All Hands All Hands TeleDentistry ForumTeleDentistry Forum

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

December , 2004December , 2004

What is the “TeleDentistry Grant?”What is the “TeleDentistry Grant?”

Brief HistoryBrief History

Grant ObjectivesGrant Objectives

TeleDentistry: Improving Access to Dental CareTeleDentistry: Improving Access to Dental Care

90% of low-income Floridians have NO 90% of low-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

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

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

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

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

TeleDentistry Grant ObjectivesTeleDentistry Grant Objectives

Improve IT infrastructure to:Improve IT infrastructure to:

Expand distance learning Expand distance learning capabilities (live interactive and capabilities (live interactive and web-based)web-based)

Implement digital radiographyImplement digital radiography

Develop and evaluate clinical Develop and evaluate clinical consultations using technologyconsultations using technology

Office of Information Office of Information SystemsSystems

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

December 2004December 2004

Quality of ServiceQuality of Service

Instructionalsupport

Website/webpage

Otherservices

DL/VideoConferencing

eLearning QR -Billing,reports

SharedDrives

PCs

Network -Internet

Printing

Email

QoS

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 = together

EE = everyone = everyone

AA = achieves = achieves

MM = maximum = maximum

SS = success = success

I. S. Infrastructure - ServersI. S. Infrastructure - Servers

Email – GroupWise 6.5 – Server Email – GroupWise 6.5 – 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 – Medicor MiPACS Quick Recovery – Medicor MiPACS activation. 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 & FloridaLamdaRailInternet2 & FloridaLamdaRail

I S MilestonesI S Milestones

Chaotic

Reactive

Proactive

Service

Value

Distance Learning/Web Distance Learning/Web Based TechnologiesBased Technologies

Boyd E. RobinsonBoyd E. Robinson

Director-Community Based ProgramsDirector-Community Based Programs

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

Upgrade TechnologyUpgrade TechnologyD3-3D3-3

St. Petersburg ClinicSt. Petersburg Clinic

TeleDentistry TeleDentistry EquipmentEquipment

Polycom Polycom TechnologyTechnology

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

Upgrade TechnologyUpgrade TechnologyD3-3D3-3

St. Petersburg ClinicSt. Petersburg Clinic

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

Synchronous Synchronous ConsultationsConsultations

Ties with Digital Ties with Digital RadiographyRadiography

Dual screen Dual screen

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

Upgrade TechnologyUpgrade TechnologyD3-3D3-3

St. Petersburg ClinicSt. Petersburg Clinic

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

““Virtual Study Groups”Virtual Study Groups”

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 treatment

Aid in the development of Aid in the development of “Virtual Study Groups”“Virtual Study Groups”

Digital RadiographyDigital Radiography

Jeff Loomis, MHAJeff Loomis, MHA

Associate Director-UF Center for TelehealthAssociate Director-UF Center for Telehealth

Why Digital Radiography?Why Digital Radiography?

EIP – Electronic Image ProcessingEIP – Electronic Image Processing

Do more and see moreDo more and see more

Archiving & DurabilityArchiving & Durability

Print, re-print, and never losePrint, re-print, and never lose

Increased EfficiencyIncreased Efficiency

Take more x-rays…fasterTake more x-rays…faster

Decreased OverheadDecreased Overhead

No 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 durability

Plates are similar to Plates are similar to regular filmregular film

Wider selection of PSP Wider selection of PSP sizessizes

Initial cost vs. Initial cost vs. replacement costsreplacement costs

Medicor ImagingMedicor Imaging

Improved processingImproved processing

Analysis toolsAnalysis tools

Clinical software Clinical software integrationintegration

Integrates with Integrates with telehealth hardwaretelehealth hardware

ImplementationImplementation

Phase 1Phase 1Main radiographyMain radiography

EndoEndo

Phase 2Phase 2Pedo, FTD, Faculty Practice, Graduate Pedo, FTD, Faculty Practice, Graduate Perio, Student ProstheticsPerio, Student Prosthetics

Satellite 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.

Case of the Month

Case of the Month

Distance Learning

(VC & Web)

Distance Learning

(VC & Web)

Digital Radiography

Digital Radiography

Clinical Consultation

Clinical 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 - 6Months 1 - 6Identify 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 instruction Satisfaction with web and video based instruction and telemedicine consultation servicesand telemedicine consultation services

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

Where are we now?Where are we now?

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

Survey instruments developed.Survey instruments developed.Case of the MonthCase of the Month

Distance 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 videoconferencing Live demonstrations of various dental procedures Online “Case of the Month” to test your clinical skills and earn CE credit Dental Study Clubs using live video conferencing and web-based instruction Web based Educational Experiences Remote Clinical Consultation Use 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

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

Participant expectationsParticipant expectations

Participant satisfaction with content and Web Participant satisfaction with content and Web formatformat

Benefits and limitations of online formatBenefits and limitations of online format

Online picture qualityOnline picture quality

Knowledge gained from Case of the Month and Knowledge gained from Case of the Month and usefulness in participant’s practiceusefulness in participant’s practice

Clinical 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

Questions?Questions?