Lighthouse 360 — Implementation Playbook (DSO)

Lighthouse 360 Implementation Playbook for DSOs

A Strategic Guide to Deploying AI-Powered Patient Communication at Scale

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1. Executive Summary

What Lighthouse 360 Does

Lighthouse 360 is an automated patient communication platform that centralizes appointment reminders, recall management, online scheduling, reputation management, and two-way texting into a unified system that integrates directly with your practice management software. The platform uses intelligent automation to reduce no-shows, fill schedules, reactivate dormant patients, and generate online reviews—all with minimal staff intervention.

Why DSOs Benefit from AI-Powered Patient Communication at Scale

Patient communication represents one of the highest-leverage opportunities for DSO standardization and efficiency gains:

• Scale Advantages: Automating communications across 15–50 locations eliminates thousands of manual phone calls daily, freeing front desk staff for higher-value patient interactions. A single automated recall campaign can reach tens of thousands of patients simultaneously.

• Standardization: Consistent messaging across all locations protects brand integrity, ensures compliance with communication regulations, and creates predictable patient experiences regardless of which location they visit.

• Data Aggregation: Centralized reporting reveals system-wide patterns—which locations have the highest no-show rates, which recall messages perform best, where online reputation needs attention. This intelligence enables data-driven operational decisions impossible with fragmented, location-by-location communication approaches.

• Labor Arbitrage: Patient communication automation directly reduces the FTE burden on front desk staff, a critical advantage given persistent staffing challenges in dental operations.

Expected Timeline: Decision to Full Deployment

DSO Size	Pilot Phase	Full Deployment	Total Timeline
15–25 locations	4–6 weeks	8–12 weeks	12–18 weeks
26–40 locations	4–6 weeks	12–16 weeks	16–22 weeks
41–50 locations	6–8 weeks	16–20 weeks	22–28 weeks

Timeline assumes adequate IT resources, reasonable PMS version consistency, and executive sponsorship. Add 4–6 weeks if significant PMS upgrades are required.

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

Technical Requirements

Hardware Requirements (Per Location)

☐ Workstation(s) running Windows 10/11 or macOS 10.14+ (Chrome browser required) ☐ Minimum 4GB RAM, 2GHz processor on primary workstation accessing the platform ☐ Dedicated tablet or monitor for real-time dashboard display (recommended, not required)

Network Requirements

☐ Minimum 25 Mbps download / 10 Mbps upload per location ⚠️ Common failure point: Locations with older DSL connections may experience sync delays ☐ Static IP address or reliable DHCP with port forwarding capability ☐ Firewall configured to allow outbound HTTPS traffic to Lighthouse 360 servers ☐ Wi-Fi stability for any mobile/tablet access points

Software Requirements

☐ Practice Management System compatibility verified:

• Dentrix (G5.1 or higher) ✓
• Eaglesoft (17.0 or higher) ✓
• Open Dental (version 19.1 or higher) ✓
• Dentrix Enterprise ✓
• Dentrix Ascend ✓
• Other PMS systems—verify with vendor ☐ PMS version audit completed across all locations ☐ Chrome browser (latest version) installed on all workstations ☐ Local admin access available for initial software installation

Integration Requirements

☐ PMS database access credentials available ☐ Server/workstation hosting PMS identified (for on-premise PMS) ☐ API access enabled (for cloud-based PMS) ☐ Third-party integration inventory completed (payment processors, imaging systems, etc.)

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Vendor Onboarding Steps

Step	Action	Timeline	Owner
1	🔵 Execute Master Services Agreement (MSA)	Day 1–3	Legal/Procurement
2	🔵 Complete Business Associate Agreement (BAA)	Day 1–3	Compliance
3	🔵 Submit location roster with addresses, PMS versions, practice IDs	Day 3–5	Operations
4	🔵 Receive dedicated Customer Success Manager (CSM) assignment	Day 5–7	Vendor
5	🔵 Schedule kickoff call with CSM and technical implementation team	Day 7–10	CSM/Operations
6	🔵 Receive enterprise admin credentials and access provisioning	Day 7–10	Vendor IT
7	🔵 Establish escalation contacts (Tier 1, Tier 2, Tier 3 support)	Day 10–14	CSM

