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Lee J, Park JS, Feng B, Wang KN. The Utilisation of Teledentistry in Australia: A Systematic Review and Meta-analysis. J Dent 2024:105265. [PMID: 39059707 DOI: 10.1016/j.jdent.2024.105265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Teledentistry is the usage of information-based technologies to deliver healthcare services remotely. It is used to deliver care in regional, rural and remote regions and was particularly useful to deliver care during the COVID-19 pandemic. OBJECTIVE This systematic review and meta-analysis aimed to determine teledentistry utilisation in Australia. METHODS The databases PubMed, Google Scholar, EMBASE and Web of Science were searched from inception to June-2024. The phrases "Dental" AND "Telehealth" AND "Australia" and "Teledentistry" AND "Australia" were used. Two authors completed the study selection and data extraction. The Joanna Briggs Institute Critical Appraisal Tools were used to assess quality and bias. RESULTS Eighteen articles met the inclusion criteria. There were six diagnostic tests, six cross-sectional studies, 4 economic evaluations, one qualitative study and one expert opinion. Teledentistry was accurate for screening caries (average sensitivity=69.7%, average specificity=97.4%). There also appeared to be a non-significant negative correlation between specificity and sensitivity (r=0.432). Opinions regarding teledentistry were mixed from clinicians but positive from patients. Teledentistry may also lead to savings for patients and healthcare providers. CONCLUSION Teledentistry increases healthcare access especially for people in regional, rural and remote areas. It is an effective screening tool for caries. Whilst the opinions of clinicians were mixed, potential implementation barriers were identified which could improve opinions of clinicians and increase implementation. CLINICAL IMPORTANCE This study demonstrates teledentistry as a satisfactory tool for screening caries. This could be beneficial to those with difficulties visiting dentists in-person, particularly if they live in regional, rural or remote areas.
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Affiliation(s)
- Joshua Lee
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia; School of Allied Health, The University of Western Australia, Crawley, Western Australia, Australia; International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia.
| | - Joon Soo Park
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia; International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia; School of Engineering, Information Technology and Physical Sciences, Federation University Australia, Ballarat, Victoria, Australia
| | - Boxi Feng
- School of Allied Health, The University of Western Australia, Crawley, Western Australia, Australia; International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia
| | - Kate N Wang
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia; International Research Collaborative - Oral Health and Equity, The University of Western Australia, Western Australia, Crawley, Australia
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Ng BMM, Samaranayaka A, Ting G, Smith M. Acceptability of teledentistry use among residents and staff in aged residential care facilities in the Otago region of New Zealand. Gerodontology 2024. [PMID: 38712514 DOI: 10.1111/ger.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES To assess ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ, and identify end-user-level factors associated with its use. BACKGROUND Difficulty in accessing oral healthcare services is a key barrier to aged residential care (ARC) residents' oral health and well-being. Teledentistry offers a possible solution, yet studies on its acceptability in ARCs are sparse, especially in New Zealand (NZ). This study assessed ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ and identified end-user-level factors associated with its use. MATERIALS AND METHODS Rest home-level residents and care staff in ARC facilities in the Otago region of NZ were surveyed to assess their awareness of teledentistry, perceptions of benefit and comfort using teledentistry, and end-user-level factors associated with the feasibility of using it in ARCs. RESULTS One hundred residents and 77 care staff from 14 facilities participated. Three-quarters of resident participants thought that teledentistry was beneficial. Three in five resident participants were comfortable receiving remote dental consultations and care advice through teledentistry. Acceptability, as measured by perceived benefits and comfort, was lower among older participants. Staff participants were receptive to teledentistry use for residents and were comfortable facilitating remote dental consultations and care through teledentistry. No staff participants disagreed with the potential benefits of teledentistry for ARC residents. CONCLUSION Teledentistry would likely be acceptable to residents and staff in ARC facilities in NZ, contributing to residents' improved access to oral health care and improved oral health and well-being.
