Implementation PlaybookDSO · Group Practice

Bola AI

Step-by-step implementation guide — pre-implementation checklist, onboarding, staff training, go-live runbook, and ROI tracking.

Contents

Bola AI — Implementation Playbook (DSO)

Bola AI Implementation Playbook for DSOs

AI Scribe Technology Deployment Guide

1. Executive Summary

What Bola AI Does

Bola AI is a voice-activated AI scribe that listens to patient-provider conversations in real-time, automatically generating clinical documentation, SOAP notes, and treatment narratives directly into your practice management system. The platform eliminates manual charting by converting natural clinical dialogue into structured, compliant documentation.

Why DSOs Specifically Benefit from AI Scribes

Scale Advantages:

A single provider saves 60-90 minutes daily on documentation; across 50 locations with 3 providers each, that's 150+ hours of recovered clinical time per day
Centralized deployment reduces per-location implementation costs by 40-60% compared to individual practice rollouts
Standardized documentation quality across all locations creates cleaner data for analytics and reporting

Standardization Benefits:

Uniform charting language and structure improves clinical handoffs, especially for multi-location patients
Consistent documentation reduces compliance risk and audit exposure across the portfolio
Standardized workflows enable meaningful provider productivity benchmarking

Data Aggregation Value:

Aggregated documentation patterns reveal clinical insights across demographics, geographies, and provider types
Normalized data feeds downstream analytics, revenue cycle, and quality improvement initiatives
Enterprise-wide visibility into documentation completion rates, turnaround times, and error patterns

Expected Timeline: Decision to Full Deployment

Phase	Duration	Milestone
Pre-Implementation	Weeks 1-2	Contracts signed, technical readiness confirmed
Wave 1 Pilot (2-3 locations)	Weeks 3-6	Pilot locations live, initial learnings captured
Wave 2 Expansion (5-8 locations)	Weeks 7-12	Scaled deployment validated
Wave 3+ Full Rollout	Weeks 13-20	All locations live
Optimization	Weeks 21-26	ROI validated, workflows refined

Total timeline for 15-50 location DSO: 5-7 months from decision to full deployment with optimization.

2. Pre-Implementation Checklist (Weeks 1-2)

Technical Requirements

Hardware Requirements (Per Location)

☐ Dedicated microphone per operatory (Bola-approved models recommended) ☐ Workstation with minimum 8GB RAM, modern processor (2019 or newer) ☐ Secondary monitor recommended for documentation review (not required) ☐ Mobile device option: iOS 14+ or Android 11+ for tablet-based capture

Software Requirements

☐ Supported PMS version confirmed (see Integration section) ☐ Chrome browser (latest version) or Bola desktop application ☐ Operating system: Windows 10/11 or macOS 11+ ☐ Antivirus/firewall exceptions configured for Bola domains

Network Requirements

☐ Minimum 25 Mbps download / 10 Mbps upload per location ☐ Latency under 100ms to Bola cloud services ☐ Ports 443 (HTTPS) and WebSocket connections enabled ☐ QoS priority for voice traffic recommended in high-volume locations

Enterprise-Level Network Standards 🟣

☐ Confirm network architecture: centralized vs. location-level connectivity ☐ VPN requirements for remote access to dashboards ☐ Firewall rule standardization across all locations ☐ Network segmentation policy for clinical vs. administrative traffic

Centralized vs. Location-Level Hosting Decision 🟣

Approach	When to Choose
Centralized cloud hosting	Preferred for most DSOs; simplified management, automatic updates
Hybrid (regional hubs)	Large geographic spread with latency concerns
Location-level instances	Rarely recommended; only if strict data residency requirements

Recommendation: Centralized cloud hosting with SSO integration for 95% of DSO deployments.

Identity & Access Management

☐ SSO compatibility confirmed (SAML 2.0, OAuth 2.0, Azure AD, Okta) 🔵 ☐ Role-based access control (RBAC) structure defined ☐ Centralized credentialing workflow established ☐ User provisioning/deprovisioning process documented

Vendor Onboarding Steps

Key Contacts to Establish 🔵

Role	Vendor Contact	Your Contact
Implementation Manager	_____________	VP of Operations
Technical Support Lead	_____________	IT Director
Training Coordinator	_____________	Learning & Development
Customer Success Manager	_____________	Chief Dental Officer
Executive Sponsor	_____________	CEO/COO

Onboarding Milestones 🔵

☐ Kickoff call scheduled (Week 1, Day 1-3) - 60 minutes ☐ Technical architecture review completed (Week 1, Day 3-5) - 90 minutes ☐ Enterprise admin credentials provisioned (Week 1, Day 5) ☐ Sandbox/test environment access confirmed (Week 1, Day 5-7) ☐ Training resources and materials received (Week 2, Day 1-3) ☐ Integration documentation reviewed (Week 2, Day 1-3)

Data/Access Prerequisites

PMS Access Requirements

☐ Admin-level PMS credentials for integration configuration ☐ API access enabled (if applicable to your PMS) ☐ Test patient records created for integration validation ☐ Provider NPI numbers and credentials loaded

Historical Data Considerations

☐ Determine if historical note ingestion is desired (for AI context learning) ☐ If yes: Export format requirements confirmed with vendor 🔵 ☐ Data scrubbing/de-identification process defined if required ☐ Historical data volume estimated (affects ingestion timeline)

API & Integration Keys

☐ PMS API keys generated (where applicable) ☐ Imaging system integration credentials (if integrated radiograph annotation is used) ☐ eServices/patient communication platform credentials (if treatment plan summaries auto-send)

Internal Stakeholder Alignment

Stakeholder Alignment Map

Stakeholder Level	Who	Role in Implementation	Engagement Required
Board/Investors	Board members, PE partners	Approve budget, track ROI	Monthly progress briefings
C-Suite	CEO, COO, CFO, CDO	Executive sponsorship, resource allocation	Weekly steering committee
Regional Managers	Regional VPs, Area Directors	Cascade communication, remove blockers	Bi-weekly ops reviews
Location Office Managers	15-50 office managers	Champion identification, local logistics	Training, daily check-ins during rollout
Providers	Dentists, specialists, hygienists	Adopt workflow, provide clinical feedback	Training, ongoing feedback loops
IT/Infrastructure	IT Director, system admins	Technical implementation	Daily during implementation
Revenue Cycle	Billing managers, coders	Monitor documentation impact on claims	Training, 30/60-day reviews

Approval Requirements 🟣

☐ Budget approval (CFO) ☐ Clinical workflow approval (Chief Dental Officer) ☐ IT security approval (IT Director/CISO) ☐ Legal/compliance review complete (General Counsel) ☐ BAA executed (Compliance) ☐ Board notification completed (CEO)

Baseline Metrics Capture ⚠️

Critical: Measure these BEFORE go-live across ALL locations using standardized methodology.

