Secondary care Dental care

Pioneering in digital dental care

Åsa Söderlund

When the National Dental Service in Region Örebro chose to open a dental reception in their virtual clinic app, they had two key objectives: Increasing accessibility for patients and reducing the burden on the environment. As the Region pioneered in digital dentistry in the National Dental Service, there were few or no guidelines on how to go about such an endeavour. Nevertheless, thanks to a committed leadership group with a profound interest in the possibilities of digital transformation, the business was able to get going at the end of April 2020.

We interviewed Therese Svanbäck, dental hygienist and project manager, to gain a deeper insight into what it means to offer digital dentistry, how they succeeded in getting patients to visit the digital reception and what potential for further development they see in the future.

Increased accessibility and reduced environmental impact

The National Dental Service in Örebro jumped in early on the region’s investment in digital care, for a large part thanks to a committed steering group. They wanted to contribute to the region’s goal of becoming the global leader in digital solution usage by 2025. Integrating Folktandvården’s digital offer in the region’s app was not obvious from the beginning. However, they soon realised how valuable it is for patients to access the full spectrum of healthcare services offered by the region, via a central entry point that would include the National Dental Service, as opposed to deploying and releasing a new virtual clinic app dedicated to dental care.

Our primary goal is above all to make it easier for patients to get in touch with the National Dental Service. Since many already have the region’s virtual clinic app installed, it seemed reasonable that they can also access dental care from there. We also see other benefits, such as increased opportunities for more collaboration across units and professional silos in the future,

says Therese Svanbäck.

Online consultations increase accessibility, but they also reduce unnecessary trips to the National Dental Service, something that bodes well with the region’s goal of reducing carbon dioxide emissions and their impact on the environment.

Many cases can be managed online

So what types of cases are handled online today within the National Dental Service in Örebro? It can be anything from advice on various forms of treatment to follow-up conversations after a major intervention or behavioural therapy conversations, e.g. around tooth decay.

Our region’s emergency clinic identified the benefits of digital appointments quite early. They often receive patients who do not have regular contact with dental care and it often regards cases that can be solved effectively remotely, such as. counselling or an initial assessment prior to a treatment plan. They have now extended their recommendations to the patients, informing them about the possibility of contacting the digital dental reception or requesting a video visit,

says Therese.

In the region’s app Digital Mottagning, patients seeking care can book a video consultation appointment with the National Dental Service. Follow-up appointments can also take place virtually and online. Two of the region’s specialist clinics also offer follow-up appointments online to patients who are in longer treatments and need to get in touch with the clinic, e.g. if the braces break or if the patient feels apprehensive about something.

Dental-care-virtual-consultations-960x540Patients respond positively

Although some patients are sceptical about online consultations, many appreciate the opportunity – particularly those who seek care from the National Dental Service via the region’s virtual clinic and who have already experienced an online consultation. The majority of those who have used the service are very positive, both in terms of technology and quality of care. It has been a tad more difficult to convince patients about online follow-up appointments, but Therese believes that it may have to do with how the providers present the alternative.

I think many people still find it a little scary to meet via video. This needs to be overcome. Those who dare to take the step are often extremely satisfied and grateful for how smoothly it works.

Information and knowledge sharing among the staff

According to Therese, the biggest challenge has, above all, been to get everyone on-board. The fact that the technology was in place and already used by many other units in the region was not an obvious success factor. It takes time to blaze new trails and create new pathways, she says.

Getting the different units and staff involved has proven to be continuous work. Some have been very positive while others have been a little more sceptical. We need to continue working with information dissemination and championing in the organisation. It boils down to changing people’s way of working, to get them to think in new ways, setting new routines – this is necessary for anyone who wants the digital way of working to become an organic part of the operations.

To spread the knowledge internally, they have set up a digital workspace where those who work in the online reception can access information material and documentation. This space also includes a discussion forum. Initially, many questions went directly to Therese, but now that more people are starting to adopt the new way of working, it is important to share this information and knowledge directly among the users. This makes the staff feel more secure and confident, and today most people working digitally are very positive – with the technology as well as with this novel way of meeting patients.

Today, patients can only book an appointment with a dentist at the online reception. In the future, Therese believes that the patient, depending on the condition they seek care for, may end up with both dentists, dental hygienists, and dental nurses. Concerning online follow-up appointments, consultations span the entirety of available healthcare services. Those who meet their patients in a virtual consultation work at their regular workplace, to establish the guidelines and working methods. Eventually, however, it may become appropriate to discuss the possibility of working from home.

Positive possibilities ahead with multiparty calls

At the moment, work is underway to refine today’s processes, but thoughts and ideas on how to develop the digital offer also constantly appear along the way, such as coordinating different specialities or different units in a better and more efficient way.

We have just started a project together with the health service, where we are reviewing the possibility of using the multiparty call function in Visiba Care. Among other things, we are looking at the possibility of involving interpreters in a simpler way, and see how we can coordinate communication among patients, general dental care and specialist dental care better. Then we sometimes encounter cases where we need to consult with the patient’s doctor before a possible treatment. It would be truly seamless to coordinate an appointment online.

The National Dental Service also works with expanding the activities within the region, e.g. at home visits or at children’s centres. Here, Therese sees great potential in the possibility of connecting directly with a dentist for advice if questions should arise.

Three keys to success according to Therese

  • Support from the leadership group and close collaboration with knowledgeable colleagues from different areas of the business has been critical towards success. Having management on board and the option to communicate directly with the IT department, and the National Dental Service’s customer service has been extremely valuable.
  • Set aside time and resources before you get started, to have the time to work out certain routines and gather answers to questions that are likely to come up. Everything takes longer than the original estimate. It is important to dare to get started and test.
  • Don’t forget the external communication so that the public becomes aware that the format of an online appointment is an option. We sent out press releases, and we got media attention that helped us reach more patients. In addition, we invested in social media advertising, posted information about these activities on TV screens at the receptions and encouraged the staff to spread the word.