Hoffman, a really interesting argument of the interesting intersection of philosophy and science. So there's two authors I want to reach out to but either way, we'll be talking about their work.
The last time we talked about medical technology, here on the Local Maximum was episode 269 with Susan Conover, that was the one as you might recall about the startup pitch and health for the use of AI in dermatology. Very cool episode. Today's guest, Melissa was recommended to me shortly after this, and I wanted to be sure we were talking about the right things that would work for this audience on the show.
So it took a bit of back and forth to get it going. But I'm really glad we got there. And I'm really glad we took the time because I love how this conversation turned out. And we're gonna learn today at the intersection of AI, data, health and our medical system. So our guest is an entrepreneur and Chief Strategy Officer at tab32, a cloud based dental technology platform. Let's welcome her to the show.
Hi, Melissa LuVisi, you've reached the Local Maximum. Welcome to the show.
Melissa LuVisi: Thank you so much for having me, Max.
Max: Thanks. Where are we? Where are you calling in from today?
Melissa: I'm calling in from Northern California in the city of Sacramento.
Max: Oh, very nice. Very nice. All right. So we're going to talk about software in in medicine and, and in Dental today. Let's let's start with something very straightforward. What is the problem with software in medicine?
Melissa: Yeah, I mean, I think the problem with healthcare systems in general is that basically, they're all on legacy software. So, you know, when we think about technology and how it evolves, you think about the technology that you were using and the 1990s, which is when medical offices were starting to digitize, right. You know, dental, which is the area of healthcare that I work in, was kind of left out of that legislation.
And so dental was never forced to digitize so we even today still have some practices that are, believe it or not working on paper. But so if you think of the big gap in terms of how technology has been innovated over the last, you know, couple of decades. I think that's one of the biggest problems that contributes to a lot of the system failures that we see in healthcare as well.
Max: Right now I when I go to the dentist, I still see those like paper folders on the side. Is that just something that's required to be there even if they have their stuff digitized? I'm sorry, this is not your thing. It's just I'm just thinking, I go to the dentist, I have experiences. But sorry, go ahead.
Melissa: Well, I don't know your dentist, so I wouldn't try to speak on their behalf. But what I would say is, you know, there's a lot of different variations of how dentists are implementing software today. So you do have a lot of dentists, especially maybe of an older generation where they're doing a hybrid.
And even if they have digitized, they still might have those folders there, because they are required to keep their records, I think for about seven years. So even if they've digitized in the last five to seven years, they might still just keep those records on hand, because they're required to. Also some dentists like to refer back to them, you know, short if your history is there, but the industry is definitely moving away from that, as it continues to consolidate.
Max: Okay, so let's get into the whole technology of dental offices and dental records. How can it leapfrog the medical field in this regard?
Melissa: Yeah, so I'm of the belief that dental has an opportunity right now to leapfrog medical, because medical was mandated to digitize in the 90s. And so a lot of the systems that they are on are legacy softwares — either in what you would call self hosted environments, or they're taking these legacy softwares, and they're hosting them in the cloud.
But the problem is, is unless you're like a Walmart, or some of these larger, you know, like a Kaiser has talked about this a lot about how they're doing like a hybrid, they have a big budget for that they're well established dental DSOs, which are called dental service organizations just simply aren't that big.
The industry is just now starting to consolidate. And now we have access to what's called a multi tenant cloud infrastructure. So kind of a serverless cloud infrastructure, which just allows us to develop a lot faster, which is what my company's technology sits on.
For those of you who don't know, I guess I have, my name is Melissa LuVisi. I work for tap32. I'm the Chief Strategy Officer here at tap32. We are a cloud based practice management software and technology platform for dentists. So we not only offer practice management software, which is management of your electronic healthcare records for your dentists.
We also have integrated radiography, radiology, so all of your radiographs, you know, dentists take a lot of X rays, we've all experienced that. We sort those in the cloud. And then we also have data warehousing and solutions for DSOs. And also for small practices, but mostly DSOs have the budget for it. It's really more of a larger organization requirements and manage the data that your dentists are collecting when they see you every six months.
Because unlike medical, actually, we do have this habit of going to our dentist, dentists have done a really good job of getting us to go, even though most Americans don't go for those of us who do go, dentists are doing a really good job of getting us to come in every six months. In fact, we might see our dentist more than we do our family medicine care provider,
Max: I know for me far more often.