Key Contacts to Establish

☐ Customer Success Manager (CSM): Primary strategic contact for rollout planning ☐ Technical Implementation Specialist: Handles integrations and technical troubleshooting ☐ Enterprise Support Line: Direct escalation path bypassing standard support queue ☐ Account Executive: Commercial issues, contract modifications, expansion discussions ☐ Training Coordinator: Schedules and delivers training sessions

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Data/Access Prerequisites

Practice Management System Access

☐ Admin-level PMS credentials for each location (for initial sync) ☐ Service account created for Lighthouse 360 ongoing sync (do not use individual user accounts) ⚠️ ☐ Patient data export permissions enabled ☐ Appointment schedule read/write access confirmed

Communication Channel Setup

☐ Phone numbers for SMS/text messaging (existing or new numbers)

• Decision required: Port existing numbers vs. provision new numbers 🟣 ☐ Email domain/sender addresses determined ☐ Email authentication (SPF, DKIM, DMARC) configured for sending domain ⚠️ Common failure point: Emails going to spam due to missing authentication

Historical Data Access

☐ Patient recall history (minimum 24 months recommended) ☐ Appointment history for no-show pattern analysis ☐ Patient communication preferences (opt-outs, preferred contact methods)

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Enterprise-Level Requirements

Network Standards Across Locations

☐ Document minimum network requirements in IT standards policy ☐ Identify locations requiring network upgrades before deployment ☐ Establish VPN requirements if centralized administration is preferred ☐ Define firewall rule templates for consistent security posture

Hosting Architecture Decision 🟣

Option	Pros	Cons	Recommended For
Centralized Hosting (single enterprise instance)	Unified reporting, simplified administration, consistent configurations	Requires robust network connectivity at all locations	DSOs with strong IT infrastructure and standardized operations
Location-Level Hosting (separate instances per location)	Location autonomy, isolated issues don't cascade	Fragmented reporting, inconsistent configurations, higher admin overhead	DSOs with highly autonomous locations or varied PMS environments
Hybrid (centralized admin, location-level execution)	Balances control with flexibility	Moderate complexity	Most DSOs with 15–50 locations

Lighthouse 360 supports enterprise multi-location architecture—confirm specific setup options with your CSM.

Single Sign-On (SSO) Requirements

☐ Determine SSO integration requirement (SAML 2.0, OAuth) ☐ Coordinate with Identity Provider (Okta, Azure AD, Google Workspace) ☐ 🔵 Submit SSO configuration request to Lighthouse 360 (enterprise feature) ☐ Test SSO authentication before location rollouts

Centralized Credentialing

☐ Define role-based access control (RBAC) structure:

• Enterprise Admin (full access, all locations)
• Regional Manager (read/write for assigned region)
• Location Manager (read/write for single location)
• Staff User (limited access per role) ☐ Create user provisioning workflow for new hires ☐ Establish offboarding process for access revocation

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Internal Stakeholder Alignment

Stakeholder Alignment Map

Stakeholder Level	Who	Role in Implementation	Communication Cadence	Required Action
Board/Investors	Board members, PE partners	Approve budget, receive progress updates	Monthly summary	🟣 Budget approval, strategic alignment
C-Suite	CEO, COO, CFO, CDO	Executive sponsorship, resource allocation, go/no-go decisions	Bi-weekly briefing	🟣 Executive sponsor designation, cross-functional coordination
VP of Operations	VP Ops, Director of Operations	Primary accountable owner, rollout oversight	Weekly working session	Day-to-day decision authority, escalation resolution
Chief Dental Officer	CDO, Clinical Director	Clinical workflow approval, provider communication	Bi-weekly alignment	Clinical workflow sign-off, provider messaging
Regional Managers	Regional Directors, Area Managers	Wave execution, location coordination	Weekly during active wave	Champion selection, local issue resolution
IT/Technology	IT Director, Systems Admin	Technical implementation, integrations, security	Daily during implementation	Infrastructure readiness, troubleshooting
Compliance/Legal	Compliance Officer, Legal Counsel	HIPAA verification, BAA execution, communication compliance	As needed	BAA approval, TCPA compliance review
Location Office Managers	Practice Managers	Day-to-day execution, staff coordination	Daily during go-live week	Staff training completion, workflow adoption
Providers	Dentists, Hygienists	Workflow adoption, patient communication buy-in	Pre-launch briefing, weekly feedback during rollout	Feature feedback, workflow input
Front Desk Staff	Receptionists, Schedulers	Primary daily users	Training sessions, daily check-ins during go-live	Hands-on adoption, real-time feedback

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Baseline Metrics to Capture BEFORE Go-Live

Why Baseline Metrics Matter

Without pre-implementation baselines, ROI measurement becomes guesswork. Capture these metrics for every location during Weeks 1–2, before any system changes.

