Reaching Our Most Remote Sites With Oral Health Services

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Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Ron Nagel

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  • Reaching Our Most Remote Sites With Oral Health Services

    1. 1. Reaching Our Most Remote Sites With Oral Health Services <ul><li>Ron Nagel DDS MPH </li></ul><ul><li>Alaska Native Tribal Health Consortium </li></ul><ul><li>www.ANTHC.org </li></ul>
    2. 2. Newtok Clinic Yukon Kuskokwim Health Corporation
    3. 4. Newtok Clinic, Yukon-Kuskokwim
    4. 5. AFHCAN Cart Alaska Federal Health Care Access Network <ul><li>Wireless Networking </li></ul><ul><li>Touchscreen </li></ul><ul><li>Mobile – Customized </li></ul><ul><ul><li>Consultation </li></ul></ul><ul><ul><li>Patient education </li></ul></ul><ul><ul><li>Provider education </li></ul></ul><ul><ul><li>Health survey tool </li></ul></ul><ul><li>WWW. AFHCAN.ORG </li></ul>
    5. 6. Peripherals Supported <ul><li>Digital Camera </li></ul><ul><ul><ul><li>Still images </li></ul></ul></ul><ul><ul><ul><li>Video Clips </li></ul></ul></ul><ul><li>TWAIN Devices </li></ul><ul><ul><ul><li>Scanners </li></ul></ul></ul><ul><ul><ul><li>Microscope Imagers </li></ul></ul></ul><ul><ul><ul><li>Specialty Scanners </li></ul></ul></ul><ul><li>Video Devices </li></ul><ul><ul><ul><li>Video Otoscope </li></ul></ul></ul><ul><ul><ul><li>Dental Camera </li></ul></ul></ul><ul><ul><ul><li>Other scopes … </li></ul></ul></ul><ul><li>ECG </li></ul><ul><li>Spirometer </li></ul><ul><li>Tympanometer </li></ul><ul><li>Audiometer </li></ul><ul><li>Vital Signs Monitor </li></ul><ul><ul><ul><li>Blood Pressure / Pulse </li></ul></ul></ul><ul><ul><ul><li>Pulsoximetry </li></ul></ul></ul><ul><ul><ul><li>Temperature </li></ul></ul></ul><ul><li>Video Conferencing </li></ul><ul><li>Under Development </li></ul><ul><ul><ul><li>Stethoscope </li></ul></ul></ul>
    6. 7. Medicaid Study Decreased Travel = Cost Savings Note: For every $1 spent by Medicaid on reimbursement, $7.95 is saved on travel costs. 79 91 Quantity $48,467 Net Savings Realized by Medicaid $55,437 <ul><li>Telemedicine Prevented travel </li></ul><ul><ul><li>Notes: </li></ul></ul><ul><ul><ul><li>Only specialty clinic travel is being saved. </li></ul></ul></ul><ul><ul><ul><li>86% of cases were from village  region </li></ul></ul></ul><ul><ul><ul><li>Assume all cases had an escort </li></ul></ul></ul><ul><ul><ul><li>Travel costs average $307.57 RT per person </li></ul></ul></ul><ul><ul><ul><li>No lodging / per diem calculated </li></ul></ul></ul>($6,970) Claims paid by Medicaid Cost
    7. 8. Clinical Guidance
    8. 9. Dental Therapists <ul><li>W.H.O. cites 52 countries that utilize Dental Therapists </li></ul><ul><li>Functions as part of the dental team under the supervision of a dentist </li></ul><ul><li>New Zealand has 88 yrs experience and Canada has over 38. </li></ul><ul><li>Exceptional safety record under general supervision for children and adults </li></ul><ul><li>They are equipped to help us provide the educational, preventive and safety net services that are most needed. </li></ul>
    9. 10. Dental Therapy Scope <ul><li>X-rays and exams </li></ul><ul><li>Cleaning , Sealants, Fluorides </li></ul><ul><li>Oral health education </li></ul><ul><li>Fillings and extractions </li></ul><ul><li>By addressing pain, infection, and function they develop relationships that change behavior to prevent disease </li></ul><ul><li>University of Washington MEDEX is now providing this training called DENTEX </li></ul>
    10. 12. Gambell Clinic, Norton Sound
    11. 13. Future Directions – Pushing More Capability to the Clinics Ultra-Portable Telehealth Technology Home Health Extending more sophisticated technologies with midlevel providers

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