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Affiliation(s)
| | | | - Graeme Ting
- New Zealand Dental Association, Auckland, New Zealand
| | - Moira Smith
- University of Otago Wellington, Wellington, New Zealand
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Netson RA, Miller S, Incorvia J, Shah A, Estrada CR, Toomey SL, Taghinia AH. Patient Experience with Virtual Preoperative Consultations in Pediatric Surgical Specialties. J Pediatr Surg 2023; 58:1776-1782. [PMID: 36690572 DOI: 10.1016/j.jpedsurg.2022.12.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/06/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND A cross-sectional study was conducted to assess the comparative effectiveness of virtual visits for preoperative evaluation and surgical decision-making in three pediatric surgical subspecialties. METHODS Patients who underwent surgical procedures in the departments of Urology, Ophthalmology, and Plastic and Oral Surgery at a tertiary care pediatric hospital over a one-year period during the COVID-19 pandemic were included. Patients were assigned to one of three clinical pathways based on their preoperative visit(s): only in-person visit(s) (IP), a combination of in-person and virtual visit(s) (IP/VV), and only virtual visit(s) (VV). Demographics, procedure information, and patient experience survey results were collected. We then assessed variations in procedure types and patient experience scores in these three patient groups. RESULTS There were 431 patients who completed the modified patient experience survey. The most common procedures were circumcision (17%), excision of lesion (16%), and strabismus repair (11%). Survey results were positive, with 90% of participants rating that they would recommend the service to others. No significant differences were found among groups in their demographics, overall care rating, and duration between preoperative clinic visit and procedure. Post-hoc power analysis indicated 87% power to detect a 10% difference in survey ratings between IP and VV cases, confirming non-inferiority in patient satisfaction for virtual preoperative visits. CONCLUSION This study demonstrated the non-inferiority of preoperative virtual visits in three pediatric surgical subspecialties as measured by patient experience scores. Additional studies with more granular scope are necessary to further elucidate telemedicine's safety and efficacy for select diagnoses. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Rebecca A Netson
- Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States
| | - Stephanie Miller
- Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States
| | - Joseph Incorvia
- Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States
| | - Ankoor Shah
- Department of Ophthalmology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States
| | - Carlos R Estrada
- Department of Urology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States
| | - Sara L Toomey
- Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States
| | - Amir H Taghinia
- Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States.
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Emami E, Harnagea H, Shrivastava R, Ahmadi M, Giraudeau N. Patient satisfaction with e-oral health care in rural and remote settings: a systematic review. Syst Rev 2022; 11:234. [PMID: 36309732 PMCID: PMC9617039 DOI: 10.1186/s13643-022-02103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/16/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND During the past decade e-oral health technology has been used to address the oral health care challenges in rural and remote settings. This review systematically evaluated the literature on patient satisfaction with e-oral health care in rural and remote communities. METHODS The systematic review included interventional and observational studies published between 1946 and 2021, in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Global Health. Patient satisfaction with received oral health care using self-reported measures, at any time after the intervention, was the main outcome of the review. The other primary outcomes were undesirable consequences of the health care (e-health or conventional) such as diagnostic error. The secondary outcomes considered were waiting time, number of visits, travel, and the cost of oral health care. Two independent researchers assessed the risk of bias using the ROBINS-I risk of bias assessment tool for non-randomized studies. RESULTS Among 898 studies, 16 studies were included in the review. In most studies reporting patient satisfaction, all patients had shown willingness for teleconsultation for a dental problem and they were mostly satisfied due to saved travel time, saved working days, and prompt treatment onset. Most of the studies acknowledged teledentistry as a cost-effective and cost-saving method. Moreover, the teledentistry consultations showed diagnostic reliability and validity values comparable to conventional dental consultations. The majority of studies were considered level 4 and 3b, due to limited sample populations, analysis based on limited alternatives or costs, non-consistent sensitivity analysis, failure to appropriately control known confounders, and/or failure to carry out an appropriate follow-up of patients. CONCLUSION Available evidence indicates that e-oral health is associated with higher patient satisfaction and has been found to be an effective and reliable method for patients in rural and remote areas. Therefore, in these areas, the use of e-oral health should be encouraged. However, methodological inconsistencies in the current evidence suggest the need for long-term cohort studies and clinical trials, as well as cost analysis on e-oral health in rural settings. SYSTEMATIC REVIEW REGISTRATION The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42016039942.
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Affiliation(s)
- Elham Emami
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College, suite 500, Montreal, QC, Canada.
| | - Hermina Harnagea
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College, suite 500, Montreal, QC, Canada
| | - Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.,Present Address: Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Motahareh Ahmadi
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College, suite 500, Montreal, QC, Canada
| | - Nicolas Giraudeau
- UMR 5112, CEPEL, CNRS, Université de Montpellier, Montpellier, France
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Poirier B, Jensen E, Sethi S. The evolution of the teledentistry landscape in Australia: A scoping review. Aust J Rural Health 2022; 30:434-441. [PMID: 35567780 PMCID: PMC9542832 DOI: 10.1111/ajr.12874] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/24/2022] [Accepted: 04/06/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION There has been a recent surge in the use of teledentistry services in Australia that has paralleled the COVID-19 pandemic. Due to the limited published literature reflecting on this transition, this article employed a systematic scoping review methodology. OBJECTIVE The objective was to explore the role of teledentistry in the provision of clinical dental services in Australia. DESIGN Two independent reviewers searched PubMed, Embase, Scopus, Web of Science and grey literature sources to identify literature eligible for inclusion. The search was restricted to Australia and service delivery. Data were categorically synthesised by modalities and reported benefits and limitations; findings were cross-referenced with the COVID-19 pandemic timeline. FINDINGS The systematic search identified 758 articles, of which 25 met the inclusion criteria. Results highlight a range of service providers and definitions of teledentistry. A shift in modality from asynchronous towards synchronous teledentistry pre- and post-COVID-19 pandemic is detailed. DISCUSSION Whilst highly useful during the COVID-19 pandemic, teledentistry provides a unique opportunity to continue to increase the accessibility of dental services, especially for patients in rural areas or those who are immunocompromised. CONCLUSION Clinicians and researchers must consider opportunities to merge existing research with the recent clinical uptake of teledentistry for patients that would benefit from teledental services beyond the COVID-19 pandemic.
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Affiliation(s)
- Brianna Poirier
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Emilija Jensen
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Sneha Sethi
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Cantey JB, Correa CC, Dugi DD, Huff E, Olaya JE, Farner R. Remote Stewardship for Medically Underserved Nurseries: A Stepped-Wedge, Cluster Randomized Study. Pediatrics 2022; 149:e2021055686. [PMID: 35411402 PMCID: PMC9648107 DOI: 10.1542/peds.2021-055686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Antibiotic overuse is associated with adverse neonatal outcomes. Many medically underserved centers lack pediatric antibiotic stewardship program (ASP) support. Telestewardship may mitigate this disparity. Authors of this study aimed to determine the effectiveness and safety of a nursery-specific ASP delivered remotely. METHODS Remote ASP was implemented in 8 medically underserved newborn nurseries using a stepped-wedge, cluster-randomized design over 3 years. This included a 15-month baseline period, a 9-month "step-in" period using random nursery order, and a 12-month postintervention period. The program consisted of education, audit, and feedback; and 24/7 infectious diseases provider-to-provider phone consultation availability. Outcomes included each center's volume of antibiotic use and the proportion of infants exposed to any antibiotics. Safety measures included length of stay, transfer to another facility, sepsis, and mortality. RESULTS During the study period, there were 9277 infants born (4586 preintervention, 4691 postintervention). Infants exposed to antibiotics declined from 6.2% pre-ASP to 4.2% post-ASP (relative risk 0.68 [95% confidence interval, 0.63% to 0.75%]). Total antibiotic use declined from 117 to 84.1 days of therapy per 1000 patient-days (-28% [95% confidence interval -22% to -34%]. No safety signals were observed. Most provider-to-provider consultations were <5 minutes in duration and occurred during normal business hours. CONCLUSIONS The number of infants exposed to antibiotics and total antibiotic use declined in medically underserved nurseries after implementing a remote ASP. No adverse safety events were seen, and the remote ASP time demands were manageable. Remote stewardship may be a safe and effective strategy for optimizing antibiotic use in medically underserved newborn nurseries.