Required Baseline Metrics

Metric Category	Specific Metric	How to Measure	Capture Period
Appointment Efficiency	No-show rate	(No-shows / Total scheduled) × 100	Trailing 90 days
	Same-day cancellation rate	(Same-day cancellations / Total scheduled) × 100	Trailing 90 days
	Average schedule fill rate	(Filled appointments / Available slots) × 100	Trailing 90 days
Recall Performance	Recall completion rate	(Patients returning for recall / Patients due for recall) × 100	Trailing 12 months
	Average days overdue for recall	Mean days past due date for overdue patients	Current snapshot
	Reactivation rate (patients >18 months)	(Reactivated patients / Dormant patient pool) × 100	Trailing 12 months
Staff Efficiency	Outbound calls per day (confirmation/recall)	Manual count or phone system report	1-week sample
	Time spent on manual reminders	Staff time study estimate	1-week sample
	Front desk FTE hours on communication tasks	Estimated % of FTE × hours	Current estimate
Patient Experience	Online review volume	Reviews posted per month	Trailing 6 months
	Average star rating (Google, Facebook)	Current aggregate rating	Current snapshot
	Patient response rate to communications	(Responses / Outbound messages) × 100	If trackable
Financial Impact	Revenue lost to no-shows	No-show rate × average appointment revenue	Trailing 90 days
	Production per day/provider	Total production / Provider days worked	Trailing 90 days

Standardizing Baseline Measurement Across Locations ⚠️

Common failure point: Locations measure metrics differently, making cross-location comparison meaningless.

☐ Create standardized metric definitions document distributed to all locations ☐ Use PMS reports (not manual estimates) wherever possible ☐ Designate one person per location responsible for baseline data capture ☐ Establish central data collection spreadsheet or form ☐ Set firm deadline for baseline submission (end of Week 2) ☐ QA baseline data for completeness and accuracy before proceeding

Baseline Data Collection Template

Location	Office Manager	Baseline Data Submitted	Data Verified	Issues/Notes
Location 1		☐ Yes ☐ No	☐ Yes ☐ No
Location 2		☐ Yes ☐ No	☐ Yes ☐ No
...

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3. Location Readiness Assessment

Readiness Scoring Framework

Score each location on the following five factors using a 1–5 scale. This produces a composite readiness score (5–25) that informs rollout sequencing.

Factor 1: IT Infrastructure Maturity

Score	Network Speed	Hardware Age	PMS Version	Description
5	100+ Mbps	< 2 years	Latest version	Excellent infrastructure, no upgrades needed
4	50–100 Mbps	2–3 years	Current -1 version	Good infrastructure, minor updates may help
3	25–50 Mbps	3–4 years	Current -2 versions	Adequate, may experience occasional issues
2	10–25 Mbps	4–5 years	Current -3 versions	Problematic, upgrades recommended before rollout
1	< 10 Mbps	> 5 years	Significantly outdated	Critical upgrades required before rollout

Factor 2: Staff Tenure and Adaptability

Score	Avg Tenure	Annual Turnover	Tech Comfort	Training History	Description
5	> 3 years	< 15%	High	Multiple successful tech adoptions	Stable, tech-savvy team
4	2–3 years	15–25%	Moderate-High	1–2 successful tech adoptions	Solid team, good adaptability
3	1–2 years	25–35%	Moderate	Mixed tech adoption history	Average stability and adaptability
2	6–12 months	35–50%	Low-Moderate	Struggled with past tech changes	Higher change management needs
1	< 6 months	> 50%	Low	No recent tech adoptions or failures	Significant change management risk

Factor 3: Patient Volume

Score	Daily Patient Volume	Characteristic	Implication
5	40–60 patients/day	High-volume, mature practice	High impact, high ROI potential, higher rollout risk
4	30–40 patients/day	Strong volume	Good impact, moderate risk
3	20–30 patients/day	Moderate volume	Balanced impact and risk
2	10–20 patients/day	Lower volume	Lower immediate impact, lower rollout risk
1	< 10 patients/day	Low volume / new location	Minimal impact, good for low-risk testing

Note: High-volume locations (5) offer the greatest impact but also the greatest risk if rollout fails. For Wave 1, consider moderate-volume locations (3–4) to balance learning with manageable risk.

