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As an international organisation, Dental Protection will often have gained experience from one country, which can highlight potential problems to drive and support members, when a similar situation arises in another country. Our international experience certainly helps us to stay ahead of the game, while others are left to react after the event.
One such topic is the remote provision of professional dental services, sometimes referred to as "teledentistry" to mirror the equivalent situation in medicine ("telemedicine"). You must ensure that the transfer of any personal patient information to other jurisdictions complies with the Data Protection principles of Data Protection and Patient confidentiality.
Definition
Teledentistry can be defined as the remote provision of dental care, advice or treatment through the medium of information technology, rather than through direct personal contact with any patient(s) involved.
The simplest part of teledentistry is that of acquiring and setting up the technology which makes it possible. But far from being an electronic panacea that overcomes all the other dento-legal problems, as some have suggested, it in fact raises a number of additional complications that need to be fully understood and properly managed. These are explained and summarised in the article which forms the Appendix to this Position Statement
Dental Protection's advice to members is as follows:
1. Ensure that any patients involved are fully aware of the involvement of any other named person(s) in their care and treatment, through teledentistry, and also that they properly understand any constraints, limitations or risks introduced as a result. To help patients understand teledentistry, you should explain to them that there may be aspects of teledentistry that are different to traditional dental practice, for example a consultation involving a physical examination. It is important for patients to seek face-face consultations where problems persist or where severe problems exist. It may be difficult for dentists to identify what treatment is needed without a physical examination and in these circumstances, dentists should act responsibly and either see the patient in person themselves or recommend a competent colleague to conduct the physical examination.
2. Establish written protocols between yourself and any other clinician/organisation with whom you have any kind of teledentistry relationship. These protocols should specify the parameters of the relationship, the role and responsibility of each party, and the arrangements in place for data protection, and quality assurance. Data protection and confidentiality are of the utmost importance and web-based teledentistry sites must make their information policies clear to users. Strong security measures should be in place to protect the privacy of patient information.
3. Insist upon knowing the identity, qualifications/training and current registration and indemnity details of any third party who becomes involved in the care of any patient that you are treating. In the case of registration and indemnity details, the relevant documentation should be checked annually and copies retained.
4. Do not extend your involvement in teledentistry beyond Ireland without the prior agreement of Dental Protection. If you are considering this, write to us providing full details of the proposed arrangements.
5. If you are in any doubt as to the adequacy of the indemnity arrangements of any other party who shares the teledentistry relationship with you, you are welcome to seek advice from Dental Protection.
Members who follow the above advice can look to Dental Protection for advice, support and assistance (including legal representation, where necessary) with any complaints, claims or other challenges arising from their involvement in teledentistry.
Each case will be considered on its individual merits, but assistance is unlikely to be given if members fail to act upon the advice provided above.