Web tool brings smile to Vic dental health system

A Web-based approach for the triage of emergency patients has enhanced the oral health outcomes of thousands of Victorians.

The new process means the treatment of oral complaints has come along way in Victoria.

In the past there was no universal approach to assessment and management of dental emergencies across the State. This often led to anomalies in the system. A new system was required to ensure those with the most serious needs would receive priority treatment.

Today, with a new Web-based triage system, called the Emergency Triage Tool, oral emergencies are ranked on the spot in terms of priority, allowing a fairer allocation of resources, and ensuring everyone keeps their smile when they walk out the door.

DHSV, which was established a decade ago, is the public dental agency charged with providing high quality, safe and accessible care to all eligible Victorians. Part of this service consists of maintaining 65 dental clinics across the state.

These clinics are similar to emergency rooms in hospitals. People come in with all ranges of oral ailments for treatment by dentists. Depending where they live - city, regional or bush, these patients are referred to the dental hospital; seen by dentists on site; or a referred to nearby private practitioners.

In the past, patients who turned up to a clinic were greeted by a receptionist who would ask few questions, and take down little information off them, before passing them onto the dentist.

However, with new government policy regarding emergency care, DHSV decided to improve the process.

It enlisted the services of BlueArc, a technology integrator and a Microsoft Gold Certified Partner, early last year to make the process a digital one rather than paper based. The project was completed several months later in May, and a further review of the system was completed in January this year.

Chad Craven, sales and marketing director at BlueArc, said it built the Web-based application using .Net 2.0 and ASP.Net. All the data in the back-end is housed on Microsoft SQL Server 2005 databases.

Today, when a patient arrives at a clinic, the receptionist asks between two to five questions. These questions are sufficient to allow the receptionist to categorize the patients into one of four groups.

The first group are those in a state of crisis such as experiencing trauma from losing a few teeth on the footy field; facial swelling due to a tooth infection; or those with a toothache that prevents them from sleeping. These people get immediate treatment.

The next group is those with less severe toothaches, which, in technical terms, respond to 'hot stimulus' such as tea or coffee, or feel pain when biting. They get treated within the week. In group three are the people whose teeth react to sweets or cold stimulus (from ice cream or cold drinks); deemed less serious, they are treated within two weeks. The more minor broken teeth, or cracked dentures, for example are treated within a month.

Once they have asked the questions, the receptionist hits the find button and the tool tells them what to do, said Shane McGuire, manager of quality and dental compliance at DHSV.

"It's now a universal approach which appropriately identifies emergencies."

"Now those with [urgent] needs are seen ahead of the low-level cases," he said.

McGuire said feedback from the clinics has been extremely positive. He said they now have a system which makes it easier to handle emergencies. A result has been a reduction in complaints and an increase in the general care of patients.

"Oral health will be improved," he said.

There have also been other benefits. The tool lets the DHSV track all the data gathered, such as trauma rates or bleeding rates, and allows it to map trends throughout the Victorian public dental services.

'Whenever you have a systematic approach, you get access to [previously unavailable] data. Now we know what the patients are saying and what their problems are. This tool give us all this information," McGuire said.

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Howard Dahdah

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