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All Hands All Hands TeleDentistryTeleDentistry ForumForum

Teresa A. Dolan, DDS, MPHTeresa A. Dolan, DDS, MPHProfessor and DeanProfessor and Dean

What is the “What is the “TeleDentistryTeleDentistry Grant?”Grant?”

Brief HistoryBrief HistoryGrant ObjectivesGrant Objectives

TeleDentistryTeleDentistry: Improving Access to Dental Care: Improving Access to Dental Care

90% of low90% of low--income Floridians have NO income Floridians have NO access to dental care*access to dental care*

UFCD Clinics: 80,000 patient visits UFCD Clinics: 80,000 patient visits annually; 11,400 visits for children living annually; 11,400 visits for children living at or below 200% of povertyat or below 200% of poverty

TeleDentistryTeleDentistry can expand access through can expand access through educational and clinical outreacheducational and clinical outreach

*Department of Health*Department of Health--Public Health Dental ProgramPublic Health Dental Program

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UFCD Statewide Network for Community Oral HealthUFCD Statewide Network for Community Oral Health

Gainesville

St. Petersburg

Hialeah

Jacksonville

Apopka

Hillsborough CC

UFCD UFCD Videoconferencing Videoconferencing

NetworkNetwork

TeleDentistryTeleDentistry includes the includes the addition of Digital Radiography addition of Digital Radiography to improve patient care to improve patient care

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TeleDentistryTeleDentistry Grant ObjectivesGrant Objectives

Improve IT infrastructure to:Improve IT infrastructure to:Expand distance learning Expand distance learning capabilities (live interactive and capabilities (live interactive and webweb--based)based)Implement digital radiographyImplement digital radiographyDevelop and evaluate clinical Develop and evaluate clinical consultations using technologyconsultations using technology

Office of Information Office of Information SystemsSystems

Godfrey Godfrey OvwighoOvwigho, Ph.D., Ph.D.Director, Information SystemsDirector, Information Systems

December 2004December 2004

Quality of ServiceQuality of ServiceInstructional

support

Website/webpage

Otherservices

DL/VideoConferencing

eLearning QR -Billing,reports

SharedDrives

PCs

Network -Internet

PrintingEmail

QoS

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Customer ServiceCustomer Service

Incidents/CallsWalk-inPhoneEmailWebFax

Technical ServiceOffice visitSite visit

Phone SupportEmail Support

Etc.

FeedbackEmail/surveyQuestionnaire

Communication

Staff ReorganizationStaff ReorganizationNetwork & Servers

Internet, Shared drives, Email, etc.

Web ServicesWebsite, eLearning,

Video-Conference (DL),Instructional Support

Clinical Financial AppsQR – patient info., Billing, reports, etc

Why IS Staff Reorganization?Why IS Staff Reorganization?

TT EE AA MM SSTT = together= togetherEE = everyone= everyoneAA = achieves= achievesMM = maximum= maximumSS = success= success

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I. S. Infrastructure I. S. Infrastructure -- ServersServers

Email Email –– GroupWise 6.5 GroupWise 6.5 –– Server Server storage increased by 70%storage increased by 70%File & Print (NetWare 6.5) 120% File & Print (NetWare 6.5) 120% storage increase.storage increase.Quick Recovery Quick Recovery –– MedicorMedicor MiPACSMiPACSactivation. Storage will increase up activation. Storage will increase up to 1000%to 1000%Web Server storage: 50%Web Server storage: 50%UPS: 30KVaUPS: 30KVaA/C: 5 tons.A/C: 5 tons.

I. S. Infrastructure I. S. Infrastructure --TelecommunicationsTelecommunications

JAX will remain at DS3 (45 JAX will remain at DS3 (45 mps).mps).Hialeah: Full T1 (1.5 mps)Hialeah: Full T1 (1.5 mps)St. Pete: Full T1 (1.5 mps)St. Pete: Full T1 (1.5 mps)Apopka: Full T1 (1.5 mps)Apopka: Full T1 (1.5 mps)HCC: Full T1 (1.5 mps)HCC: Full T1 (1.5 mps)Internet2 & Internet2 & FloridaLamdaRailFloridaLamdaRail

I S MilestonesI S Milestones

Chaotic

Reactive

Proactive

Service

Value

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Distance Learning/Web Distance Learning/Web Based TechnologiesBased Technologies

Boyd E. RobinsonBoyd E. RobinsonDirectorDirector--Community Based ProgramsCommunity Based Programs

Goal #1: Expand and Evaluate Goal #1: Expand and Evaluate Video TeleconferencingVideo Teleconferencing

Upgrade TechnologyUpgrade TechnologyD3D3--33St. Petersburg ClinicSt. Petersburg Clinic

TeleDentistryTeleDentistryEquipmentEquipmentPolycom Polycom TechnologyTechnology

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Goal #1: Expand and Evaluate Goal #1: Expand and Evaluate Video TeleconferencingVideo Teleconferencing

Upgrade TechnologyUpgrade TechnologyD3D3--33St. Petersburg ClinicSt. Petersburg Clinic

Video Teleconferencing CartVideo Teleconferencing CartActive Consultations (Oral Active Consultations (Oral Pathology first)Pathology first)

Synchronous Synchronous ConsultationsConsultationsTies with Digital Ties with Digital RadiographyRadiographyDual screen Dual screen

Goal #1: Expand and Evaluate Goal #1: Expand and Evaluate Video TeleconferencingVideo Teleconferencing

Upgrade TechnologyUpgrade TechnologyD3D3--33St. Petersburg ClinicSt. Petersburg Clinic

Video Teleconferencing CartVideo Teleconferencing CartActive Consultations (Oral Active Consultations (Oral Pathology first)Pathology first)

“Virtual Study Groups”“Virtual Study Groups”

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Interactive Distance LearningInteractive Distance Learning

Goal #2: Develop Web Goal #2: Develop Web Based TechnologiesBased Technologies

““Case of the Month”Case of the Month”Develop educational site for Develop educational site for dental patients with common, dental patients with common, chronic, or difficult treatmentchronic, or difficult treatmentAid in the development of Aid in the development of “Virtual Study Groups”“Virtual Study Groups”

Digital RadiographyDigital Radiography

Jeff Loomis, MHAJeff Loomis, MHAAssociate DirectorAssociate Director--UF Center for TelehealthUF Center for Telehealth

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Why Digital Radiography?Why Digital Radiography?

