Eli Schwarz KOD DDS, MPH, PhD, FHKAM, FCDSHK, FACD, FRACDS Telehealth in Dentistry: The School Based Setting as a Virtual Dental Home Eli Schwarz KOD DDS, MPH, PhD, FHKAM, FCDSHK, FACD, FRACDS Telehealth Alliance of Oregon Summit, March 2016

Acknowledgments Paul Glassman Maureen Harrington Maysa Namakian Linda Mann Jon Klein Meagan Kintz Jennifer Clemens I don’t think we need to add for this presentation, since Meredith will talk about it Funding: Oregon Health Authority/ Office of Rural Health Eli Schwarz Richie Kohli Eli Schwarz - School of Dentistry

What we will talk about today Context: Access issues in dental care Framework: State-wide workforce project Virtual Dental Home concept Capitol Dental Care telehealth project Next steps Eli Schwarz - School of Dentistry

Surgeon-General’s report on oral health, 2000 Oral Health in America Oral health, like general health, has improved dramatically in recent decades …. However, not all Americans are achieving the same degree of oral health ……. What amounts to “a silent epidemic” of oral diseases is affecting our most vulnerable citizens .. Surgeon-General’s report on oral health, 2000 Eli Schwarz - School of Dentistry

The majority of underserved people with the majority of dental disease do not take advantage of the traditional dental care delivery system Eli Schwarz - School of Dentistry

Access issues in dental care Access – geographic – financial Persistent problem in dental care Health disparities – social determinants Eli Schwarz - School of Dentistry

Eli Schwarz - School of Dentistry

State wide workforce dental pilot project Eli Schwarz - School of Dentistry

Courtesy: Dr. Paul Glassman

Telehealth connected dental team Community based oral health delivery system- preventive and simple therupetic restorations in the community Edu, triage, case management., preventive, itr Eli Schwarz - School of Dentistry

Equipment for asynchronous store and forward dental information transfer Eli Schwarz - School of Dentistry

Courtesy: Dr. Paul Glassman Eli Schwarz - School of Dentistry

Courtesy: Dr. Paul Glassman

Courtesy: Dr. Paul Glassman

The Virtual Dental Home comes to Polk County Eli Schwarz - School of Dentistry

Capitol Dental Care telehealth project The specific aims of this project are to: Demonstrate the ability to create and deploy telehealth-connected oral health teams capable of reaching children who have not been receiving dental care on a regular basis and providing community-based dental diagnostic, prevention and early intervention services; Undertake on-site data collection for diagnostic records and perform preventive procedures designed to keep children from developing advanced dental disease; Demonstrate a reduced need for most children to be seen by dentists in stationary dental practices or clinics (the Virtual Dental Home); Achieve the Triple Aim in oral health care in Oregon with people having better experiences of care, better oral health and doing so at a lower the cost per-capita; and Develop lessons that can be used to disseminate the Virtual Dental Home concept throughout Oregon. Eli Schwarz - School of Dentistry

Preliminary outcomes after 6 months (One elementary school, 2nd grade) Children examined; N=113 (90%) Consent forms sent out; N=265 No response; N=66 No Cavities 28% Untreated Cavities Treated Cavities Returned forms; N=199 (75%) 72% No to participate; N=74 (67 reported, child had dentist) 43% of Children kept healthy in the community; 57% Referred to dentist Yes to participate; N=125 (63%) Last minute refusals; Absent from school N=12 Eli Schwarz - School of Dentistry

Next steps Oregon Health Authority approval of dental pilot project with dental hygienist expanded duties Extension of present project Expansion of project to additional sites Final evaluation Eli Schwarz - School of Dentistry

The future: Hub and spoke system Courtesy: Dr. Paul Glassman Eli Schwarz - School of Dentistry

Thanks for your attention schwarz@ohsu.edu Eli Schwarz - School of Dentistry