Update - Community - A Partnership in Virtual Health

A Partnership in Virtual Health
3/28/2007

New teledentisty collaboration helps meet needs of the most underserved communities.
By Veronica Jauriqui

Good oral health is now a phone call away for some of California’s most underserved children.

In a collaboration among Childrens Hospital Los Angeles (CHLA), USC School of Dentistry (USCSD), the California Telemedicine and eHealth Center (CTEC), three communities in the rural district of Tulare County now have direct access to quality oral health care by some of the state’s premier dental providers.

The partnership formally opened preventative dental clinics last month on school campuses in the school districts of Woodlake, Lindsay and Cutler-Orosi, tucked away in the more remote regions of the central San Joaquin Valley.

The clinics are equipped with state-of-the-art dental operatories, including digital intra-oral imaging and X-ray equipment, says Jose Polido, director of the division of dentistry at CHLA and a USCSD faculty member. Each facility is virtually connected to CHLA’s dental clinic through leading-edge videoconferencing and high-speed broadband networks.

“With this technology, we have the ability to do a live videoconferencing examination at a remote location, looking at X-rays and intra-oral photographs and assessing that information in real time,” Polido says.

A full-time dental hygienist rotating through the three clinics will provide preventative services, including fluoride treatments and sealants. USC School of Dentistry faculty will conduct the remote exams hundreds of miles away in a CHLA facility in Hollywood. The hygienist will also provide ongoing oral health education to children, their families and school district health personnel.

Census numbers reveal that Tulare County is the nation’s leading agricultural producer, but has the highest percentage of poverty and unemployment in California. Nearly two-thirds of the population under the age of 18 live below poverty level. Comprised substantially of migrant populations, the county also has the fifth highest percentage of poverty in the nation.

Its demographics have changed little since the USC Mobile Clinic began its work in the area in 1970. Access to care has always been an issue, says Roseann Mulligan, USCSD associate dean for the office of Community Health Programs.

“We’ve been coming to Tulare County every year in partnership with the local communities, but the need is still great. Annually we continue to treat children who are in desperate need of oral health care,” Mulligan says. “Having a continuing, ongoing presence in the community, particularly an interaction that stresses disease prevention is critical to making strides in improving the oral health picture.”

The virtual clinics will refer children in need of restorative treatments to local dental providers and clinics that accept Med-ical and other government-subsidized insurances. For those children without resources, the USCSD Mobile Clinic will continue to be a resource.

“These additional clinics are part of an important partnership to expanding our community efforts,” she says.

The dental clinics are the latest in a developing ehealth network that connects CHLA healthcare providers with remote communities, says Daniel Plotkin, CHLA’s eHealth Program administrator. CHLA officials have worked closely with school district and county office of education leadership.

“We see these three remote dental clinics as being three additional operatories at CHLA’s dental clinic,” Plotkin says. “The technology allows children treated in the rural areas of Tulare County to receive the same attention that they would in our onsite clinic.”

Since October, more than 750 children have been screened. Polido anticipates the entire kindergarten through 12th grade population to receive screenings by the summer, providing a unique opportunity to understand the oral health status and needs of these rurally located and underserved pediatric groups.

“Our long term goal is more than treating cavities, it’s making sure that the ones who do get cavities don’t get new ones. It’s behavior modification and teaching habits for lifelong good oral health,” he says.

The clinics were designed with funding and support from Sullivan-Schein Dental, Pelton & Crane, and through grants to the three school districts from the U.S. Department of Agriculture. The U.S. Health Resources and Services Administration (HRSA) also helped fund key portions of the program.