Melissa: Yeah. And so there's a big conversation between the connection of our oral health care and our bought our physical body health care. And what kind of preventative diseases can we see in the mouth if people are going to the dentist more than their family health care provider? And right now, the reality is, is we have absolutely no data on it.
It's a little bit of a black box, we have some disparate research studies here and there. But our mission is to you know, free the data out from underneath the death of these dentists on these old servers.
Max: So first of all, we'll have an introduction to this episode, so people will know who you are coming into. Okay. All right. I just want to ask you, the multi tenant cloud infrastructure, what do you mean by that? What's, what's multi tenant, and why is it important for your purposes?
Melissa: Yeah, so when you think of a server, right? Let's think of a server sitting in a dental office. This is what you would call a single tenant server. This is kind of the first generation of computers right where these server based operating systems, and they would call it legacy software. So if you want to have multiple offices, or you have to back that up in case the server fails, because you're required to keep your records for seven years. And if that server are, you know, to update. So traditionally, you would have a dental office or a medical office that would have a server that would then run software on it that would manage your healthcare records, right? If the if you need to make an update to that technology, you have to update each server one at a time.
So I don't know if you know, we're so used to now like Chrome does an update, I swear to god almost every other day. But my browser, right, but back in the 90s, in the early 2000s, if we wanted to update our computers, and they happened almost maybe once a year, even. And you had to get the CD-ROM, you had to download it, and you had to update your computer. Well, a lot of healthcare technologies are still on that technology. And that's just really time consuming when we talk about how do we innovate in a software space?
Max: Yeah, so it sounds just like kind of best practices for some cloud infrastructure, right? Like, what are you on? Are you talking about using some kind of, you know, like, whether it's Google Cloud or Amazon, or? Or do you guys use some?
Melissa: Yeah, so we sit on the Google Cloud infrastructure, so and we're on their multi tenant system. So multi tenancy is, you know, the way it's been described to me as single tenants like, Okay, you buy a community of servers, like think of them as people buying one house at a time. If you need to make a renovation, you have to go into every single house to make that renovation, versus buying a skyrise of condos, and you can make the renovation fairly quickly within the skyrise of condos. That's how the technology has been best described to me
Max: So you kind of touched on this, but what do you think we could learn about our health with this data? Do you have any specific examples? Do you have any specific hopes and dreams in terms of what you guys would be trying to achieve?
Melissa: Yeah, actually, our CEO and founder and Kiltesh Patel was recently recently wrote an article for Harvard science for I think it's the Harvard Science Magazine, talking about the connection of diabetes in health care and oral health.
So, you know, the health of our gums tells a story. And when we have access to that data, we now can start to understand, hey, what are some precursors that we might be seeing in our mouth to potentially pre diagnosing things like diabetes or other diseases, whole body diseases that we start to see in our mouth first.
Once we get that data and connect that I think it's going to be a very interesting conversation. Another thing that we're seeing a lot is an every industry seeing it right is the introduction of AI, and more specifically, the introduction of AI when we start talking about radiographs.
Max: So tell me a little more about that.
Melissa: Yeah, so I'm in dental right now, there's, you know, Bena, we are working on our own product. And I can't talk too much about that. But you have seen a lot of different companies right now where they are working for the rate, because we were there working with the AI, looks at the radiograph and works in conjunction with the doctor to help diagnose the, what are caries, which are basically your cavities that you then need to fill in for.
And so that is happening a lot in dental, you know, our approach has always been, we want to collect the data first and then build our models. So that takes a little bit longer versus, you know, some of the versus building the model and learning as you go along. So we haven't released anything on that. But you're seeing a lot of that and you're seeing it, you're seeing it across healthcare. I think AI will play a big role when it comes to radiology, no matter what healthcare sector you're in.
Max: Okay, so I've kind of two two directions. I want to go with this. I mean, the first is, you know, when just looking at the data related to say, I don't know, whatever qualitative thing they have at the dentist, you know, they tell me I my gums are no good and they gotta brush more or whatever. Okay, but just looking at that you said you can find precursors of stuff.
It sounds like, I mean, that's yes, that's like machine learning AI, but it sounds like you're going to need or the industry is just going to need a lot of statisticians, you know, the types of people who I you know, the types of machine learning that I kind of sometimes promote on this podcast, like, you know, people who are good at Bayesian inference and trying to figure out what causes what, that sort of thing.