Factor 4: Existing Tech Stack Compatibility

Score	PMS Compatibility	Imaging Integration	Other Systems	Description
5	Fully compatible, current version	None or fully compatible	Clean tech stack, few integrations	Seamless integration expected
4	Compatible, minor update needed	Compatible	1–2 integrations, all compatible	Minor preparation needed
3	Compatible with workarounds	Potential conflicts	Multiple integrations, mostly compatible	Some technical work required
2	Major version upgrade required	Known conflicts	Complex tech stack	Significant preparation required
1	Incompatible PMS	Incompatible	Heavy legacy systems	Major overhaul needed before rollout

Factor 5: Local Champion Availability

Score	Champion Profile	Availability	Description
5	Tech-forward provider or manager, enthusiastic about the tool	Dedicated time allocated	Ideal champion in place
4	Capable manager, positive about technology	Available with some schedule adjustment	Strong champion potential
3	Competent manager, neutral on technology	Limited availability	Adequate champion with support
2	Manager willing but lacks tech confidence	Minimal availability	Champion will need significant support
1	No willing candidate identified	No availability	Champion must be developed or assigned

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Composite Readiness Score Calculation

Scoring Worksheet (Per Location)

Location Name:	Score (1–5)	Weight	Weighted Score
IT Infrastructure Maturity		1.0
Staff Tenure and Adaptability		1.5
Patient Volume		0.75
Tech Stack Compatibility		1.25
Local Champion Availability		1.5
Total Composite Score			/30

Weighting rationale: Staff and champion factors weighted higher because people drive adoption success more than technology.

Readiness Tiers

Composite Score	Tier	Rollout Recommendation
24–30	Tier 1: High Readiness	Wave 1 pilot candidate
18–23	Tier 2: Moderate Readiness	Wave 2 candidate
12–17	Tier 3: Low Readiness	Wave 3 candidate, address gaps first
< 12	Tier 4: Not Ready	Delay until remediation complete

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Rollout Sequence Recommendations

Selecting Wave 1 Pilot Locations

Choose 2–3 locations that meet ALL of the following criteria:

☐ Composite score 22–27 (high readiness but not your absolute best location)

• Rationale: You want locations likely to succeed but not so perfect that lessons don't transfer to typical locations

☐ Moderate patient volume (Score 3–4, not 5)

• Rationale: Manageable risk while still generating meaningful data

☐ Strong local champion identified (Score 4–5)

• Rationale: Champion engagement is the #1 predictor of successful adoption

☐ Representative of portfolio diversity

• Include at least one location with your most common PMS
• Include at least one location representing typical (not exceptional) staff dynamics
• Avoid locations that are outliers in any dimension

☐ Geographic proximity to central team or regional manager (if possible)

• Rationale: Easier hands-on support during critical pilot phase

Sample Rollout Sequence

Wave	Locations	Selection Rationale	Timeline
Wave 1 (Pilot)	2–3 locations	High readiness, moderate volume, strong champions, representative	Weeks 3–6
Wave 2 (Early Majority)	5–8 locations	Moderate-high readiness, apply learnings from Wave 1	Weeks 7–12
Wave 3 (Remaining)	8–15 locations	Addressed gaps from Wave 1–2, standardized deployment	Weeks 13–20
Wave 4 (Remediation)	Remaining locations	Required infrastructure or staffing issues resolved	Weeks 21+

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4. Rollout Strategy

Wave Structure Recommendation

Wave 1: Pilot Phase (2–3 Locations)

Duration: 4 weeks Objectives:

• Validate technical integration in real-world conditions
• Identify workflow gaps and training improvements
• Capture lessons for Wave 2 refinement
• Build internal success stories and champions

Timeline:

Week	Activities
Week 1	🔵 Vendor technical setup, integration testing, staff training
Week 2	Go-live, intensive support, daily check-ins
Week 3	Stabilization, workflow refinement, issue resolution
Week 4	Lessons learned documentation, metrics review, Wave 2 preparation

