We Need Lasting Telehealth Policy Changes To Protect Us Beyond COVID-19

posted by Sean G. Boynes & Julie Frantsve-Hawley, DentaQuest

on June 3, 2020

Industry, state, and national leaders have moved to encourage greater telehealth use during the COVID-19 crisis. A broad industry coalition including health insurance providers advocated for telehealth policy changes to help preserve hospitals’ limited supply and personnel resources for those most in need. Amid this pandemic, we’ve experienced first-hand how telehealth keeps more people – especially seniors, the medically compromised and other vulnerable populations – protected at home and could help minimize overall disruptions to care.

But these actions are limited in scope and temporary; as emergency orders expire, Americans’ health needs could again be disrupted if COVID-19 reemerges or another force majeure occurs. We need long-term policy changes so telehealth can address patient needs during crises and beyond. Let’s use these interim, reactive changes to jumpstart greater telehealth adoption.

Today, virtual care is on the rise for patient screening, communication and triage that otherwise would be delayed by COVID-19. Patients are connecting with providers in new ways across disciplines, with technology facilitating medical, behavioral and dental care. This trend will have a lasting influence on consumers, who already want faster, more affordable, and more convenient health encounters, and can be the basis for securing more supportive policies and greater awareness about the types, tools, and benefits and barriers to telehealth.

Otherwise, we lose what could be the ideal environment to fundamentally reshape America’s health care system and permanently prioritize access to care.

One largely unknown subset of telehealth is a great example of this. Tooth decay is the most common chronic disease among children and teens. Millions of children and adults go without regular dental care, which makes them vulnerable to oral and other health problems that can cause pain and absences from school and work. But teledentistry reduces absenteeism and facilitates a variety of oral health services and public health care virtually, including diagnosis, consultation, treatment, and case management. It can also link oral health providers to other providers for better care coordination and can rely on smartphones, intraoral – within the mouth – cameras, test strips, or other technology.

Patients can take advantage of teledentistry from wherever they are, making it a vital tool to bridge health care gaps nationwide. Thanks to social distancing rules, many providers and patients have experienced how teledentistry improves access to care for people who otherwise cannot see a dentist in person – a persistent issue for many of the nation’s underserved communities.

Transforming the Care Experience

Medicine began transitioning years ago from a “fix me” model to one that prioritizes keeping people healthy, but dentistry remains transactional and focused on intervention and stabilization. Telehealth, specifically teledentistry, is an important part of reshaping that experience, and not just during a crisis.

Programs deployed pre-pandemic demonstrate how teledentistry successfully expands oral health care to those who otherwise would have none. One New York program connects a rural community health center with Rochester-based pediatric dentists through live web-based video that links people located apart. Through this program, 93% of kids completed initial treatments that otherwise were not locally accessible, compared to just 15% before teledentistry.

California, Colorado and other states found success with the Virtual Dental Home (VDH) model in public schools, nursing homes and other settings. Here, a dental assistant or hygienist treats patients in person and uploads resulting information to a secure server, enabling a dentist to review at another time and send back a diagnosis and treatment plan. A six-year VDH analysis concluded it’s a safe, effective and less costly model for dental care.

For Oregon’s rural communities, a teledentistry program enables dental hygienists to assess schoolchildren’s mouths visually, chart likely areas of tooth decay, take pictures and X-rays of a child’s mouth, and use laptops to transmit this information to a remote dentist, who reviews these materials and develops a treatment plan for each participating child.

Most recently, COVID-19 raised telehealth’s profile as a way to give or receive services while respecting social distancing. When we think about a typical dentist visit, our mind goes to procedural medicine. Teledentistry, however, comes in different forms. It can be a hotline consultation, a video chat with a provider, an electronic exchange of health information such as X-rays, or remote patient monitoring for someone’s specific vitals like blood pressure. There’s even an app that enables people to test the pH of their saliva, an indicator for tooth decay. Similarly, saliva testing may soon be available for coronavirus diagnostics via other apps.

Agencies like OSHA are reinforcing services like teledentistry as a core strategy for mitigating risk. Telehealth overall ensures PPE are used only as necessary, minimizes avoidable emergency room use, and ensures care for the most vulnerable, including those in nursing homes.

These real-world examples demonstrate telehealth creates a safer, healthier, more cost-effective health system – all of which have never been more critical. We need to build on these and other telehealth successes as evidence for policy changes with a lasting impact, connecting millions of people with the health care necessary for lifelong health and wellbeing.

Sean G. Boynes, DMD, MS serves as vice president of health improvement for the DentaQuest Partnership for Oral Health Advancement overseeing national programs and initiatives focused on the integration and coordination of person centered care, developing and implementing value based oral health strategies and operations, and evaluating and testing metrics through meaningful oral health measurement.

Julie Frantsve-Hawley, Ph.D., CAE is director of analytics and evaluation at the DentaQuest Partnership for Oral Health Advancement, where she leads a strategy to transform data into knowledge that can be used to elevate oral health’s visibility, inform policy, care, community, and financing system decisions, and increase awareness about Partnership impacts.