Reaching Our Most Remote SitesWith Oral Health Services

Ron Nagel DDS MPHAlaska Native Tribal Health Consortiumwww.ANTHC.org

Newtok Clinic, Yukon-Kuskokwim

AFHCAN CartAlaska Federal Health Care Access Network

Wireless Networking Touchscreen Mobile – Customized

Consultation Patient education Provider education Health survey tool

WWW. AFHCAN.ORG

Peripherals Supported Digital Camera

Still images Video Clips

TWAIN Devices Scanners Microscope Imagers Specialty Scanners

Video Devices Video Otoscope Dental Camera Other scopes …

ECG Spirometer Tympanometer Audiometer Vital Signs Monitor

Blood Pressure / Pulse Pulsoximetry Temperature

Video Conferencing Under Development

Stethoscope

Medicaid StudyDecreased Travel = Cost Savings

Quantity Cost

Claims paid by Medicaid 91 ($6,970)

Telemedicine Prevented travelNotes:

• Only specialty clinic travel is being saved. • 86% of cases were from village region• Assume all cases had an escort• Travel costs average $307.57 RT per person• No lodging / per diem calculated

79 $55,437

Net Savings Realized by Medicaid $48,467

Note: For every $1 spent by Medicaid on reimbursement, $7.95 is saved on travel costs.

Clinical Guidance

Dental Therapists W.H.O. cites 52 countries that utilize Dental

Therapists Functions as part of the dental team under

the supervision of a dentist New Zealand has 88 yrs experience and

Canada has over 38. Exceptional safety record under general

supervision for children and adults They are equipped to help us provide the

educational, preventive and safety net services that are most needed.

Dental Therapy Scope

X-rays and exams Cleaning , Sealants, Fluorides Oral health education Fillings and extractions By addressing pain, infection, and

function they develop relationships that change behavior to prevent disease

University of Washington MEDEX is now providing this training called DENTEX

Gambell Clinic, Norton Sound

Future Directions – Pushing More Capability to the Clinics

Ultra-Portable Telehealth Technology

Home Health

Extending more sophisticated technologies with midlevel providers