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. One such topic is the remote provision of professional dental services, sometimes referred to as 'teledentistry'.
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 acquiring and setting up the technology which makes it possible. But far from being an electronic panacea for the needs of the patient and the clinical team, teledentistry 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.
There are two common situations which constitute teledentistry:
- Where a patient seeks advice from a clinician remotely;
- Where the treating clinician seeks advice from another clinician remotely.
Dental Protection’s advice to members is as follows:
- Consider the extent to which it would be considered appropriate to provide advice to a patient remotely either directly or in conjunction with a treating clinician. One factor to take into account is, for example, whether you are registered as a dental practitioner in the jurisdiction where the patient is based. If not, your actions might be deemed illegal.
- Ensure that any patients involved are fully aware of the limitations of teledentistry when it comes to meeting their expectations. Patients should be made aware of the involvement of any other named person(s) in their care and treatment, through teledentistry. It is also important to ensure that they properly understand any constraints, limitations or risks introduced as a result. These factors and any discussions with patients should be fully recorded in the clinical records.
- 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, quality assurance and other relevant matters.
- Each clinician should be fully aware of their obligations to the patient and act in accordance with regulatory requirements, particularly in relation to consent.
- 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.
- Do not extend your involvement in teledentistry beyond your country, without the prior agreement of Dental Protection. If you are considering this, contact us and provide full details of the proposed arrangements. Remember, it is important to contact Dental Protection whenever you change your scope of practise, to ensure you are eligible for the full benefits of membership.
- 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, please seek advice from Dental Protection.
Members who follow the advice offered above can look to Dental Protection for 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.