Teledentistry
Who We Are Finger Lakes Community Health: Community/Migrant Health Center (FQHC) 9 Health Center Sites Migrant Voucher Program in 42 Counties 23,000 patients seen in 2014 (UDS) 13,814 patients best served in language Other than English in 2014 (UDS)
Where We Are
Challenges in Providing Care to Rural Cost of health care services Cultural beliefs Lack of trust in health care system Language differences Literacy Migratory lifestyle Poverty Transportation barriers Communities
Mobile Dental Services Geneva ABCD Lake Ontario ABCD Red Creek ABCD Migrant Summer Schools (Sodus, North Rose, Red Creek) 6 School Districts FLCH mobile dental teams and primary prevention strategy has decreased rate from 60% to 22% for children with advanced decay, pediatric dentist and treatment under sedation or general anesthesia For those requiring treatment of ECC 15 % Completion Rate
Telemedicine vs Telehealth Telemedicine generally refers to the provision of clinical services from a distance. The Institute of Medicine of the National Academy of Science defines telemedicine as the use of electronic information and communication technologies to provide and support health care when distance separates the participants. Telehealth refers to a broader scope of services that includes telemedicine, but also includes other services that can be provided remotely using communication technologies. The Office for the Advancement of Telehealth describes telehealth as including telemedicine and a variety of other services.
Steps to Success with Telehealth FLCH Telehealth Program Development a 3-layer strategy - Layer 1: Broadband/Internet Connectivity - Layer 2: Telehealth infrastructure and end-user equipment - Layer 3: Telehealth Program Development and Clinical and Educational Applications
Store and Forward vs Real Time
Real Time
Typical Clinical Set Up Internet Provider Side Patient Side
The Benefits of Telemedicine Patients /Families Reduced travel Timely appointments Services in their community Additional support Providers Direct patient interaction Expanded Services Access to other experts Health Care Systems Improved access Improved outcomes Resources utilization Cost and Time efficient
Other Key Components For Successful Telehealth Programs Care Coordination: Scheduling Pre-Visit Requirements Concurrent Chart Review Coordinate with PCMH Team/Specialty Team Quality Assurance Reports Case Conferencing: Providers, Care Managers, Patient Navigators Quality Improvement Activities: Data Collection Monitor and Report Outcomes Continuous Quality Improvement Regularly Evaluate Program
TeleDentistry at FLCH
TeleDentistry at FLCH
TeleDentistry Outcomes April 2010- December 2014 N= 378 Consults Improved access to care Decrease in lost work time Decreased travel costs Decreased time to treatment Decrease no show rates High patient satisfaction Increased interaction between dental providers Almost ½ require treatment under general anesthesia Operating room: 40% Nitrous oxide: 35% Conscious sedation: 12% Local anesthesia :5% Lost follow up: 8% 92% COMPLETION RATE
Things To Keep In Mind Start small with an evaluation model to develop/familiarize with equipment and process flow Reach out to folks who have already done this Develop a community partnership model with like-minded organizations Beware of hype!! Educate yourself and ask a lot of questions!! Technology is the easy part Focus time, effort, and money on program development and on a sustainable business model And finally: COLLABORATION!!
Ongoing Challenges: Reimbursement, Licensure Issues Lack of consistent telemedicine reimbursement policies between Federal, State and private payers NYS just passed a telehealth parity law that is effective on January 1, 2016. Lack of State-supported Telemedicine Infrastructure Cross-State license issues for providers
Remember Two thoughts on telehealth: Telehealth is not about fancy equipment and technology. It s a tool to improve access and enhance quality of care. Implementing telehealth is a process, not a destination.
FLCH Contact Information Tony Mendicino, Dental Director TonyM@flchealth.org Sirene Garcia, Director of Special Programs Sirene@flchealth.org Carly Sisson, Teledental Coordinator Carlys@flchealth.org Finger Lakes Community Health PO Box 423 Penn Yan, NY 14527 315-531-9102 www.flchealth.org