EIP EIP –– Electronic Image ProcessingElectronic Image ProcessingDo more and see moreDo more and see more

Archiving & DurabilityArchiving & DurabilityPrint, rePrint, re--print, and never loseprint, and never lose

Increased EfficiencyIncreased EfficiencyTake more xTake more x--rays…fasterrays…faster

Decreased OverheadDecreased OverheadNo more film or chemicals to No more film or chemicals to purchasepurchase

Slide taken from Air Techniques presentation

Technology ConsiderationsTechnology ConsiderationsPhosphor Storage Plates (PSP) vs. Direct DigitalPhosphor Storage Plates (PSP) vs. Direct Digital

Equipment durabilityEquipment durabilityPlates are similar to Plates are similar to regular filmregular filmWider selection of PSP Wider selection of PSP sizessizesInitial cost vs. Initial cost vs. replacement costsreplacement costs

MedicorMedicor ImagingImaging

Improved processingImproved processingAnalysis toolsAnalysis toolsClinical software Clinical software integrationintegrationIntegrates with Integrates with telehealth hardwaretelehealth hardware

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ImplementationImplementationPhase 1Phase 1

Main radiographyMain radiographyEndoEndo

Phase 2Phase 2PedoPedo, FTD, Faculty Practice, Graduate , FTD, Faculty Practice, Graduate PerioPerio, Student Prosthetics, Student ProstheticsSatellite clinicsSatellite clinics

EVALUATIONEVALUATION

Neale Chumbler, PhDNeale Chumbler, PhD

Why do we evaluate?Why do we evaluate?

Teledentistry is not a single form of technology, Teledentistry is not a single form of technology, but part of the wider process of healthcare but part of the wider process of healthcare delivery.delivery.Any new form of technology should be rigorously Any new form of technology should be rigorously evaluated in terms of improving health outcomes evaluated in terms of improving health outcomes and reducing costs.and reducing costs.

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Case of the Month

Case of the Month

Distance Learning

(VC & Web)

Distance Learning

(VC & Web)

Digital Radiography

Digital Radiography

Clinical ConsultationClinical

Consultation

EvaluationEvaluation

Primary Evaluation ObjectivesPrimary Evaluation Objectives

Assemble and share information Assemble and share information concerning the origin, concerning the origin, implementation, and outcomes of the implementation, and outcomes of the teledentistry initiative.teledentistry initiative.

Months 1 Months 1 -- 66Identify appropriate measures to assess the Identify appropriate measures to assess the project.project.

Determine how the project’s outcomes will be Determine how the project’s outcomes will be assessed.assessed.

Satisfaction with web and video based Satisfaction with web and video based instruction and telemedicine consultation instruction and telemedicine consultation servicesservices

Determine how the project’s success will be Determine how the project’s success will be assessed.assessed.

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Where are we now?Where are we now?

UFCD Needs Assessment developed and UFCD Needs Assessment developed and administered via Eadministered via E--mail and on paper.mail and on paper.Survey instruments developed.Survey instruments developed.

Case of the MonthCase of the MonthDistance Learning via Video ConferencingDistance Learning via Video Conferencing

IRB approvalIRB approval

University of Florida College of Dentistry Needs Assessment:Teledentistry - December 2004

https://dentistry.medinfo.ufl.edu/cgi-bin/eval.cgi?dir=Teledentistry

9. What component of the proposed UFCD teledentistry program are you most likely to use?

Check all that apply.Live interactive videoconferencingLive demonstrations of various dental proceduresOnline “Case of the Month” to test your clinical skills and

earn CE creditDental Study Clubs using live video conferencing and web-

based instructionWeb based Educational ExperiencesRemote Clinical ConsultationUse of Digital Radiography

Survey Instrument: Distance Survey Instrument: Distance Learning via Video ConferencingLearning via Video Conferencing

Participant satisfaction and expectationsParticipant satisfaction and expectations

Picture and sound qualityPicture and sound quality

Benefits and limitations of videoconferencingBenefits and limitations of videoconferencing

Knowledge gained from the course Knowledge gained from the course

Applicability and benefit to the participant’s Applicability and benefit to the participant’s practice practice

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Survey Instrument: Case of the MonthSurvey Instrument: Case of the Month

Participant expectationsParticipant expectationsParticipant satisfaction with content and Web Participant satisfaction with content and Web formatformatBenefits and limitations of online formatBenefits and limitations of online formatOnline picture qualityOnline picture qualityKnowledge gained from Case of the Month and Knowledge gained from Case of the Month and usefulness in participant’s practiceusefulness in participant’s practiceClinical confidence about topicClinical confidence about topic

What’s Next????What’s Next????

Develop survey instruments for Develop survey instruments for Clinical Consultation and Digital Clinical Consultation and Digital Radiography.Radiography.

Case of the Month Randomized TrialCase of the Month Randomized Trial

Data Collection and AnalysisData Collection and Analysis

Proof of effectiveness for Proof of effectiveness for future funding opportunitiesfuture funding opportunities

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Questions?Questions?