Wave 2: Early Majority (5–8 Locations)

Duration: 4–6 weeks Objectives:

• Scale validated playbook to larger group
• Test train-the-trainer model
• Refine centralized support processes
• Build organizational momentum

Timeline:

Week	Activities
Week 1	Technical setup (batch processing multiple locations), champion training
Week 2	Staff training (champion-led), final testing
Week 3	Staggered go-lives (2–3 locations per day)
Week 4–5	Stabilization, support, refinement
Week 6	Lessons learned, metrics review, Wave 3 preparation

Wave 3: Remaining Locations (8–15+ Locations)

Duration: 6–8 weeks Objectives:

• Execute standardized, efficient deployment
• Minimize per-location effort through playbook maturity
• Achieve enterprise-wide adoption

Timeline:

Week	Activities
Week 1–2	Batch technical setup, champion training
Week 3–4	Staggered go-lives (3–5 locations per day)
Week 5–6	Stabilization, support
Week 7–8	Full deployment verification, optimization handoff

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Go/No-Go Criteria Between Waves 🟣

Executive decision required to advance from one wave to the next.

Wave 1 → Wave 2 Go/No-Go Checklist

Criteria	Threshold	Actual	Status
Technical integration stable	No critical integration failures for 7 consecutive days		☐ Go ☐ No-Go
Staff adoption rate	> 80% of trained staff using system daily		☐ Go ☐ No-Go
Patient communication delivery rate	> 95% messages delivered successfully		☐ Go ☐ No-Go
No-show rate trending	Stable or improved vs. baseline		☐ Go ☐ No-Go
Critical issues outstanding	Zero unresolved critical (Sev 1) issues		☐ Go ☐ No-Go
Champion feedback	Positive/neutral; no major workflow concerns		☐ Go ☐ No-Go
Training materials validated	Updated based on pilot learnings		☐ Go ☐ No-Go

Decision: All criteria must be "Go" to advance. If any are "No-Go," extend pilot by 1–2 weeks and remediate.

Wave 2 → Wave 3 Go/No-Go Checklist

Criteria	Threshold	Actual	Status
Wave 2 locations stable	> 90% of locations operating without daily support		☐ Go ☐ No-Go
Train-the-trainer model validated	Champions able to independently train staff		☐ Go ☐ No-Go
Support capacity	Central team can support additional wave volume		☐ Go ☐ No-Go
No-show rate improvement	Measurable improvement in > 50% of Wave 2 locations		☐ Go ☐ No-Go
Critical issues outstanding	Zero unresolved critical issues from Wave 2		☐ Go ☐ No-Go

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Rollback Plan ⚠️

Rollback Triggers

• Critical system failure affecting patient care or communication
• PMS integration failure causing data corruption or sync failures
• HIPAA/compliance violation discovered
• Staff unable to operate basic functions after reasonable support period
• Patient complaints exceeding acceptable threshold (define: e.g., >5% of patients contacted)

Rollback Procedure (Per Location)

Step	Action	Timeline	Owner
1	Document the issue triggering rollback decision	Immediately	Location Champion
2	Notify central team and vendor	Within 1 hour	Location Champion
3	🔵 Disable automated communications (pause, don't delete)	Within 2 hours	Vendor Support
4	Revert to manual communication workflows	Same day	Office Manager
5	Communicate to staff: rollback is temporary, not failure	Same day	Regional Manager
6	Root cause analysis	Within 48 hours	Central Team + Vendor
7	Remediation plan with timeline	Within 1 week	Central Team + Vendor
8	Re-deployment when remediation verified	TBD	Central Team

Isolation Protocol

• Rollback at one location does NOT affect other locations
• Wave progression pauses only if rollback issue is systemic (affecting multiple locations)
• Individual location rollback allows continued progress at other locations

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5. Configuration & Integration (Weeks 2–3)