Documentation Efficiency Metrics

Metric	Measurement Method	Target Baseline Period
Average documentation time per patient	Time study: 10 patients per provider	2 weeks pre-implementation
Documentation completion rate (same-day)	PMS report: % of notes completed day-of-service	30 days pre-implementation
After-hours documentation time	Self-reported provider survey	2 weeks pre-implementation
Notes requiring amendments/addenda	PMS audit log	30 days pre-implementation

Clinical & Revenue Metrics

Metric	Measurement Method	Target Baseline Period
Patients seen per provider per day	PMS scheduling report	30 days pre-implementation
Treatment plan acceptance rate	PMS treatment planning report	30 days pre-implementation
Claim denial rate (documentation-related)	RCM system filter	90 days pre-implementation
Average revenue per patient visit	PMS production report	30 days pre-implementation

Standardized Measurement Protocol 🟣

☐ Create enterprise-wide metric extraction templates ☐ Assign metric collection to single owner (recommend: Director of Analytics) ☐ Establish data validation process to ensure cross-location comparability ☐ Build baseline dashboard before Wave 1 go-live ☐ Document any location-specific anomalies that may affect comparison

3. Location Readiness Assessment

Scoring Framework

Factor 1: IT Infrastructure Maturity

Score	Criteria
5	Fiber internet (100+ Mbps), hardware <2 years old, PMS on latest version, modern workstations in all ops
4	High-speed internet (50+ Mbps), hardware <3 years old, PMS within 1 version of latest
3	Adequate internet (25+ Mbps), hardware 3-4 years old, PMS supported but not latest
2	Marginal internet (10-25 Mbps), some outdated hardware, PMS 2+ versions behind
1	Unreliable internet (<10 Mbps), aging hardware, outdated PMS requiring upgrade before integration

Factor 2: Staff Tenure & Adaptability

Score	Criteria
5	Average tenure >3 years, <10% annual turnover, history of successful tech adoptions
4	Average tenure 2-3 years, 10-15% turnover, positive but limited tech adoption history
3	Average tenure 1-2 years, 15-20% turnover, mixed tech adoption results
2	Average tenure <1 year, 20-30% turnover, tech adoption has been challenging
1	High turnover location (>30%), frequent manager changes, prior tech failures

Factor 3: Patient Volume

Score	Criteria	Implication
5	80+ patients/day	Highest impact potential; reserve for Wave 2+
4	60-79 patients/day	Strong impact; Wave 2 candidate
3	40-59 patients/day	Moderate impact; good pilot balance
2	25-39 patients/day	Lower volume; good for cautious pilot
1	<25 patients/day	Limited impact; deprioritize unless strategic

Factor 4: Tech Stack Compatibility

Score	Criteria
5	PMS has native Bola integration, imaging system compatible, no conflicting software
4	PMS has API integration, imaging compatible with minor configuration
3	PMS requires workaround but functional, imaging partially compatible
2	PMS integration complex, may require additional middleware
1	PMS not currently supported, significant technical barriers 🔵

Factor 5: Local Champion Availability

Score	Criteria
5	Tech-forward provider AND office manager both committed; prior champion experience
4	Strong champion identified (either provider or office manager); engaged and capable
3	Potential champion identified but needs development; willing but inexperienced
2	No clear champion; will need to recruit/develop during pilot
1	Key stakeholders resistant; leadership vacuum at location

Composite Scoring & Rollout Sequencing

Scoring Template

Location	IT Infra (1-5)	Staff (1-5)	Volume (1-5)	Tech Stack (1-5)	Champion (1-5)	Composite	Wave
Location A						/25
Location B						/25
Location C						/25
...						/25

Wave Assignment Guidelines

Composite Score	Recommended Wave	Rationale
20-25	Wave 1 (Pilot)	High readiness, manageable risk, will generate positive proof points
15-19	Wave 2	Good candidates after pilot learnings applied
10-14	Wave 3	May need remediation before deployment
<10	Wave 4 / Remediation	Address gaps before rollout; don't force deployment

Wave 1 Selection Criteria ⚠️🟣

Wave 1 pilot locations should be:

☐ Score 20+ on composite readiness
☐ Geographically accessible for hands-on support (within 2-hour travel for regional manager)
☐ Representative of your portfolio mix (1 high-volume, 1 mid-volume; 1 GP-focused, 1 specialty if applicable)
☐ Led by a credible champion whose success will influence peer locations
☐ NOT your highest-revenue locations (protect critical cash flow during learning phase)
☐ NOT your most troubled locations (don't conflate tech rollout with turnaround)

4. Rollout Strategy

Recommended Wave Structure 🟣

Wave Architecture for 15-50 Location DSO

Wave	# of Locations	Duration	Key Activities
Wave 1 (Pilot)	2-3 locations	4 weeks	Deep implementation, daily check-ins, rapid iteration
Wave 2 (Validation)	5-8 locations	4 weeks	Apply pilot learnings, scale champion model, stress-test support capacity
Wave 3 (Scale)	8-15 locations	4-6 weeks	Streamlined deployment, reduced vendor involvement
Wave 4 (Completion)	Remaining	4-6 weeks	Final locations, address any remediation-required sites

