Title: 0706 - Piloting Teledental Approaches to Non-traumatic Dental Conditions in Emergency Departments
Adham Abdelrahim (Presenter)
Marshfield Clinic Research Institute
Harshad Hegde, Marshfield Clinic Research Institute
Amit Acharya, Marshfield Clinic
Objectives: Non-traumatic dental condition visits (NTDCs) sub-optimally managed in the medical emergency department (EDs) represent about 1.4% to 2% of all ED visits and are associated with high cost of care. Feasibility of establishing a TeleDental approach to manage NTDCs in ED settings was undertaken to test the hypothesis that remote teledental consults with general dental practitioners will more cost effectively manage NTDC visits to the ED with reduced waiting time compared to EDs provider management.
Methods: Patients (n=13/20) with NTDCs presenting at Marshfield Clinic Urgent Care or ED settings were recruited. Participants were interviewed and assessed by a tele-dental provider using intra-oral and high-definition pan-tilt-zoom cameras. Comparisons were drawn between 1) differential diagnosis provided by the medical and teledental providers, 2) waiting time to medical and teledental provider interaction, and 3) cost associated with managing the NTDC in ED settings compared to teledental examination estimated by applying limited dental examination costs as a proxy for estimating teledental cost, to assess feasibility of: 1) instituting a TeleDental approach to manage NTDC visits in medical settings; and 2) TeleDental provider establishment of a preliminary diagnosis and treatment plan utilizing TeleDental infrastructure.
Results: Seven male and six female patients presented in the ER (n=2) and UC (n=11) setting. Insurance status of participants included 76.92% with medical and 61.5% with dental insurance. Private medical insurance was the most common primary payer (46.15%) covering ED visit. An estimated cost saving of 67.81%±15.1 resulted when estimated teledental visit cost was compared to medical cost. Mean wait-time to-provider-interaction was 45.79%±39.4 sooner for teledental consult.
Conclusions: Preliminary testing of teledental intervention in the ED setting demonstrated potentials for potential savings in both cost and time. Larger interventional studies in multi-site setting are needed to validate this approach and evaluate impact on cost, ED workflow and patient outcomes.
This abstract is based on research that was funded entirely or partially by an outside source:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE