Teledentistry-Assisted Affiliated Practice Dental Teams
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Teledentistry-Assisted Affiliated Practice Dental Teams

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Presentation by Fred Summerfelt, RDH, MEd, Associate Professor of Dental Hygiene, Northern Arizona University

Presentation by Fred Summerfelt, RDH, MEd, Associate Professor of Dental Hygiene, Northern Arizona University

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Teledentistry-Assisted Affiliated Practice Dental Teams Teledentistry-Assisted Affiliated Practice Dental Teams Presentation Transcript

  • MATRC Telehealth Summit Teledentistry-Assisted Affiliated Practice Dental Teams Fred Summerfelt RDH, AP, M.Ed March 18, 2013 1 2 AZ’s Affiliated Practice Dental Hygiene Model The AZ Affiliated Practice Dental Hygiene Model • 2004 §32-1289 signed into law • Allows an affiliated agreement, with standing orders, between a dental hygienist and a dentist • APDHs may see patients of any age who are: Allows APDHs to see patients without general supervision! • • enrolled in the National School Meal Program – or • 3 enrolled in a federal, state, or local health program – or from a family with a household income of less than 200% of the federal poverty guidelines 4
  • AZ’s Affiliated Practice Dental Hygiene Model • 2009 SB 1400 added to §32-1289 • Affiliated practice dental hygiene patients must be seen by a dentist within 12 months of initial treatment by the dental hygienist otherwise further dental hygiene services are prohibited APDH Services • Specific language concerning elderly and medically-compromised patients 5 Affiliated Practice Dental Hygiene Services 6 Affiliated Practice Dental Hygiene Services • Assessment • Preventive • Blood pressure & medical history • All procedures for a complete prophylaxis • Screen and photograph oral cavity and surrounding structures • Apply sealants according to ADA and CDC guidelines • Chart dental restorations and clinical findings • Administer topical fluoride gels and varnish as indicated according to ADA and CDC guidelines • Expose and process x-rays • Conduct a caries risk analysis 7 8
  • Affiliated Practice Dental Hygiene Services Teledentistry • Patient Education Dental Hygienist • Discuss patient’s home care procedures General Dentist Allied Health Professionals • Provide appropriate home care instruction • Provide tobacco cessation intervention and a referral when appropriate Dental Specialists A Digitally-Linked Oral Healthcare Team Pedodontist 9 Telehealth & Telemedicine 10 Teledentistry • Presents as: • In use since the 1950s • An emerging Web-based intervention system • Prevalent in rural communities • Effectively use telecommunications technology • A distance-learning framework • Transmitted Electronic Data • Graphics, audio, and video images shared between physically separated professionals • Diagnosis, consultation, and treatment planning 11 • A vehicle to decrease the phenomenon of professional isolation common to rural and underserved areas 12 View slide
  • Teledentistry NAU’s Teledentistry Equipment • Utilizing current technologies, it is possible to acquire and digitally transmit all necessary subjective and objective diagnostic data to a distant dentist for: Are there digital technologies that allow us to see better than the eye can see in face-to-face examinations? • Triage • Dental treatment planning • Referral 13 Nomad Pro X-ray Unit 14 Nomad Pro X-ray Unit • Certified by all 50 states • Allows the operator to be in the room when the x-ray is exposed • Easy to use • Long battery life • Protective carrying case • Ideal for remote locations 15 16 View slide
  • Nomad Pro X-ray Unit Nomad Pro X-ray Unit Lead and Glass Shield Area of Protection Primary Protective Shielding 17 Scan-X Duo Processor 18 Scan-X Duo Processor • Sturdy piece of equipment • Carrying case • Easy to maintain - periodic cleaning strip • Processes phosphor plates quickly • Scans and erases phosphor plates, ready for reuse 19 20
  • Scan-X Duo Processor Acclaim Intraoral Camera 30,000 images per x-ray film! 21 Acclaim Intraoral Camera 22 Acclaim Intraoral Camera • Has proven to be very valuable in the public health environment • Barrier sheaths prevent the need for sterilizing mirrors • Projected images allow for excellent viewing of the intraoral environment • Photographs are easy to take 23 24
  • 25 26 27 28
  • VELscope VELscope 29 VELscope 30 Spectra 31 32
  • Spectra 2.4 1.7 2.8 2.5 Green Sound Enamel Blue Red Orange Yellow Incipient Advanced Incipient Advanced Enamel Enamel Root Root Caries Caries Caries Caries 33 2.4 34 35 36
  • Rather than take the patient to the typical dental home . . . 37 . . . take many services to the patient! 38 Linking the Team Members • Store and forward the diagnostic data • On the laptop computer • On a DVD, CD, or by e-mail • On a thumb drive or other hard drive • Direct real-time link to the team members • Satellite link • Hard wired into an Internet connection 39 40
  • Link via Cloud Computing! Linking the Team Members • Patient Privacy and HIPAA compliance • Current technology exists - medical data • Data encrypted to insure privacy • Encrypt store-and-forward data • Encrypt real-time data • Encrypt live-action video • Multiple group members can participate 41 42 43 44 Student Training • Approximately six hours • Nomad training manual • Nomad certification exam • Phosphor plate management • Scan-X Duo competency • DXXTR x-ray exposure experience • Acclaim intraoral photos on peers
  • 45 46 47 48
  • Kaibab Band of the Paiutes 450 Mile Round Trip 49 50 51 52
  • Kaibab Band of the Paiutes • Screened and referred 23 kids for care • Five had immediate needs - acquired their digital diagnostic data • Forwarded diagnostic data to my affiliated dentist who confirmed the need for immediate care • Forwarded the data to the pedodontist at Polacca • The kids’ parents were told to call to be put right on the the pedodontist’s schedule - no further exam required • An opportunity to save each patients' family a 450-mile round trip for an exam and treatment planning! 53 54 Havasupai 55 56
  • 57 Teledentistry Curriculum 58 Teledentistry Curriculum • The APDH • Courses complete with methods and materials • Interested Parties • Teledentistry • Community leaders • HIPAA & Teledentistry • Funding agencies • Nomad Training • Continuing Education • Teledentistry Equipment Set Up • Dental professionals • Hands-on Training • Comprehensive Training • Future Trends in Teledentistry • To form enhanced dental teams 59 60
  • Verde Health Initiative • NAU has partnered with VHI to provide teledentistry services to Verde Valley area schools Questions? • Beaver Creek School in Rimrock, AZ • Approximately 350 student patients • Diagnostic and preventive services • Hopefully expanding to other schools next year 61 62 Thank You! Fred Summerfelt, RDH, AP, M.Ed. Associate Professor Northern Arizona University (928) 523-0953 fred.summerfelt@nau.edu 63 64
  • References McKinnon, M., Luke, G., Bresch, J., Moss, M., & Valachovic, R. (2007). Emerging allied dental workforce models: Considerations for academic dental institutions. Journal of Dental Education, 71(11), 1476-1491. Patient Protection and Affordable Care Act, U.S.C. H. R. 3950 (2010). Senate Bill 1400 Amending Section 32-189, A. R. S. § 32-1289 (2009). Title 32 Professions and Occupations, A. R. S. § 32-1289 (2004). U.S. Department of Health and Human Services. (2001). Oral health in America: A report of the surgeon general. U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research: Rockville, MD. 65