Wave 1 Pilot Location Selection

Recommended Pilot Composition:

Location 1: Mid-size general practice, strong champion, representative workflows
Location 2: Higher complexity (specialty mix or multi-provider), tests edge cases
Location 3 (optional): Different region/market to test geographic variation

Timeline Per Wave

WAVE 1 (Weeks 3-6)
├── Week 3: Configuration, champion training
├── Week 4: Go-live + daily check-ins
├── Week 5: Stabilization, workflow refinement
└── Week 6: Retrospective, learnings documentation

[1-week buffer for learning synthesis]

WAVE 2 (Weeks 8-11)
├── Week 8: Parallel configuration (5-8 locations)
├── Week 9: Champion training sessions (regional)
├── Week 10: Staggered go-lives (2-3 per day over 3 days)
└── Week 11: Stabilization and early optimization

[1-week buffer]

WAVE 3 (Weeks 13-18)
├── Weeks 13-14: Configuration (8-15 locations)
├── Week 15-16: Champion training (may be virtual at scale)
├── Weeks 17-18: Go-lives and stabilization

WAVE 4 (Weeks 20-25)
├── Remediation of low-readiness locations
├── Final deployments
└── Portfolio-wide optimization begins

Go/No-Go Criteria 🟣

Criteria to Advance from Wave 1 to Wave 2

Category	Go Criteria	No-Go Criteria
Technical Stability	<5 critical bugs, all blocking issues resolved	Persistent integration failures, data loss incidents
User Adoption	>80% of notes captured via Bola, providers report net-positive experience	<50% adoption, significant workaround use, provider rejection
Documentation Quality	Notes meet clinical and compliance standards, no increase in errors	Quality degradation, compliance concerns raised
Support Capacity	Vendor SLAs met, internal support model validated	Support overwhelmed, response times unacceptable
Champion Confidence	Champions willing to advocate to peers	Champions request additional support before scaling

Go/No-Go Decision Process 🟣

☐ Wave retrospective completed with pilot locations ☐ Quantitative criteria assessed against thresholds ☐ Champion feedback collected and synthesized ☐ Technical issues log reviewed with vendor 🔵 ☐ Go/No-Go recommendation prepared for steering committee ☐ Executive decision documented

Rollback Plan ⚠️

Triggers for Rollback

Critical data integrity issue affecting patient records
Systematic documentation errors affecting clinical care
Integration failure causing PMS disruption
Provider refusal rate >30% at a location

Rollback Procedure (Per Location)

Immediate (Hour 1): Disable Bola integration, revert to manual charting
Communication (Hours 1-2): Notify location staff, regional manager, central team
Documentation (Day 1): Log all affected records, identify any data gaps
Root Cause (Days 1-3): Work with vendor to identify and resolve issue 🔵
Remediation (Days 3-7): Implement fix in test environment
Re-validation (Days 7-10): Pilot fix at affected location with enhanced monitoring
Re-deployment: Resume normal operations with fix validated

Impact Isolation

Rollback at one location does NOT trigger rollback at others
Other wave locations continue unless systemic issue identified
Central team documents learnings to prevent recurrence

5. Configuration & Integration (Weeks 2-3)

Practice Management System Integration

Dentrix Enterprise Integration

Step	Action	Owner	Duration	Notes
1	Confirm Dentrix Enterprise version compatibility 🔵	IT + Vendor	30 min	Requires v18+ for full API access
2	Enable Dentrix API access in System Configuration	IT	15 min	⚠️ Requires admin credentials
3	Generate API credentials for Bola	IT	15 min	Document in secure credential store
4	Configure Bola Dentrix connector in admin portal 🔵	Vendor	1 hour	Vendor-assisted
5	Map Bola fields to Dentrix clinical note structure	IT + Clinical	2 hours	Customizable per documentation preferences
6	Configure user mapping (Dentrix users → Bola users)	IT	1 hour	Automate via SSO if possible
7	Test in sandbox: Create test patient, generate note, verify sync	IT + Champion	1 hour	Document any sync errors
8	Validate clinical note appearance in Dentrix	Provider	30 min	Provider sign-off required before go-live

Eaglesoft Integration

Step	Action	Owner	Duration	Notes
1	Verify Eaglesoft version (21+ recommended) 🔵	IT + Vendor	30 min	Earlier versions may require Patterson support
2	Enable Eaglesoft Integration Module	IT	30 min	May require Patterson activation 🔵
3	Install Bola Eaglesoft connector on server	IT	1 hour	⚠️ Requires server access during off-hours
4	Configure connector settings 🔵	Vendor	1 hour
5	Map clinical note templates	IT + Clinical	2 hours
6	Test patient note generation and sync	IT + Champion	1 hour
7	Provider validation	Provider	30 min

Open Dental Integration

Step	Action	Owner	Duration	Notes
1	Confirm Open Dental version (21+ preferred)	IT	15 min	Open Dental generally integration-friendly
2	Enable Open Dental API in Program Properties	IT	15 min	Setup → Program Links
3	Generate API key for Bola	IT	15 min
4	Configure Bola Open Dental connector 🔵	Vendor	1 hour
5	Configure FHIR bridge if using advanced clinical workflows	IT + Vendor 🔵	2 hours	Optional for enhanced interoperability
6	Map note templates and clinical fields	IT + Clinical	2 hours
7	Test and validate	IT + Champion + Provider	1.5 hours

Imaging System Integration (If Applicable)

Common Imaging Systems

Imaging System	Integration Type	Configuration Steps
Dexis	Direct integration	Enable API, configure Bola connector, map image annotations
Carestream	API-based	Establish API access, configure DICOM bridge if needed
Schick	Via PMS	Typically passes through PMS integration
Apteryx (XrayVision)	Direct/API	Enable API access, configure study linking

Integration Validation Checklist

☐ Images from imaging system accessible in Bola interface ☐ AI-generated radiograph annotations (if using this feature) display correctly ☐ Annotations save to correct patient record ☐ Image references appear properly in generated notes