So, I mean, it sounds like this data could just be used in in in In just some really interesting datasets to have some kind of data scientists play with it and figure out what they can achieve. I don't know, that's just a thought. I don't know if you have any, any thoughts on top of that, or should go over?
Melissa: Yeah, I mean, in theory, right, that's the goal. We haven't even scratched the surface when it comes to because the data has been so inaccessible for so many years. We're just starting to explore what we can learn from the data.
Max: Right. And so when you're talking about radiographs, you're using AI on this is this is going to be like, image recognition type systems. Yeah.
Melissa: And there's some in Dental today, we haven't released didn't get at 1032.
Max: Yeah, I have been shocked, especially going through the medical system for various reasons. And, you know, I feel like a lot of a lot of problems could be solved with with some of this image recognition, I've been shocked how little it's used, it's like, okay, like, this Tech has been around for at least ten years, okay, maybe maybe seven years. And it's like, like, we need this somebody, somebody hook it up. And it's not that hard!
Melissa: But it goes back to having large datasets, right, AI is only as good as the datasets that it can learn from. And if you don't have a certain, my understanding is, if you don't have a certain mass of data, then really, it's not that accurate. And when we look at things like health care appointments, for example, are, you know, you're expected to see a patient in a very short amount of time, you can't have your software, adding more time to that.
And I think that's true, no matter what industry that you're in, especially in healthcare. And so I think that some of the challenges that healthcare is seen from a software perspective, is the data has been so inaccessible for so long. And that's where dental has an opportunity to not only get their data available, but to put it into an infrastructure, like a multi tenant infrastructure, you know, put it into more modern infrastructures that will future proof, the data collection and the software development. Whereas making those changes on the healthcare side, I think will be a lot more challenging for the larger organizations over there.
Max: Yeah. So this whole system that you're envisioning, what part of it is kind of out now? What have they been doing now? What value has been gotten out of it now? And what's upcoming, like in the future?
Melissa: Yeah. So we, I'll say, we are working on our own AI models, I can't say when that's going to be released. In terms of practice management, we, which is our core product, that's what we went to market with in 2016. We've been, it's been around for about 10 years, and that is, you know, everything across the care continuum. So our product does do a text messaging, which you then can glean really interesting engagement data. How many texts do I need to send a patient to get them to come in after I've done a treatment plan for them? How do I get patient compliance?
And then we have so and then we have our own radiology within our practice management that comes as a part of the package. And then we offer our Open Data Warehouse. So we are, to my knowledge, the only cloud provider in the industry right now that offers open data access to the data, the practice management is collecting for our clients. And so that's why I said we're barely scratching the surface, you know, as dental technology is developing very rapidly.
Max: Can you tell me what, the AI models that you're working on now, what those are going to do?
Melissa: I unfortunately can't speak to that.
Max: Well, are they in the topic of image recognition? Are they text-based? Are they like, you know, some kind of statistical model based on data gathering?
Melissa: Yeah, I can't, I can't go any further into what we're doing right now. But stay tuned in the next 24 months.
Max: All right. 24 months — things do move slow in there. But it still is exciting. So one more question to consider, like what are some of the privacy and security concerns that come up when doing this kind of work?
Because, you know, like there are so many leaks that just it seems like you know, in terms of people's, you know, personal data and financial data or whatever it just seems like everybody is running around without, with their pants down sometimes. And kind of scary when it comes to medical data? You know? So what kind of concerns are you hearing from? From that?
Melissa: Ya know it? That's a really great question. And unfortunately, dentists are targets. So you know, a lot of dentists have typically been your mom and pop dentist shop, right? You know, it's single dentist owner, you've been going like, maybe there's, a lot of times their family run, your parents went to their parents, then they became dentists, then you're going to that office. And so these aren't necessarily like health care centers with security budgets, or a lot of security knowledge, which unfortunately makes dentists a target for security issues.
And you know, because we sit on the Google Cloud, I think that a lot of people don't understand cloud as much, yes, if you're building out your own cloud, that is yet another expense that you have to take on from a security perspective.
And so our partnership with Google allots us a lot of security from that perspective, you know, Google's health care, the site of Google's healthcare, part of their corporation, when they have to report to the government, they have a lot of their security already, like stuff to compliance, those kinds of things, we are, at the end of this, in the next couple of months, we'll have our sock to compliance also completed independent of our certificates that we get through Google.
