CP41 - Transforming Oral Health Care Through the Use of Teledentistry Before, During, and After COVID-19: FQHCs’ Perspective

Poster Type: Research

Track/Topic: Technological Solutions and Tools to Improve Care and Population Health Management

Research Objectives: The objectives of this research were to identify and explain trends in how safety net clinics used teledentistry during the first year of the COVID-19 pandemic, to triage care for patients with dental emergencies, deliver preventive services, and manage progressive disease using minimally invasive dentistry.

Research Study Design/Methods: We conducted a community engaged mixed methods study with Health Choice Network (HCN). We extracted data including procedures, encounters, and patient information from the dental records of patients at twenty clinics (n=488,024). We conducted semi-structured individual interviews with representatives from these clinics (n=21). We analyzed interview transcripts, and member checked findings with community partners. Qualitative results guided the quantitative analysis, which we conducted by examining patterns and factors associated with teledentistry utilization. We then compared the results of the statistical analysis with those of the qualitative analysis to identify and seek to explain areas of concordance and discordance.

Research Principal Findings and Quantitative/Qualitative Results: Health centers that had used teledentistry before the pandemic; that had strong medical-dental integration in which telehealth was established on the medical side; whose states provided clear and early assurance of reimbursement; and that approached teledentistry as a “team effort” requiring ongoing training and commitment were more successful in utilizing teledentistry as a resource for serving dental patients during the pandemic. Conversely, health centers whose staff were skeptical of telehealth; who experienced reopening pressures from various stakeholders; or whose patient population faced intervening social determinants of health were less successful in optimizing teledentistry to address patients’ dental needs.

Research Conclusions on Impact on Health Centers: Teledentistry was an important resource that many safety net clinics used during the first year of the pandemic to triage patients with suspected dental emergencies, deliver preventive services, and manage progressive disease using minimally invasive techniques. Contextual factors including policy climate, staffing characteristics, and confidence in the modality influenced clinics’ introduction and sustainment of teledental services. Acknowledging the likelihood of future pandemics, teledentistry preparedness is an essential activity in pandemic preparedness to manage population-level disease, maintain revenue, and reserve in-person resources for emergency or urgent dental needs.

Authors:

Sarah Raskin, Consultant/ Assistant Professor, Virginia Commonwealth University

Madhuli Samtani-Thakkar, Biostatistician, Analytics and Evaluation, CareQuest Institute for Oral Health

Vuong Diep, Health Science Specialist, Analytics and Evaluation, CareQuest Institute for Oral Health

Farren Hurwitz, Business Development Manager, Health Choice Network

Julie Frantsve-Hawley, Director, Analytics and Evaluation, CareQuest Institute for Oral Health

Katherine Chung-Bridges, MD, MPH, Director of Research, Health Choice Network

Eric Tranby, Data and Impact Manager, Analytics and Evaluation, CareQuest Institute for Oral Health

Deborah George, Clinician, Jessie Trice Community Health Center Inc

Michelle Fundora, BHSA, CPHRM, Operations Manager, Health Choice Network

Margarita Ollet, MBA, BSN, RN, Executive Vice President and COO, Health Choice Network

Sarah Raskin

Consultant/ Assistant Professor, Virginia Commonwealth University

Appearances