Test Environment Setup

Enterprise Test Environment Approach (Recommended for DSO) 🟣

Centralized Test Environment:

Single test instance with synthetic patient data
Accessible by central IT and location champions
Used for configuration validation before location deployment
Maintains test versions of each PMS (if multi-PMS environment)

☐ Test environment provisioned by vendor 🔵 ☐ Test patient records created (minimum 20 synthetic patients with varied scenarios) ☐ All integrations configured in test before production ☐ Champions trained in test before touching production ☐ Regression testing checklist developed for validating updates

Per-Location Testing Protocol

Before each location goes live: ☐ Test new patient creation → note generation → PMS sync ☐ Test existing patient → appointment note → sync ☐ Test procedure-specific documentation (exam, hygiene, treatment) ☐ Test multi-provider scenario (if applicable) ☐ Test documentation amendment/addendum workflow ☐ Provider signs off on output quality

Security & HIPAA Compliance Verification

Enterprise HIPAA Checklist ⚠️

Requirement	Action	Owner	Complete
BAA Execution 🔵	Obtain and execute Business Associate Agreement with Bola	Legal/Compliance	☐
Data Encryption	Verify encryption at rest (AES-256) and in transit (TLS 1.2+)	IT + Vendor 🔵	☐
Access Controls	Configure RBAC aligned with minimum necessary principle	IT	☐
Audit Logging	Confirm audit logs capture user access, note generation, PHI access	IT + Compliance	☐
User Authentication	SSO integration with MFA enabled	IT	☐
Data Retention	Align Bola data retention with your retention policies	Compliance	☐
Incident Response	Confirm vendor's breach notification procedures meet your requirements 🔵	Compliance	☐
Subprocessor Review	Review Bola's subprocessors (AWS, etc.) for compliance	Compliance	☐
Employee Training	Vendor confirms employee HIPAA training 🔵	Compliance	☐
Risk Assessment	Complete security risk assessment for AI scribe deployment	IT/Compliance	☐

Access Control Configuration

☐ Define role-based access levels:

Enterprise Admin: Full configuration, all location access
Regional Admin: Configuration for region, read access to other regions
Location Admin: Local user management, local reports
Provider: Own patient documentation
Staff: Assigned patient access per workflow ☐ Configure SSO group mappings ☐ Document access request/approval workflow ☐ Establish quarterly access review process

Standardized vs. Location-Specific Configuration

Standardized Configuration Template (Apply to All Locations) 🟣

Setting Category	Standardized Setting	Rationale
Note structure	Uniform SOAP format with branded header	Consistency for multi-location patients, compliance
Clinical terminology	Standardized dental terminology library	Clean data for analytics
Auto-save frequency	Every 30 seconds	Prevent data loss
Quality thresholds	Confidence score >85% before auto-approval	Quality control
Signature workflow	Provider review + e-signature required	Compliance
Audit settings	Full audit trail enabled	HIPAA compliance
Data retention	7-year retention aligned with state requirements	Compliance

Location-Specific Configuration (Allowed Variation)

Setting Category	Allowed Variation	Governance
Provider preferences	Note verbosity, preferred phrase templates	Provider discretion with clinical review
Specialty templates	Specialty-specific note templates (ortho, pedo, perio)	Must map to standard fields
Operatory naming	Local operatory designations	No impact on data integrity
Workflow triggers	When during appointment to activate	Office manager discretion
Notification preferences	How/when providers alerted to review notes	Provider/office manager discretion

6. Team Training Plan

Train-the-Trainer Model 🟣

Champion Selection Criteria

Criteria	Weight	Assessment Method
Tech comfort	25%	Prior tech adoption success, self-reported comfort
Communication skills	25%	Observation, peer feedback
Respect from peers	20%	Office manager nomination, provider endorsement
Availability	15%	Can dedicate 4-6 hours to training preparation
Tenure	15%	Minimum 6 months at location preferred

Ideal Champion Profile: Office manager OR lead dental assistant with strong peer relationships. Providers make excellent secondary champions but shouldn't be sole trainers (time constraints).

Champion Responsibilities

Complete champion certification program (4-6 hours)
Adapt central training materials to local context
Deliver training to all location staff (2-4 hours total)
Serve as first-line support during go-live week
Collect and relay staff feedback to regional/central team
Conduct new hire training and quarterly refreshers

Champion Certification Program 🔵

Module	Duration	Format	Content
1. Bola Overview	45 min	Video + Q&A	What it does, why DSO is adopting, benefits to staff
2. Technical Workflow	90 min	Live demo	Step-by-step operation, common scenarios
3. Edge Cases & Troubleshooting	60 min	Scenario-based	What can go wrong, first-line resolution
4. Training Delivery Skills	45 min	Interactive	How to train peers, handling resistance
5. Practice Teaching	60 min	Role-play	Champion teaches mock session, receives feedback
Certification Test	30 min	Online quiz	80% pass threshold

Role-Specific Training Outlines

Dentists/Providers

Estimated Training Time: 90 minutes (60 min session + 30 min hands-on practice)

Format: Live demo with hands-on practice, can be delivered remotely for Wave 2+

Content:

Why we're implementing Bola (2 min CDO video message)
How Bola fits into clinical workflow - appointment start to close
What appears on screen during patient encounter
Voice capture: what to say naturally vs. what to avoid
Reviewing and approving AI-generated notes
Interpreting confidence scores and handling low-confidence sections
When and how to override or edit AI output
Documentation for complex cases (specialty considerations)
Q&A

Common Resistance Points & Responses:

Resistance	Response
"I'm faster typing my own notes"	"Let's time it - most providers discover they're spending 1-2 hours daily they don't realize. Try it for a week."
"AI can't understand dental terminology"	"Bola is dental-specific. It knows the difference between mesial and medial. Let me show you."
"What if it makes a mistake?"	"You review every note before signing - AI drafts, you approve. You're never ceding clinical judgment."
"I don't want to change how I talk to patients"	"You don't have to. Bola captures natural conversation. Just practice once and see."