But I think too, there's a big knowledge gap and just get very nervous when they hear cloud. And I just have to remind them that Google security budget is, you know, larger than the entire dental industry. But it's a huge issue. And you know, I've heard of DSOs, where they were posting on social media talking about how they were firing a practice. And then those practices would become targets, because they pointed out that, hey, they hadn't been ingested yet, by the larger organization that did have a security budget.
And so dentists and dental service organizations right now are really having to be aware of that. And, and it's hard to find tech talent, you know, you come out of this, the industry, like finding technologists is, isn't easy when you're in tech, let alone in an industry like dental where it really just hadn't had any tech infrastructure. So that's kind of you know, we're a lot more people are coming into dental with different backgrounds, which I think is enriching the conversation, frankly.
Max: Yeah, I know, a lot of times these conversations go like it's not about how big the tech budget is. But it's like the, you know, the way you describe some of these dental offices, it's like, okay, maybe Google's ironclad, somebody calls the dental office and says, Oh, you know, there's a problem with the Google Cloud. I'm from Google, you know, give us your login.
And I know, it almost sounds like, oh, we shouldn't fall for that. But, you know, it can happen to anybody in a moment where they're not really focusing on what's happening. So it's always like, okay, like, what, what kind of social engineering? Are these criminals? Honestly, you're gonna be trying to get through, and it's definitely something to think about, I think.
Melissa: Yeah, I mean, luckily, luckily, also our founders that come out of the hospital systems for the UC system, so like UC Davis and UC San Diego, they worked on those hospital infrastructures, and like our head of security comes out of that. So, you know, obviously, we're gonna try. Anyone in tech is trying their best, but I think our partnership with Google positions us and puts us in a good position for it.
Max: Yeah. Yeah. So let's end on a positive note. I know we already spoke about this a little bit, but what, you know, what would you see not the end game, but what would you see as like the, the, your your dream use case for for kind of cloud infrastructure and AI in the dental industry?
Melissa: Yeah, I mean, I think my, our dream use case is we just have to get access to the data. I, you know, one of the things I wrote an article for Newsweek just a few weeks ago where I talked about the huge discrepancy between children and the financial burden that dental lack of dental access and health care puts on small on children, and especially within, you know, the disparities that we see 40% of Americans go to the dentist, I think was the last statistic I read anywhere, but it hovers between 40 and 50% of Americans are going that's 50% of Americans who aren't going.
If children don't get early access to dental health care, you then see this compounding effect back to where they ended up being young adults. And I shared my story a little bit as a foster youth who didn't have access to dental health care. And I'm still to this day dealing with my dental bills, if you will, because it's a continuous thing that I have to stay on top of, and I work in the industry, so I have pretty good dental health care. Not everyone has that. So I think if we start to get access to the data, we can also start to identify where we can put resources to help close those disparities and those gaps in care.
Max: Yeah, yeah, no, I truly believe you know, in medicine in general, that we're not getting the value we could, when we go to these doctors and dentists like, and it's not, I'm not blaming the individuals there. It's just like, you know, if I'm complaining about a specific set of problems, and they're observing a specific set of problems, I feel like an information system should be able to come back with a list of suggestions that is better than what an individual doctor would often come out with.
So I would definitely, you know, like medicine that way, I've definitely had issues that could have been caught way sooner, if it weren't left to left to just, you know, doctors saying, Oh, this is what you have, you know, based on my experience, it's like, okay, yeah, your experience is great, but I need the experience of, you know, hundreds of 1000s of doctors across millions of patients, you know, average, that would be way better.
Melissa: Yeah, I mean, it's a real gray area, you know, my husband is a family medicine doctor. So we spent a lot of time talking about this. And, you know, he works at a large organization where they have systems like that. And, you know, I think that he would argue that the system doesn't always take into account, the person, the nuance and the intersection of the individual. So I think we will always need health care providers to work alongside our technology.
Max: And I wasn't suggesting Yes, yeah.
Melissa: But so it's a little bit of a gray area, because I think a lot of people have that experience where they feel like doctors or healthcare providers weren't necessarily listening to them. So maybe technology can counteract that. But there's also the other side of that coin, where, you know, technology sometimes doesn't pick up on certain intersections within our society. And so we're really going to have to work side by side as humans and technology to really come to the best outcome.