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Affiliation(s)
- Joseph B. Cantey
- Department of Pediatrics, Divisions of Neonatology and
Allergy, Immunology, and Infectious Diseases, University of Texas Health San
Antonio, San Antonio, Texas
| | - Cynthia C. Correa
- Department of Obstetrics and Gynecology, Dimmit Regional
Hospital, Carrizo Springs, Texas
| | - Daniel D. Dugi
- Department of Family Medicine, Cuero Regional Hospital,
Cuero, Texas
| | - Erin Huff
- Department of Obstetrics and Gynecology, Hill Country
Memorial Hospital, Fredericksburg, Texas
| | - Jorge E. Olaya
- Division of Neonatology, Department of Pediatrics,
University of Texas Health San Antonio, San Antonio, Texas
| | - Rachael Farner
- Department of Pediatrics, Divisions of Neonatology and
Allergy, Immunology, and Infectious Diseases, University of Texas Health San
Antonio, San Antonio, Texas
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Xiao J, Meyerowitz C, Ragusa P, Funkhouser K, Lischka TR, Mendez Chagoya LA, Al Jallad N, Wu TT, Fiscella K, Ivie E, Strange M, Collins J, Kopycka-Kedzierawski DT. Assessment of an Innovative Mobile Dentistry eHygiene Model Amid the COVID-19 Pandemic in the National Dental Practice-Based Research Network: Protocol for Design, Implementation, and Usability Testing. JMIR Res Protoc 2021; 10:e32345. [PMID: 34597259 PMCID: PMC8549859 DOI: 10.2196/32345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Amid COVID-19, and other possible future infectious disease pandemics, dentistry needs to consider modified dental examination regimens that render quality care, are cost effective, and ensure the safety of patients and dental health care personnel (DHCP). Traditional dental examinations, which number more than 300 million per year in the United States, rely on person-to-person tactile examinations, pose challenges to infection control, and consume large quantities of advanced-level personal protective equipment (PPE). Therefore, our long-term goal is to develop an innovative mobile dentistry (mDent) model that takes these issues into account. This model supplements the traditional dental practice with virtual visits, supported by mobile devices such as mobile telephones, tablets, and wireless infrastructure. The mDent model leverages the advantages of digital mobile health (mHealth) tools such as intraoral cameras to deliver virtual oral examinations, treatment planning, and interactive oral health management, on a broad population basis. Conversion of the traditional dental examinations to mDent virtual examinations builds upon (1) the reliability of teledentistry, which uses intraoral photos and live videos to make diagnostic decisions, and (2) rapid advancement in mHealth tool utilization. OBJECTIVE In this pilot project, we designed a 2-stage implementation study to assess 2 critical components of the mDent model: virtual hygiene examination (eHygiene) and patient self-taken intraoral photos (SELFIE). Our specific aims are to (1) assess the acceptance and barriers of mDent eHygiene among patients and DHCP, (2) assess the economic impact of mDent eHygiene, and (3) assess the patient's capability to generate intraoral photos using mHealth tools (exploratory aim, SELFIE). METHODS This study will access the rich resources of the National Dental Practice-Based Research Network to recruit 12 dentists, 12 hygienists, and 144 patients from 12 practices. For aims 1 and 2, we will use role-specific questionnaires to collect quantitative data on eHygiene acceptance and economic impact. The questionnaire components include participant characteristics, the System Usability Scale, a dentist-patient communication scale, practice operation cost, and patient opportunity cost. We will further conduct a series of iterative qualitative research activities using individual interviews to further elicit feedback and suggestion for changes to the mDent eHygiene model. For aim 3, we will use mixed methods (quantitative and qualitative) to assess the patient's capability of taking intraoral photos, by analyzing obtained photos and recorded videos. RESULTS The study is supported by the US National Institute of Dental and Craniofacial Research. This study received "single" institutional review board approval in August 2021. Data collection and analysis are expected to conclude by December 2021 and March 2022, respectively. CONCLUSIONS The study results will inform the logistics of conducting virtual dental examinations and empowering patients with mHealth tools, providing better safety and preserving PPE amid the COVID-19 and possible future pandemics. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/32345.