Day 1 Cheat Sheet (Provider):

┌────────────────────────────────────────────────────────────────┐
│                  BOLA AI - PROVIDER QUICK START                 │
├────────────────────────────────────────────────────────────────┤
│ START CAPTURE                                                   │
│ • Click [Record] when patient is seated                         │
│ • Green dot = listening                                         │
│                                                                 │
│ DURING APPOINTMENT                                              │
│ • Speak naturally to patient                                    │
│ • State procedure names clearly: "We're going to do a           │
│   composite restoration on tooth 14, MO"                        │
│ • Findings: "I see moderate inflammation in the lower right     │
│   quadrant"                                                     │
│                                                                 │
│ END CAPTURE                                                     │
│ • Click [Stop] when clinical complete                           │
│ • Note generates in ~30 seconds                                 │
│                                                                 │
│ REVIEW & SIGN                                                   │
│ • Yellow highlight = confidence <90%, review carefully          │
│ • Click to edit any section                                     │
│ • [Sign] when satisfied                                         │
│                                                                 │
│ TROUBLE?                                                        │
│ • Not recording? Check mic icon in system tray                  │
│ • Note looks wrong? Click [Regenerate] or edit manually         │
│ • System down? Use paper template backup, enter later           │
│                                                                 │
│ CHAMPION: _____________ | SUPPORT: help@bola.ai | ext. ___      │
└────────────────────────────────────────────────────────────────┘

Hygienists

Estimated Training Time: 60 minutes

Format: Group session with champion, hands-on practice

Content:

Overview: How Bola will help you and the practice
Your touchpoints: When Bola is active during hygiene appointments
Capturing hygiene findings: probing depths, bleeding, patient education notes
Handoff documentation: What to capture before provider exam
Reviewing hygiene note sections
Communicating with providers via documentation

Touchpoints for Hygienists:

Initial patient assessment capture
Hygiene findings documentation
Patient education notes
Handoff to provider
Post-provider follow-up documentation

Day 1 Cheat Sheet (Hygienist):

┌────────────────────────────────────────────────────────────────┐
│                  BOLA AI

AI-generated implementation guide based on public vendor information. Verify specifics directly with Bola AI.

Implementation Playbook — DSO · Group Practice

Bola AI

avized.com

Generated May 28, 2026

AI-generated guide based on public vendor information. Verify specifics directly with Bola AI.

Bola AI — Implementation Playbook (DSO)

Bola AI Implementation Playbook for DSOs

AI Scribe Technology Deployment Guide

1. Executive Summary

What Bola AI Does

Why DSOs Specifically Benefit from AI Scribes

Scale Advantages:

A single provider saves 60-90 minutes daily on documentation; across 50 locations with 3 providers each, that's 150+ hours of recovered clinical time per day
Centralized deployment reduces per-location implementation costs by 40-60% compared to individual practice rollouts
Standardized documentation quality across all locations creates cleaner data for analytics and reporting

Standardization Benefits:

Uniform charting language and structure improves clinical handoffs, especially for multi-location patients
Consistent documentation reduces compliance risk and audit exposure across the portfolio
Standardized workflows enable meaningful provider productivity benchmarking

Data Aggregation Value:

Aggregated documentation patterns reveal clinical insights across demographics, geographies, and provider types
Normalized data feeds downstream analytics, revenue cycle, and quality improvement initiatives
Enterprise-wide visibility into documentation completion rates, turnaround times, and error patterns

Expected Timeline: Decision to Full Deployment

Phase	Duration	Milestone
Pre-Implementation	Weeks 1-2	Contracts signed, technical readiness confirmed
Wave 1 Pilot (2-3 locations)	Weeks 3-6	Pilot locations live, initial learnings captured
Wave 2 Expansion (5-8 locations)	Weeks 7-12	Scaled deployment validated
Wave 3+ Full Rollout	Weeks 13-20	All locations live
Optimization	Weeks 21-26	ROI validated, workflows refined

Total timeline for 15-50 location DSO: 5-7 months from decision to full deployment with optimization.

2. Pre-Implementation Checklist (Weeks 1-2)

Technical Requirements

Hardware Requirements (Per Location)

Software Requirements

Network Requirements

Enterprise-Level Network Standards 🟣

Centralized vs. Location-Level Hosting Decision 🟣

Approach	When to Choose
Centralized cloud hosting	Preferred for most DSOs; simplified management, automatic updates
Hybrid (regional hubs)	Large geographic spread with latency concerns
Location-level instances	Rarely recommended; only if strict data residency requirements

Recommendation: Centralized cloud hosting with SSO integration for 95% of DSO deployments.

Identity & Access Management

Vendor Onboarding Steps

Key Contacts to Establish 🔵

Role	Vendor Contact	Your Contact
Implementation Manager	_____________	VP of Operations
Technical Support Lead	_____________	IT Director
Training Coordinator	_____________	Learning & Development
Customer Success Manager	_____________	Chief Dental Officer
Executive Sponsor	_____________	CEO/COO

Onboarding Milestones 🔵

Data/Access Prerequisites

PMS Access Requirements

Historical Data Considerations

API & Integration Keys

Internal Stakeholder Alignment

Stakeholder Alignment Map

Stakeholder Level	Who	Role in Implementation	Engagement Required
Board/Investors	Board members, PE partners	Approve budget, track ROI	Monthly progress briefings
C-Suite	CEO, COO, CFO, CDO	Executive sponsorship, resource allocation	Weekly steering committee
Regional Managers	Regional VPs, Area Directors	Cascade communication, remove blockers	Bi-weekly ops reviews
Location Office Managers	15-50 office managers	Champion identification, local logistics	Training, daily check-ins during rollout
Providers	Dentists, specialists, hygienists	Adopt workflow, provide clinical feedback	Training, ongoing feedback loops
IT/Infrastructure	IT Director, system admins	Technical implementation	Daily during implementation
Revenue Cycle	Billing managers, coders	Monitor documentation impact on claims	Training, 30/60-day reviews

Approval Requirements 🟣

Baseline Metrics Capture ⚠️

Critical: Measure these BEFORE go-live across ALL locations using standardized methodology.

