Teledentistry is commonly associated with expanding access to care in public health dentistry, usually by enabling hygienists to provide oral care services within their scope of practice while working under the remote supervision of a dentist. This model has been proven to work and continues to expand.
However, teledentistry’s superior ability to deliver secure connectivity and streamline remote clinical collaboration is propelling the rapid adoption of this technology within private practice dentistry too. In this case, the challenge may be less about improving access to care among underserved and underprivileged populations and more about increasing case acceptance, enhancing the patient experience, and expanding collaborative care in highly competitive suburban and urban areas.
Teledentistry could be considered a subset of digital dentistry. When properly implemented, the result is like having a supercharged process I like to call the “virtual workflow.”
When powered by teledentistry, the virtual workflow helps a variety of private practice business models break down the barriers to treatment that can erode the standard of patient care and the bottom line. These barriers include time, case acceptance, efficiency, and profitability.
How Does Teledentistry Work?
For example, at the hub of my company’s TeleDent platform is scalable and secure cloud-based software that enables both real-time streaming and “store and forward” clinical data collection including diagnostic images, videos, clinical notes, treatment plans, and more, enabling the clinician to remotely conduct an evaluation and recommend next steps.
Teledentistry applications aggregate and integrate several components of digital dentistry including digital clinical imaging, electronic health records, and telecommunications technology while using an internet connection to link dental clinicians and their patients or dental clinicians with their colleagues.
This increased opportunity for simplified clinician-to-clinician connectivity and collaboration is the win-win that will build interdisciplinary care teams and improve patient outcomes.
Private Practice Teledentistry: Poised for Growth
We are in the midst of a perfect storm of private practice adoption of teledentistry. First, the technology is ready to deploy. It has been field-tested effectively in public health settings. Second, the ADA introduced two new teledentistry CDT codes this year. They are:
- D9995 Teledentistry: Synchronous; real-time encounter. Reported in addition to other procedures (eg, diagnostic) delivered to the patient on the date of service.
- D9996 Teledentistry: Asynchronous; information stored and forwarded to the dentist for subsequent review. Reported in addition to other procedures (eg, diagnostic) delivered to the patient on the date of service.
What’s more, there are many potential private practice applications for teledentistry.
In this scenario, teledentistry can be used as a catalyst for increased referrals and ease of clinical collaboration. In this business model, it is more likely that the specialists will adopt the technology first, then invite general practitioner dentists to join their collaboration network.
This can be a win-win as specialists can increase their availability, boost responsiveness, and enhance secure communication between themselves and their most active referring dentists. The GPs will benefit from streamlining the referral process, increasing case acceptance, improving the patient experience, and gaining predictable outcomes for complex, co-managed cases.
Some of the most likely specialists who would benefit from teledentistry-enabled referrals and clinical collaboration include periodontists, endodontists, oral surgeons, and orthodontists. In fact, orthodontists appear to the early adopters among dental specialists.
Dentist-Owned Hygiene Clinics
How can private practice dentists expand their service areas without investing in an additional, fully equipped dental office? By taking the hub-and-spoke approach, a full-service dental office can be linked to hygiene clinics that the dentist owns and operates.
These remote, standalone hygiene clinics would be located on the periphery of the dental office’s service area but remain within reasonable driving distance. In this manner, the satellite hygiene clinic can consult with the dentist in the hub office to coordinate treatment or, if needed, schedule an appointment with the dentist in the main office. This can also be thought of as a self-referral business model. While currently this is restricted to states where the practice allows this type of general supervision, it appears to be a legislative change that is gaining momentum.
Group Practice Virtual Clinician Rotation
DSOs and group practices often have specialists who rotate among offices in different locations. But what happens when the periodontist or oral surgeon is in a particular location on Mondays and Wednesdays, but you have an implant candidate sitting in the chair on Tuesday?
Teledentistry enables any office within the group to schedule a clinician or patient consultation with specialists no matter where they might be, even if they’re not in any office setting. The result is enhanced operational efficiency, increased case acceptance, improved patient experience, and a consistent standard of care.
Teledentistry can also enable a rapidly growing dental service organization or group practice to augment the specialist care it provides or fill the gaps in a specific location until a specialist is hired to work full-time in that office.
Dentist/Dental Lab Collaboration
Dental labs can take a page out of the teledentistry for specialist/GP collaboration playbook explained above. For example, a dental-lab owner could use a teledentistry platform to build a network of referring dentists. This would not only be a market differentiator, but it also may help offset the critical challenge of offshore dental lab outsourcing.
In this application, dentists and dental lab operators can share CBCT images, digital impression files, and patient photos in real time to increase case accuracy and ultimately ensure patient satisfaction.
The capability of real-time communication rather than relying on the traditional information handoff enhances collaboration and understanding, especially when it comes to planning and completing highly profitable complex restorative cases. Teledentistry can reduce the number of remakes that ultimately chip away at the bottom lines of both the dentist and the lab owner—not to mention the reduction of patient dissatisfaction.
Although many private practice dentists are affiliated with a local hospital, their time on-site is limited or non-existent. With the growing trend of uninsured patients turning to emergency rooms for urgent dental care, teledentistry can help emergency room staff triage these patients more effectively and refer them to affiliated dentists who accept Medicare and Medicaid.
With the standard procedure for emergency room oral care currently being pain medication, antibiotics, and release, teledentistry offers a vast improvement. What’s more, a recent survey of emergency department physicians found that 20% of them are not confident when treating dental trauma cases. Teledentistry can offset this by connecting these physicians with an affiliated dentist whenever a dental trauma patient is admitted.
This will be an area of continued growth as we continue to bridge the gap between dentistry and medicine. For example, teledentistry can help dentists and physicians co-manage medically compromised patients diagnosed with oral disease to reduce systemic disease progression, mitigate risk, and achieve an improved state of wellness. In the case of the growing field of dental sleep medicine, dentists can use teledentistry to cultivate referrals and collaborate with certified sleep physicians who have patients who are not compliant with continuous positive airway pressure treatment and are seeking alternatives.
Whether teledentistry technology is used for public health or private practice, there are several common denominator benefits. They are improved patient experience, simplified workflow, and easier communication and collaboration among the care team.
Mr. Herman is the CEO and Founder of MouthWatch LLC, a leader in leader in innovative teledentistry solutions, digital case presentation tools, and intraoral imaging devices. The company is dedicated to finding new ways to constantly improve the dental health experience for both patient and provider. He can be reached at Brant@MouthWatch.com.