Max: Yeah, I feel like, in my opinion, is I feel like the problem is maybe I mean, this is maybe just my sense of it, I could be completely wrong. I feel like a lot of people go to the doctor with a problem that's maybe not not really a problem are not really solvable by the doctor, but then it's like, okay, the doctors for their experiences, they see a lot of issues that are not really issues all day, but then when you come in with a real issue, you know, you need them to believe you. You need them to solve it. So I feel like that's, that's, that's part of the problem. Am I saying, you know, I
Melissa: know, definitely, definitely, I think that happened, that certainly happens a lot. And it certainly happens in places like, you know, emergency rooms, for example. Did you know for, I think it's something like 14% of emergency visits are dental emergencies. Really? Like that's a huge impact on the system, right? Here's where preventative care could start to eliminate some of these challenges we're seeing and systems. And we're in a pretty easy way. Right?
Max: Right. Like if I have a, well, yes, if I have a toothache, I go to the dentist, they can fix it. If I don't fix it, I'll end up in the emergency room or, you know, maybe we can sort of predict who's going to have dental problems or something like that. Right.
Melissa: Yeah. Or just, you know, how do we, you know, get to those cases? How do we get to those cases, provide that patient education? Because prevention is all about patient education, too. And I think that's also where technology plays a role. Right? How do we engage with our patients in a meaningful way, when everyone's so busy, and, like, who wants to get a bunch of crowns when they're like looking at trying to buy a new car for their family, you know?
Like, these are the conversations at least in dental, I think a lot of people this is where like, it overlaps a little bit with consumerism in that regard, like people are trying to make these decisions, but can I push that crown off until I do XYZ and the problem is, is if you push some of the you push this care off, now it becomes a root canal you know, now it because it can be actually quite dangerous as tooth infection can lead to death.
And so these these things, the severity of it, I think a lot of people don't know or it's so that's kind of one of our roles also as people in the dental industry is how do we get the conversation around dental happening a little bit more so that we can just so people that are a little bit more aware and are going to their checkups? You know?
Max: Yeah. Yeah. All right. Sounds good. Makes sense to me. So, Melissa, any last thoughts on this conversation today? And we'll certainly link to your article, Newsweek. And where else can we find more about you and more about the company you work for?
Melissa: Yeah, I mean, I think the best place to find me is probably on LinkedIn, when that's really where I keep all of my business stuff. I certainly am on the other platforms, but they are much more personal lifestyle based but on LinkedIn is where I do a lot of my work with tap32. And yeah, no, this conversation’s been really good. And I really appreciate you having me.
Max: Thanks so much for coming on the show.
Melissa: Yeah.
Max: All right. Remember to go to localmaxradio.com/289 To get more information on this episode. It's funny, even as a so-called server engineer, which is what I was really a back end engineer, it was my job to figure out how Foursquare's servers manage the data coming in and out how to split things up among multiple machines and actually write the code.
Among other things, actually, I was the machine learning engineer first kind of so I had to do data science, I had to do, you know, data engineering to some extent, but I'm always amazed at how much more there is to learn in this field, security, protocols, hardware, it really never ends, no matter how much experience you get. So I really enjoyed this conversation from that perspective. And then also, we got to talk about normal stuff like, like going to the dentist.
So alright, so in the future, in addition to the reading I've been doing, I mentioned at the beginning, I'm also working on my heart on my constitutional documents, which you might have heard of, if you weeks ago, I've got more books. One is by Akhil Amar, the professor at Yale. And another book is a biography of George Mason, and my grants proposal, which is this decentralized database protocol.
I'm working on newmap.ai, continuing to work more on that, and there's going to be some exciting announcements soon. So if by chance, anyone out there is a scholar programmer who is really interested in computer science theory, let me know — I could use some help on this project. I know I slipped this in on the end here, because I'm just kind of dipping my toe in the water. But we'll hear more about it soon. Front and center. All right. Have a great week, everyone.
That's the show. To support the Local Maximum, sign up for exclusive content and our online community at maximum.locals.com. The Local Maximum is available wherever podcasts are found. If you want to keep up, remember to subscribe on your podcast app. Also check out the website with show notes and additional materials at localmaxradio.com. If you want to contact me, the host, send an email to localmaxradio@gmail.com. Have a great week.