Documentation Efficiency Metrics

Metric	Measurement Method	Target Baseline Period
Average documentation time per patient	Time study: 10 patients per provider	2 weeks pre-implementation
Documentation completion rate (same-day)	PMS report: % of notes completed day-of-service	30 days pre-implementation
After-hours documentation time	Self-reported provider survey	2 weeks pre-implementation
Notes requiring amendments/addenda	PMS audit log	30 days pre-implementation

Clinical & Revenue Metrics

Metric	Measurement Method	Target Baseline Period
Patients seen per provider per day	PMS scheduling report	30 days pre-implementation
Treatment plan acceptance rate	PMS treatment planning report	30 days pre-implementation
Claim denial rate (documentation-related)	RCM system filter	90 days pre-implementation
Average revenue per patient visit	PMS production report	30 days pre-implementation

Standardized Measurement Protocol 🟣

3. Location Readiness Assessment

Scoring Framework

Factor 1: IT Infrastructure Maturity

Score	Criteria
5	Fiber internet (100+ Mbps), hardware <2 years old, PMS on latest version, modern workstations in all ops
4	High-speed internet (50+ Mbps), hardware <3 years old, PMS within 1 version of latest
3	Adequate internet (25+ Mbps), hardware 3-4 years old, PMS supported but not latest
2	Marginal internet (10-25 Mbps), some outdated hardware, PMS 2+ versions behind
1	Unreliable internet (<10 Mbps), aging hardware, outdated PMS requiring upgrade before integration

Factor 2: Staff Tenure & Adaptability

Score	Criteria
5	Average tenure >3 years, <10% annual turnover, history of successful tech adoptions
4	Average tenure 2-3 years, 10-15% turnover, positive but limited tech adoption history
3	Average tenure 1-2 years, 15-20% turnover, mixed tech adoption results
2	Average tenure <1 year, 20-30% turnover, tech adoption has been challenging
1	High turnover location (>30%), frequent manager changes, prior tech failures

Factor 3: Patient Volume

Score	Criteria	Implication
5	80+ patients/day	Highest impact potential; reserve for Wave 2+
4	60-79 patients/day	Strong impact; Wave 2 candidate
3	40-59 patients/day	Moderate impact; good pilot balance
2	25-39 patients/day	Lower volume; good for cautious pilot
1	<25 patients/day	Limited impact; deprioritize unless strategic

Factor 4: Tech Stack Compatibility

Score	Criteria
5	PMS has native Bola integration, imaging system compatible, no conflicting software
4	PMS has API integration, imaging compatible with minor configuration
3	PMS requires workaround but functional, imaging partially compatible
2	PMS integration complex, may require additional middleware
1	PMS not currently supported, significant technical barriers 🔵

Factor 5: Local Champion Availability

Score	Criteria
5	Tech-forward provider AND office manager both committed; prior champion experience
4	Strong champion identified (either provider or office manager); engaged and capable
3	Potential champion identified but needs development; willing but inexperienced
2	No clear champion; will need to recruit/develop during pilot
1	Key stakeholders resistant; leadership vacuum at location

Composite Scoring & Rollout Sequencing

Scoring Template

Location	IT Infra (1-5)	Staff (1-5)	Volume (1-5)	Tech Stack (1-5)	Champion (1-5)	Composite	Wave
Location A						/25
Location B						/25
Location C						/25
...						/25

Wave Assignment Guidelines

Composite Score	Recommended Wave	Rationale
20-25	Wave 1 (Pilot)	High readiness, manageable risk, will generate positive proof points
15-19	Wave 2	Good candidates after pilot learnings applied
10-14	Wave 3	May need remediation before deployment
<10	Wave 4 / Remediation	Address gaps before rollout; don't force deployment

Wave 1 Selection Criteria ⚠️🟣

Wave 1 pilot locations should be:

☐ Score 20+ on composite readiness
☐ Geographically accessible for hands-on support (within 2-hour travel for regional manager)
☐ Representative of your portfolio mix (1 high-volume, 1 mid-volume; 1 GP-focused, 1 specialty if applicable)
☐ Led by a credible champion whose success will influence peer locations
☐ NOT your highest-revenue locations (protect critical cash flow during learning phase)
☐ NOT your most troubled locations (don't conflate tech rollout with turnaround)

4. Rollout Strategy

Recommended Wave Structure 🟣

Wave Architecture for 15-50 Location DSO

Wave	# of Locations	Duration	Key Activities
Wave 1 (Pilot)	2-3 locations	4 weeks	Deep implementation, daily check-ins, rapid iteration
Wave 2 (Validation)	5-8 locations	4 weeks	Apply pilot learnings, scale champion model, stress-test support capacity
Wave 3 (Scale)	8-15 locations	4-6 weeks	Streamlined deployment, reduced vendor involvement
Wave 4 (Completion)	Remaining	4-6 weeks	Final locations, address any remediation-required sites

Wave 1 Pilot Location Selection

Recommended Pilot Composition:

Location 1: Mid-size general practice, strong champion, representative workflows
Location 2: Higher complexity (specialty mix or multi-provider), tests edge cases
Location 3 (optional): Different region/market to test geographic variation

Timeline Per Wave

WAVE 1 (Weeks 3-6)
├── Week 3: Configuration, champion training
├── Week 4: Go-live + daily check-ins
├── Week 5: Stabilization, workflow refinement
└── Week 6: Retrospective, learnings documentation

[1-week buffer for learning synthesis]

WAVE 2 (Weeks 8-11)
├── Week 8: Parallel configuration (5-8 locations)
├── Week 9: Champion training sessions (regional)
├── Week 10: Staggered go-lives (2-3 per day over 3 days)
└── Week 11: Stabilization and early optimization

[1-week buffer]

WAVE 3 (Weeks 13-18)
├── Weeks 13-14: Configuration (8-15 locations)
├── Week 15-16: Champion training (may be virtual at scale)
├── Weeks 17-18: Go-lives and stabilization