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Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Patricia Ragusa
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Tamara R Lischka
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | | | - Nisreen Al Jallad
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Eden Ivie
- Mouthwatch LLC, Metuchen, NJ, United States
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Shahrul AI, Abd Rahman ANA. Telemedicine as an Alternative Way to Provide Multidisciplinary Cleft Care During the COVID-19 Pandemic. Open Dent J 2021. [DOI: 10.2174/1874210602115010446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The current coronavirus pandemic is changing the way healthcare professionals provide services to patients. Healthcare professionals are required to provide quality care while reducing the risk of viral transmission. This pandemic has disrupted the timely multidisciplinary team care for patients with clefts across the globe. Thus, telemedicine has been recognized and accepted by various medical and dental specialists as a viable alternative to face-to-face consultation. In addition, telemedicine incorporating a digital workflow in cleft management will further reduce the risk of viral transmission and enhance the quality of treatment being provided to these patients.
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Böhm da Costa C, da Silva Peralta F, Aurelio Maeyama M, Goulart Castro R, Lúcia Schaefer Ferreira de Mello A. Teledentistry System in Dental Health Public Services: A Mixed-Methods Intervention Study. Int J Med Inform 2021; 153:104533. [PMID: 34303136 DOI: 10.1016/j.ijmedinf.2021.104533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Health information and communication technologies, such as Teledentistry, can help expand access to dental health public services making it more effective. OBJECTIVE To analyze the factors that affect the implementation of a Teledentistry system in dental health public services. METHODS The study follows the Implementation Research methodological framework. A mixed-method approach was applied using a triangulation design-sequential model to collect, analyze, and interpret qualitative and quantitative data about the implementation of a Teledentistry system. A compulsory teleconsultation from the general dentist was planned to access periodontics specialized care. The study was developed in a South Brazilian capital city and the platform of the Santa Catarina Telehealth Center was used. Qualitative and quantitative data were collected sequentially to achieve a better understanding of implementation research issues. RESULTS In seven months, 68 teleconsulting was performed by 22% of the general dentists, prior to the referrals on periodontics. Only one reported not needing to refer the patient to the periodontist as a result of the teleconsulting guidance. Teledentistry system implementation and usage were influenced by the managers' political and administrative awareness to deploy and maintain the intervention. Lack of sufficient resource investment, lack of system integration, and internet failures were relevant limiting factors. The teleconsultant guidelines contributed to general dentistry's better decision-making regarding treatment, urgency of case management, and prioritization of referrals to the periodontists CONCLUSION: Identifying the factors that influence the implementation and finding solutions to overcome them, can prevent future failures and improve usage of the system.
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Affiliation(s)
- Christine Böhm da Costa
- Health Department, Joinville Municipality, Santa Catarina, Brazil. Address: Rua Dr. João Colin, 2700 - Santo Antônio. CEP, 89218-035 Joinville, SC, Brazil.
| | - Felipe da Silva Peralta
- Health Department, Joinville Municipality, Santa Catarina, Brazil. Address: Rua Dr. João Colin, 2700 - Santo Antônio. CEP, 89218-035 Joinville, SC, Brazil.
| | - Marcos Aurelio Maeyama
- Vale do Itajaí University, Itajaí, Santa Catarina, Brazil. Address: Rua Uruguai, 458 - Centro. CEP, 88302-901 Itajaí, SC, Brazil.
| | - Renata Goulart Castro
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. Address: Campus Universitário João David Ferreira Lima. Post Graduation Program in Dentistry. Centro de Ciências da Saúde - Trindade. CEP 88040-900 Florianópolis, SC, Brazil.
| | - Ana Lúcia Schaefer Ferreira de Mello
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. Address: Campus Universitário João David Ferreira Lima. Post Graduation Program in Dentistry. Centro de Ciências da Saúde - Trindade. CEP 88040-900 Florianópolis, SC, Brazil.
