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



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
  • 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
  • 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 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