WAVE 4 (Weeks 20-25)
├── Remediation of low-readiness locations
├── Final deployments
└── Portfolio-wide optimization begins

Go/No-Go Criteria 🟣

Criteria to Advance from Wave 1 to Wave 2

Category	Go Criteria	No-Go Criteria
Technical Stability	<5 critical bugs, all blocking issues resolved	Persistent integration failures, data loss incidents
User Adoption	>80% of notes captured via Bola, providers report net-positive experience	<50% adoption, significant workaround use, provider rejection
Documentation Quality	Notes meet clinical and compliance standards, no increase in errors	Quality degradation, compliance concerns raised
Support Capacity	Vendor SLAs met, internal support model validated	Support overwhelmed, response times unacceptable
Champion Confidence	Champions willing to advocate to peers	Champions request additional support before scaling

Go/No-Go Decision Process 🟣

Rollback Plan ⚠️

Triggers for Rollback

Critical data integrity issue affecting patient records
Systematic documentation errors affecting clinical care
Integration failure causing PMS disruption
Provider refusal rate >30% at a location

Rollback Procedure (Per Location)

Immediate (Hour 1): Disable Bola integration, revert to manual charting
Communication (Hours 1-2): Notify location staff, regional manager, central team
Documentation (Day 1): Log all affected records, identify any data gaps
Root Cause (Days 1-3): Work with vendor to identify and resolve issue 🔵
Remediation (Days 3-7): Implement fix in test environment
Re-validation (Days 7-10): Pilot fix at affected location with enhanced monitoring
Re-deployment: Resume normal operations with fix validated

Impact Isolation

Rollback at one location does NOT trigger rollback at others
Other wave locations continue unless systemic issue identified
Central team documents learnings to prevent recurrence

5. Configuration & Integration (Weeks 2-3)

Practice Management System Integration

Dentrix Enterprise Integration

Step	Action	Owner	Duration	Notes
1	Confirm Dentrix Enterprise version compatibility 🔵	IT + Vendor	30 min	Requires v18+ for full API access
2	Enable Dentrix API access in System Configuration	IT	15 min	⚠️ Requires admin credentials
3	Generate API credentials for Bola	IT	15 min	Document in secure credential store
4	Configure Bola Dentrix connector in admin portal 🔵	Vendor	1 hour	Vendor-assisted
5	Map Bola fields to Dentrix clinical note structure	IT + Clinical	2 hours	Customizable per documentation preferences
6	Configure user mapping (Dentrix users → Bola users)	IT	1 hour	Automate via SSO if possible
7	Test in sandbox: Create test patient, generate note, verify sync	IT + Champion	1 hour	Document any sync errors
8	Validate clinical note appearance in Dentrix	Provider	30 min	Provider sign-off required before go-live

Eaglesoft Integration

Step	Action	Owner	Duration	Notes
1	Verify Eaglesoft version (21+ recommended) 🔵	IT + Vendor	30 min	Earlier versions may require Patterson support
2	Enable Eaglesoft Integration Module	IT	30 min	May require Patterson activation 🔵
3	Install Bola Eaglesoft connector on server	IT	1 hour	⚠️ Requires server access during off-hours
4	Configure connector settings 🔵	Vendor	1 hour
5	Map clinical note templates	IT + Clinical	2 hours
6	Test patient note generation and sync	IT + Champion	1 hour
7	Provider validation	Provider	30 min

Open Dental Integration

Step	Action	Owner	Duration	Notes
1	Confirm Open Dental version (21+ preferred)	IT	15 min	Open Dental generally integration-friendly
2	Enable Open Dental API in Program Properties	IT	15 min	Setup → Program Links
3	Generate API key for Bola	IT	15 min
4	Configure Bola Open Dental connector 🔵	Vendor	1 hour
5	Configure FHIR bridge if using advanced clinical workflows	IT + Vendor 🔵	2 hours	Optional for enhanced interoperability
6	Map note templates and clinical fields	IT + Clinical	2 hours
7	Test and validate	IT + Champion + Provider	1.5 hours

Imaging System Integration (If Applicable)

Common Imaging Systems

Imaging System	Integration Type	Configuration Steps
Dexis	Direct integration	Enable API, configure Bola connector, map image annotations
Carestream	API-based	Establish API access, configure DICOM bridge if needed
Schick	Via PMS	Typically passes through PMS integration
Apteryx (XrayVision)	Direct/API	Enable API access, configure study linking

Integration Validation Checklist

Test Environment Setup

Enterprise Test Environment Approach (Recommended for DSO) 🟣

Centralized Test Environment:

Single test instance with synthetic patient data
Accessible by central IT and location champions
Used for configuration validation before location deployment
Maintains test versions of each PMS (if multi-PMS environment)

Per-Location Testing Protocol

Security & HIPAA Compliance Verification

Enterprise HIPAA Checklist ⚠️

Requirement	Action	Owner	Complete
BAA Execution 🔵	Obtain and execute Business Associate Agreement with Bola	Legal/Compliance	☐
Data Encryption	Verify encryption at rest (AES-256) and in transit (TLS 1.2+)	IT + Vendor 🔵	☐
Access Controls	Configure RBAC aligned with minimum necessary principle	IT	☐
Audit Logging	Confirm audit logs capture user access, note generation, PHI access	IT + Compliance	☐
User Authentication	SSO integration with MFA enabled	IT	☐
Data Retention	Align Bola data retention with your retention policies	Compliance	☐
Incident Response	Confirm vendor's breach notification procedures meet your requirements 🔵	Compliance	☐
Subprocessor Review	Review Bola's subprocessors (AWS, etc.) for compliance	Compliance	☐
Employee Training	Vendor confirms employee HIPAA training 🔵	Compliance	☐
Risk Assessment	Complete security risk assessment for AI scribe deployment	IT/Compliance	☐

Access Control Configuration

☐ Define role-based access levels:

