eHealth, teledentistry and health workforce challenges: results of a pilot project.

BACKGROUND: In the twenty-first century, health systems have to cope with the challenges posed by their rapidly changing environment. Among these changes, the emergence of digital health solutions is an opportunity to make health systems better, but also a compelling force to change. Community dentistry is one area of health care, where the rapid technological development has the potential for substantial performance improvement benefitting dental patients in terms of access to care and conveniance. METHODS: This study is based on a survey of the dental care provided by three units (Oral Medicine, Periodontology, Orthodontics) of the Department of Community Dentistry, Semmelweis University, Budapest. During a period of 12 weeks, we have collected time balance data on 1131 patients, 539 in the traditional and 592 in a pilot teledentistry setting, in order to estimate how much time could be spared by monitoring patients through videoconferencing instead of face-to-face visits. RESULTS: According to our findings, teledentistry has the potential to shorten the visit with an average of 5-10 min per patient, which adds up to 58-116 work hours in a year. If the pilot was rolled out to all the 13 chairs of the surveyed 3 specialties (orthodontics, periodontology and oral medicine) the time saving would sum up to 186 workdays in one shift alone, which would translate to close to 4500 additional patients per year, considering remote patient monitoring cases alone. Further, if inactive doctors and highly qualified dental hygienists were involved in delivering telecare, 2.67 times as many workdays could be spared, which would allow about 12,000 more patients treated per year. CONCLUSIONS: The rapid development of digital health technologies coupled with the evolving task distribution between health professionals have a great potential to improve health system performance in pursuit of population health. Unfortunately, the adaptation to these technological changes is uneven, and without a national strategy, the poor will unlikely benefit from these opportunities in public dental care.

An Experience of Public Dental Care during the COVID-19 Pandemic: Reflection and Analysis.

Since its emergence in China, the COVID-19 pandemic has become the number 1 health challenge in the world with all affected countries trying to learn from each other's experiences. When it comes to health services, dental care does not seem to be a priority area, despite the fact that it is among the highest risk medical specialisations in terms of spreading the infection. Using the Department of Community Dentistry of Semmelweis University as a case study, the objective of this paper is to introduce and analyze the system and organizational level measures, which have been implemented in dental care in Hungary during the first months of the COVID-19 outbreak. The system level measures to promote social distancing, to reduce the use of health services and to protect high risk health professionals, together with the deployment of protective equipment and the reorganization of patient pathways at the organizational level proved to be effective in keeping the outbreak in control. There are two, less frequently mentioned ingredients of successful coping with the COVID-19 challenge. First, mental health support is at least as important as physical protection. Second, most of the interventions do not require big financial investments, but behavioural change, which in turn requires leadership and change management skills.

Possibilities of telemedicine regarding the COVID-19 pandemic in light of the international and Hungarian experiences and recommendations / A telemedicina lehetoségei a COVID-19-pandémia kapcsán a nemzetközi és a magyarországi tapasztalatok és ajánlások tükrében: (A COVID­19-pandémia orvosszakmai kérdései)

The COVID-19 outbreak was formally announced as a pandemic by WHO on the 11th of March, 2020. This attracts attention to the possibilities of telemedicine again. In support of stopping the spread of the novel coronavirus infection, whilst keeping the healthcare system running and minimizing the risk of being infected, we also need to find new ways, methods, and platforms to deal with this pandemic. By providing a literature overview and sharing practical guidelines, including the special example of Hungarian teledentistry, we present both international and Hungarian initiatives to involve telemedicine on different levels of healthcare systems regarding COVID-19. Both international and national data show that telemedicine can play a major role in the triage process, early identification, diagnosis and treatment of infected individuals, and management of patient pathways in a way that ensures the medical team does not come into contact with potentially infected patients. It also plays an important role in remote monitoring of medical conditions and care of patients with chronic diseases and reconnects vulnerable groups of healthcare personnel to the care system. In addition to the potential benefits of telemedicine, we must not forget the limitations of this method. However, it is important to emphasize that due to its wide availability, telemedicine services can provide sufficient flexibility for both primary and specialist care (outpatient and inpatient clinical care). For that very reason, it is an urgent need to define the national professional guidelines, legal and financing possibilities in this field in a long-term sustainable way.* Orv Hetil. 2020; 161(24): 983-992. *Disclaimer: We closed the writing of this manuscript on the 30th of April, 2020. The COVID-19 pandemic and related research studies still have been changing dynamically since then.