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Samarrai R, Riccardi AC, Tessema B, Setzen M, Brown SM. Continuation of telemedicine in otolaryngology post-COVID-19: Applications by subspecialty. Am J Otolaryngol 2021; 42:102928. [PMID: 33545447 PMCID: PMC7816955 DOI: 10.1016/j.amjoto.2021.102928] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 12/12/2022]
Abstract
Objective The purpose of this paper is to review the literature and compile key clinically relevant applications of telemedicine for use in otolaryngology relevant to the post-COVID-19 era. Study design Systematic Literature Review. Data sources Pubmed and Google Scholar. Review methods Pubmed and Google Scholar were queried using combined key words such as “telemedicine,” “covid” and “otolaryngology.” The searches were completed in March–August 2020. Additional queries were made with particular subspecialty phrases such as “rhinology” or “otology” to maximize yield of relevant titles. Relevant articles were selected for abstract review. Applicable abstracts were then selected for review of the full text. Results Initial search identified 279 results. These were screened for relevance and 100 abstracts were selected for review. Abstracts were excluded if they were not in English, not related to otolaryngology, or if the full text was unavailable for access. Of these, 37 articles were selected for complete review of the full text. Conclusion The sudden healthcare closures during the COVID-19 pandemic resulted in a sharp increase in the use of telemedicine, particularly in subspecialty fields. Otolaryngologists are at a unique risk of infection resulting from the examination of the head and neck and aerosol-generating procedures due to the predilection of viral particles for the nasal cavities and pharynx. The COVID-19 pandemic may have served as a catalyst to implement telemedicine into clinical practice, however identifying ways to integrate telemedicine long term is key for a sustainable and viable practice in the post-COVID-19 era. Although many states are now finding themselves on the down-sloping side of their infection rate curve, many others remain at the apex. Additionally, the risk of future waves of this pandemic, or the onset of another pandemic, should not be overlooked. Practice modification guidelines that mitigate infection risk by utilizing telemedicine would be useful in these instances. Telemedicine can help to reduce infection spread by limiting unnecessary in-person interactions and help conserve personal protective equipment (PPE) by facilitating remote care with the added benefits of expanding care to broad geographic areas, limiting cost, time, and travel burden on patients and families, and enabling consistent follow up.
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Peck CJ, Parsaei Y, Lattanzi J, Gowda AU, Yang J, Lopez J, Steinbacher DM. The Geographic Availability of Certified Cleft Care in the United States: A National Geospatial Analysis of 1-Hour Access to Care. J Oral Maxillofac Surg 2021; 79:1733-1742. [PMID: 33812798 DOI: 10.1016/j.joms.2021.02.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Children with cleft lip and/or palate (CLP) require longitudinal multidisciplinary care. Travel distance to comprehensive cleft centers may be a barrier for some families. This study evaluated the geospatial availability of certified cleft teams across the United States. MATERIALS AND METHODS A geographic catchment area within a 1-hour travel radius of each American Cleft Palate-Craniofacial Association-certified cleft center was mapped using TravelTime distance matrix programming. The proportion of children located within each catchment area was calculated using county-level data from the National Kids Count Data Center, with aggregate estimates of patients with CLP based on state-level data from the Centers for Disease Control and Prevention. One-hour access was compared across regions and based on urbanization data collected from the US Census. RESULTS There were 182 American Cleft Palate-Craniofacial Association-certified centers identified. As per study estimates, 28,331 (27.3%) children with CLP did not live within 1-hour travel distance to any center. One-hour access was highest in the Northeast (84.2% of children, P < .001) and lowest in the South (65.7%) and higher in states with the greatest urbanization in comparison with more rural states (85.1 vs 37.4%, P < .001). Similar patterns were seen for access to 2 or more cleft centers. The number of CLP children-per-center was highest in the West (775) and lowest in the Northeast (452). CONCLUSIONS Travel distances of more than 1 hour may affect more than 25,000 (1 of 4) CLP children in the US, with significant variation across geographic regions. Future studies should seek to understand the impact of and provide strategies for overcoming geographic barriers.
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Affiliation(s)
- Connor J Peck
- Medical Student, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Yassmin Parsaei
- Medical Student, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT; and Orthodontic Resident, Division of Orthodontics, University of Connecticut, Farmington, CT
| | - Jakob Lattanzi
- Undergraduate Research Assistant, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Arvind U Gowda
- Surgical Resident, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Jenny Yang
- Surgical Resident, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Joseph Lopez
- Craniofacial Fellow, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Derek M Steinbacher
- Chief of Oral and Maxillofacial Surgery, Professor of Plastic Surgery, Yale School of Medicine, New Haven, CT.