Enterprise Admin: Full configuration, all location access
Regional Admin: Configuration for region, read access to other regions
Location Admin: Local user management, local reports
Provider: Own patient documentation
Staff: Assigned patient access per workflow ☐ Configure SSO group mappings ☐ Document access request/approval workflow ☐ Establish quarterly access review process

Standardized vs. Location-Specific Configuration

Standardized Configuration Template (Apply to All Locations) 🟣

Setting Category	Standardized Setting	Rationale
Note structure	Uniform SOAP format with branded header	Consistency for multi-location patients, compliance
Clinical terminology	Standardized dental terminology library	Clean data for analytics
Auto-save frequency	Every 30 seconds	Prevent data loss
Quality thresholds	Confidence score >85% before auto-approval	Quality control
Signature workflow	Provider review + e-signature required	Compliance
Audit settings	Full audit trail enabled	HIPAA compliance
Data retention	7-year retention aligned with state requirements	Compliance

Location-Specific Configuration (Allowed Variation)

Setting Category	Allowed Variation	Governance
Provider preferences	Note verbosity, preferred phrase templates	Provider discretion with clinical review
Specialty templates	Specialty-specific note templates (ortho, pedo, perio)	Must map to standard fields
Operatory naming	Local operatory designations	No impact on data integrity
Workflow triggers	When during appointment to activate	Office manager discretion
Notification preferences	How/when providers alerted to review notes	Provider/office manager discretion

6. Team Training Plan

Train-the-Trainer Model 🟣

Champion Selection Criteria

Criteria	Weight	Assessment Method
Tech comfort	25%	Prior tech adoption success, self-reported comfort
Communication skills	25%	Observation, peer feedback
Respect from peers	20%	Office manager nomination, provider endorsement
Availability	15%	Can dedicate 4-6 hours to training preparation
Tenure	15%	Minimum 6 months at location preferred

Ideal Champion Profile: Office manager OR lead dental assistant with strong peer relationships. Providers make excellent secondary champions but shouldn't be sole trainers (time constraints).

Champion Responsibilities

Complete champion certification program (4-6 hours)
Adapt central training materials to local context
Deliver training to all location staff (2-4 hours total)
Serve as first-line support during go-live week
Collect and relay staff feedback to regional/central team
Conduct new hire training and quarterly refreshers

Champion Certification Program 🔵

Module	Duration	Format	Content
1. Bola Overview	45 min	Video + Q&A	What it does, why DSO is adopting, benefits to staff
2. Technical Workflow	90 min	Live demo	Step-by-step operation, common scenarios
3. Edge Cases & Troubleshooting	60 min	Scenario-based	What can go wrong, first-line resolution
4. Training Delivery Skills	45 min	Interactive	How to train peers, handling resistance
5. Practice Teaching	60 min	Role-play	Champion teaches mock session, receives feedback
Certification Test	30 min	Online quiz	80% pass threshold

Role-Specific Training Outlines

Dentists/Providers

Estimated Training Time: 90 minutes (60 min session + 30 min hands-on practice)

Format: Live demo with hands-on practice, can be delivered remotely for Wave 2+

Content:

Why we're implementing Bola (2 min CDO video message)
How Bola fits into clinical workflow - appointment start to close
What appears on screen during patient encounter
Voice capture: what to say naturally vs. what to avoid
Reviewing and approving AI-generated notes
Interpreting confidence scores and handling low-confidence sections
When and how to override or edit AI output
Documentation for complex cases (specialty considerations)
Q&A

Common Resistance Points & Responses:

Resistance	Response
"I'm faster typing my own notes"	"Let's time it - most providers discover they're spending 1-2 hours daily they don't realize. Try it for a week."
"AI can't understand dental terminology"	"Bola is dental-specific. It knows the difference between mesial and medial. Let me show you."
"What if it makes a mistake?"	"You review every note before signing - AI drafts, you approve. You're never ceding clinical judgment."
"I don't want to change how I talk to patients"	"You don't have to. Bola captures natural conversation. Just practice once and see."

Day 1 Cheat Sheet (Provider):

┌────────────────────────────────────────────────────────────────┐
│                  BOLA AI - PROVIDER QUICK START                 │
├────────────────────────────────────────────────────────────────┤
│ START CAPTURE                                                   │
│ • Click [Record] when patient is seated                         │
│ • Green dot = listening                                         │
│                                                                 │
│ DURING APPOINTMENT                                              │
│ • Speak naturally to patient                                    │
│ • State procedure names clearly: "We're going to do a           │
│   composite restoration on tooth 14, MO"                        │
│ • Findings: "I see moderate inflammation in the lower right     │
│   quadrant"                                                     │
│                                                                 │
│ END CAPTURE                                                     │
│ • Click [Stop] when clinical complete                           │
│ • Note generates in ~30 seconds                                 │
│                                                                 │
│ REVIEW & SIGN                                                   │
│ • Yellow highlight = confidence <90%, review carefully          │
│ • Click to edit any section                                     │
│ • [Sign] when satisfied                                         │
│                                                                 │
│ TROUBLE?                                                        │
│ • Not recording? Check mic icon in system tray                  │
│ • Note looks wrong? Click [Regenerate] or edit manually         │
│ • System down? Use paper template backup, enter later           │
│                                                                 │
│ CHAMPION: _____________ | SUPPORT: help@bola.ai | ext. ___      │
└────────────────────────────────────────────────────────────────┘

Hygienists

Estimated Training Time: 60 minutes

Format: Group session with champion, hands-on practice

Content:

Overview: How Bola will help you and the practice
Your touchpoints: When Bola is active during hygiene appointments
Capturing hygiene findings: probing depths, bleeding, patient education notes
Handoff documentation: What to capture before provider exam
Reviewing hygiene note sections
Communicating with providers via documentation

Touchpoints for Hygienists:

Initial patient assessment capture
Hygiene findings documentation
Patient education notes
Handoff to provider
Post-provider follow-up documentation

Day 1 Cheat Sheet (Hygienist):

┌────────────────────────────────────────────────────────────────┐
│                  BOLA AI