Step-by-Step PMS Integration

Dentrix Integration

Step	Action	Time Estimate	Owner
1	Verify Dentrix version (G5.1+ required)	5 min	Location IT
2	Identify Dentrix server location (workstation hosting database)	10 min	Location IT
3	🔵 Download Lighthouse 360 connector from vendor portal	5 min	Vendor
4	Install connector on Dentrix server workstation	15 min	Location IT
5	Enter Dentrix database path in connector configuration	5 min	Location IT
6	🔵 Enter Lighthouse 360 credentials and sync settings	10 min	Vendor Support
7	⚠️ Run initial sync (may take 30–60 min for large patient databases)	30–60 min	Automated
8	Verify patient data sync accuracy (spot check 10 patients)	15 min	Office Manager
9	Test appointment sync (create test appointment, verify appears in Lighthouse)	10 min	Office Manager
10	Configure sync frequency (recommended: every 5 minutes)	5 min	Location IT

Eaglesoft Integration

Step	Action	Time Estimate	Owner
1	Verify Eaglesoft version (17.0+ required)	5 min	Location IT
2	Identify Eaglesoft server/database location	10 min	Location IT
3	🔵 Request Eaglesoft API credentials from Patterson	1–3 days	Vendor/Patterson
4	🔵 Download Lighthouse 360 connector	5 min	Vendor
5	Install connector on Eaglesoft server	15 min	Location IT
6	⚠️ Configure API connection (common failure point: firewall blocking)	20 min	Location IT
7	Run initial sync	30–60 min	Automated
8	Verify data accuracy	15 min	Office Manager
9	Test bidirectional sync (appointment changes in PMS reflect in Lighthouse)	10 min	Office Manager

Open Dental Integration

Step	Action	Time Estimate	Owner
1	Verify Open Dental version (19.1+ required)	5 min	Location IT
2	Enable Open Dental API (Setup > Miscellaneous > API)	5 min	Location IT
3	🔵 Generate API key for Lighthouse 360	10 min	Vendor Support
4	🔵 Enter API key in Lighthouse 360 configuration	5 min	Vendor Support
5	Configure data mapping (provider IDs, operatory IDs, appointment types)	20 min	Location IT + Vendor
6	Run initial sync	15–30 min	Automated
7	Verify sync accuracy	15 min	Office Manager

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Communication Channel Setup

SMS/Text Messaging Setup

Step	Action	Time Estimate	Owner
1	🟣 Decide: Port existing numbers vs. provision new numbers	Decision	VP Operations
2	🔵 If porting: Submit number porting request to Lighthouse 360	1–5 days	Vendor
3	🔵 If new numbers: Request number provisioning per location	1–2 days	Vendor
4	⚠️ Register for 10DLC (A2P messaging compliance)	1–4 weeks	Vendor + DSO Compliance
5	Verify number activation	5 min	Office Manager
6	Test inbound and outbound SMS	10 min	Office Manager

Note: 10DLC registration is now required by carriers for business text messaging. Plan for 2–4 week approval timeline. ⚠️ Failure to register can result in message blocking.

Email Configuration

Step	Action	Time Estimate	Owner
1	Determine sending domain(s) (e.g., notifications@dsoname.com)	15 min	Marketing/IT
2	⚠️ Configure SPF record in DNS	15 min	IT
3	⚠️ Configure DKIM record in DNS	15 min	IT
4	Configure DMARC policy	10 min	IT
5	🔵 Verify domain authentication in Lighthouse 360	10 min	Vendor Support
6	Send test emails, verify inbox delivery (not spam)	15 min	Office Manager

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Test Environment Setup

Recommended Approach: Centralized Test Environment

For DSOs, establish a single centralized test environment rather than per-location testing:

☐ 🔵 Request sandbox/test instance from Lighthouse 360 ☐ Load representative sample data (anonymized or test data) ☐ Test all message types: appointment reminders, recall, review requests, two-way texting ☐ Test integrations with each PMS type in use across locations ☐ Document test cases and expected results ☐ Assign QA owner responsible for test verification

Validation Checklist (Before Location Go-Live)

Test Case	Expected Result	Verified	Notes
New appointment creates reminder sequence	Reminder sent per configured timing	☐
Appointment cancellation stops reminders	No further reminders sent	☐
Patient confirms via text	Confirmation reflected in PMS	☐
Patient replies with question	Two-way text appears in dashboard	☐
Recall due date triggers outreach	Recall message sent	☐
Review request sent post-appointment	Patient receives review request	☐
Opt-out request processed	Patient removed from communications	☐
HIPAA-sensitive data handling	No PHI in