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Bergeron M, Ishman SL. Persistent Obstructive Sleep Apnea Burden on Family Finances and Quality of Life. Otolaryngol Head Neck Surg 2021; 165:483-489. [PMID: 33464173 DOI: 10.1177/0194599820986566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We previously found that financial concerns negatively affect the quality of life of families of children with persistent obstructive sleep apnea (OSA) after tonsillectomy. The goal is to quantify the financial impact on families of children with persistent OSA and assess contributing factors. STUDY DESIGN Cross-sectional survey study with comparison group. SETTING Upper airway center at a tertiary pediatric hospital. METHODS Participants included consecutive children with persistent OSA from September to October 2017. Healthy children seen in a general otolaryngology clinic served as controls. Families of both groups completed the Family Impact Questionnaire and the modified Comprehensive Score for Financial Toxicity (COST). RESULTS Families of the 50 patients (25 study and 25 control) completed the surveys: the mean age was 6.4 years (95% CI, 5.0-7.8), and 19 (38%) were female. There were no differences in age, sex, race, or insurance status between groups (P > .05). The mean apnea-hypopnea index for the study group was 7.9 events/h (range, 5.5-10.3), and 40% (10/25) had Down syndrome. Positive airway pressure and/or oxygen were used by 72% (18/25). The Comprehensive Score for Financial Toxicity for study patients (21.9; 95% CI, 14.8-26.0) was significantly lower than for controls (30.2; 95% CI, 26.6-30.8; P = .003), reflecting elevated financial toxicity. Study families reported greater financial impact on the Family Impact Questionnaire (8.4; 95% CI, 6.1-10.7) versus controls (3.6; 95% CI, 1.8-5.4; P = .002); concerns regarding missed days of work and school were common (30.7%). CONCLUSION Families of children with persistent OSA reported a high financial burden related to their children's disease and were more likely to report financial toxicity than families of controls. Concern regarding missed work and school associated with appointments and treatment was a significant factor.
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Affiliation(s)
- Mathieu Bergeron
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Otolaryngology-Head and Neck Surgery, Sainte-Justine Hospital, Montreal, Canada
| | - Stacey L Ishman
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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da Costa CB, Peralta FDS, Ferreira de Mello ALS. How Has Teledentistry Been Applied in Public Dental Health Services? An Integrative Review. Telemed J E Health 2019; 26:945-954. [PMID: 31573410 DOI: 10.1089/tmj.2019.0122] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: There are inequities in the provision of oral health care, and a large proportion of the population face challenges in accessing public dental health care options. Introduction: Teledentistry (TD), a new branch of telemedicine dedicated to dentistry, is a potential approach that can be used to overcome these challenges. Therefore, the purpose of this integrative review was to collect information regarding the inclusion of the application of TD tools in the public dental health services. Methods: Five electronic databases (PubMed/Medline, Virtual Health Library, CINAHL, Scopus, and Web of Science) were searched for relevant articles if they reported on original data related to the use of TD in public dental health services. Results/Discussion: Twenty-four studies met the inclusion criteria and were, consequently, included in the review. Our key findings indicated that TD can be used for training and continuing education of professionals, for remote patient care, to exchange information among health professionals, and orientation. It increases the access to dental care and enables general practitioners to interact with specialties. The benefits include cost-effective health equity services, improve dental knowledge, and reduce consultation waiting time. However, despite the advances made with the use of this technology, there are still some obstacles to overcome, such as limited infrastructure, low levels of motivation and the lack of compliance, professional resistance, and legal and security issues. Conclusion: TD may be very a useful tool for dental public health increasing the quality of the care by improving access, professional education, and patient satisfaction.
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Affiliation(s)
- Christine Böhm da Costa
- Post Graduation Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Felipe da Silva Peralta
- Post Graduation Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
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Miladinović M, Živković D. Most recent advancements in teledentistry. PRAXIS MEDICA 2018. [DOI: 10.5937/pramed1802063m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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