Teledentistry in Texas · Teledent Is a Teledentistry software that securely stores patient information. Legal issues “Dentists are at great legal risk when practicing teledentistry

Teledentistry in Texas

Amber Lovatos, R.D.H., B.S.D.H.

1. Texas LawsA closer look at Teledentistry in Texas

➔ Texas Dental Practice Act What can we legally do?

➔ Application of TeledentistryHow can we utilize teledentistry in Texas?

➔ Legal Considerations Other considerations for utilizing teledentistry.

Does a teledentistry exam done in Texas qualify as an exam? Yes, No, Maybe?

Texas

With Texas notoriously restrictive laws, the answer will not be surprising.

Texas Dental Practice ActTitle 22, Part 5, Chapter 108, Subchapter A, Rule 108.8

Records of the Dentist

(b)(2)(C) Documentation of the findings of a tactile and

visual examination of the soft and hard tissues of the oral

cavity…

A licensed dentist may delegate a service, task, or

procedure to a dental hygienist without having had an exam within

a year ifExemptions

-2 years experience

-service provided @-nursing facility-school-based healthcenter

-community health center

So what can WE do in Texas?

MORE THAN YOU THINK!!

NYU College of Dentistry,

incorporates Teledentistry technology into their curriculum.

Dental School Application

AEGD- Distance LearningNYU Lutheran of Dental Medicine, NY

Outreach ProgramsNYU College of Dentistry, NYU

Interprofessional Collaboration-speech therapists, pediatricians, nurses, physician assistants.

NYU College of Dentistry, NYU

Interprofessional

Consultation/Referrals

● Emergency Rooms

● Pediatricians

● Pregnancy Centers

● Nursing Homes

How can a Texas dentist apply this technology?

Imagination

Consultations &

Referrals

Collaboration

● Ortho- phase-1 interceptive care

● Minor Emergencies

Consultations & Referrals

● Endo.

● Oral Surgery

● Pathology

2. Legality By the end of this section, you will have a better understanding legal considerations in Teledentistry.

➔ LicensureIs there a license to practice teledentistry?

➔ HIPAA Major concern for safeguarding patient information.

➔ Legal Issues

What are the legal risks?

Licensure- dentists can only practice in states that you are licensed in.

There are TWENTY states with restrict laws,

TEXAS is one of them. FYI

There is no special license to utilize teledentistry.

HIPAA

Patient information must be stored

and shared through a secure server.

Electronic devices being used to

record or store patient information

should be encrypted and password

protected.

Teledent

Is a Teledentistry software that securely stores patient information.

Legal issues

“Dentists are at great legal risk when practicing teledentistry because one can be sued from anywhere Web-based information can be accessed.”

Malpractice

“As a general rule, the policy would protect you for professional activities that are considered to be normal and customary according to the rules and regulations of the state licensing board. “

Billing

In Texas, one cannot bill for an exam when accessing a patient through telecommunication.

Codes

● D9995-Synchronous ● D9996-Asynchronous

Through teledentistry we can REDUCE traditional barriers & foster EQUALITY of care.

Tip

Contact your legislator

ReferencesJampani, N. D., Nutalapati, R., Dontula, B. S. K., & Boyapati, R. (2011). Applications of

teledentistry: A literature review and update. Journal of International Society of Preventive & Community Dentistry, 1(2), 37–44. http://doi.org/10.4103/2231-0762.97695

Bharahit, P.M., Singh, A., Dwivedi, A., (2016). Utilization of teledentistry as a tool to screen for

dental caries among a 12-year old school children in a rural region of india. Journal of Public

Health Dentistry, 77(), 174-180. Retrieved from

http://resolver.ebscohost.com.libproxy.uthscsa.edu/ children

Queyroux, A., Saricassapian, B., Herzong, D., Muller, K., Herafa, I., Ducoux, D., Marin, B., Dantoine,

T., Preux, P.M., Tchalla, A., (2016). Accuracy of Teledentistry for Diagnosing Dental Pathology

Using Direct Examination as a Gold Standard: Results of the tele-e-dent Study of Older Adults

Living in Nursing Homes. Journal of American Medical Directors Association, 18(6), 528-532.

Retrieved from http://resolver.ebscohost.com.libproxy.uthscsa.edu/nursinghome

ReferencesEstai, M., Kangasingam, Y., Huang, B., Checker, H., Steeele L., Kruger E., Tennant M., (2016). The

efficacy of remote screening for dental caries by mid-level dental providers using a mobile

teledentistry model. Community Dentistry And Oral Epidemiology, 44(5), 435-441. Retrieved

from http://resolver.ebscohost.com.libproxy.uthscsa.edu/remotescreening

Estai, M., Kangasingam, Y., Huang, B., Checker, H., Steeele L., Kruger E., Tennant M., (2016). The

efficacy of remote screening for dental caries by mid-level dental providers using a mobile

teledentistry model. Community Dentistry And Oral Epidemiology, 44(5), 435-441. Retrieved

from http://resolver.ebscohost.com.libproxy.uthscsa.edu/remotescreening

Image 1: http://www.asdablog.com/the-ethics-of-teledentistry/

ReferencesEstai, M., Bunt, S., Kanagasingam, Y., Kruger, E., Tennant, M., (2016). Diagnostic accuracy of

teledentistry in the detection of dental caries: a systemic review. Journal of Evidence Based

Dental Pracitce, 16(3), 161-172. Retrieved from

http://resolver.ebscohost.com.libproxy.uthscsa.edu/ diagnostic

Martin, A.B., Nelson, J.D., Bhavsar, G.P., McElligott, J., Garr, D., Leite, R.S., (2016). Feasibility

assessment for using telehealth technology to improve access to dental care for rural and

underserved populations. Journal of Evidence Based Dental Practices, 15(4), 228-235. Retrieved

from https://www-scopus-com.libproxy.uthscsa.edu/Feasibility

Image 2: http://www.oralhealthworkforce.org/resources/variation-in-dental-hygiene-scope-

of-practice-by-state/

ContactAmber Lovatos, R.D.H., B.S.D.H.

Assistant Clinical Professor

Department of Periodontics & Dental Hygiene |7500 Cambridge | Suite 6488| Houston, TX 77054

281.253.0966 tel | 713.486.0410 fax | [email protected]