Should we apply medical standards to dentistry? – Claus Oustrup

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  Posted by: Dental Design      2nd August 2018

Dentistry shares a number of similarities with the general health industry. After all, both aim to provide the best patient care, and even the technology used for procedures share certain features.

Radiographs, in particular, are a common occurrence in both professions, however, the workflow implemented by professionals for taking and processing these images is very different. This disparity is something that could directly impact the level of care a patient receives, as more accurate and reliable radiograph reading and reporting, and the consequentially improved treatment planning will help a patient receive the level of care they deserve.

In light of this, it’s worth considering – should we be applying a more uniform approach to how imaging is undertaken throughout the general health care and allied health care industries?

 

The medical workflow

Arguably the biggest difference between dental and medical radiographic procedures is the number of people involved.

In a medical setting, the first step of diagnosis for a patient requiring a radiograph is to be referred by their specialist, general practitioner or surgeon for imaging. The patient will then go to the hospital or clinic’s radiology department. The radiographer takes the images in a DICOM (Digital Imaging and Communications in Medicine) format. These are then sent to the radiologist who can report on the images and detect any abnormalities that need to be addressed.

This report is then sent to the GP/surgeon/specialist who originally referred the patient for the radiograph so that they can write a care plan based on the information attained from the radiology report of findings and the patient consultation. The files transferred include a link to the images that have a DICOM header to identify the specific patient.

 

Three roles

The first difference a dental professional will notice about this workflow is that the imaging process is split between individuals with three distinct roles: the referrer, the operator and the practitioner.

Although radiographs are in common usage throughout dentistry, dentists will likely take on all three of these roles themselves, and this opens the process up to a number of problems. Reading radiographs  is an specific field in its own right and should a professional fail to report on any abnormality captured by the radiograph, they may be liable for legal action against them should this abnormality develop into something that could have been prevented with detection and treatment. This is particularly pertinent considering that legal cases against dentists are on the rise and the key reason why the standard medical workflow has split the three roles.[i]

 

What are the benefits of differentiating roles?

One of the most significant benefits of keeping these roles separate within the radiographic process is that this allows the patient to experience a more holistic diagnosis. Each role in the medical workflow is occupied by an individual with specialist knowledge, and this means that they can identify any problems in the radiograph and speak to each other to gain second opinions.

By splitting the duties this way it also helps to safeguard these institutions from legal action as all of these professionals have the proper training to fulfill their responsibilities accurately. Further still, as more than one person is involved in the diagnostic process it’s more likely that any issues or causes for concern will be identified.

 

A difference in data

By transferring reports in DICOM format, it’s almost guaranteed that patient misidentification will not occur. Practice management systems used by dental professionals often send files and in most cases also back up files in JPEG format, and this can lead to patient misidentification as these images will not have a DICOM header. JPEG images can only be transferred under GDPR if they are encrypted, however, they should still not be reported on as the reporting entity cannot link them to a patient in a safe manner due to the lack of this DICOM header.

 

How can we enforce these standards in dentistry?

Of course, it is very difficult for dental practices to have dedicated radiology departments, but that doesn’t mean that dental professionals can’t take certain steps to ensure that they streamline their processes. Ensuring that dental professionals receive the training required to read radiographs properly is crucial, as they can more effectively pinpoint any problems reveal and report these issues to the patient.

In addition to the dentist’s on-going radiology training, another way is to refer radiographs to specialists who have the specific and deep knowledge to examine these radiographs properly. Though this may slow the diagnostic process slightly, dental professionals can cover themselves in legal situations while also providing a better level of patient care.

An innovative way to receive this all-important guidance from the comfort of their own clinic, PROPACS from PRO Diagnostics UK is an online portal that allows professionals easy access to specialist radiologist reporting. A GDPR compliant, cloud-based X-ray image storage system, PROPACS also allows professionals to securely archive any diagnostic images and reports from a case, keeping them fully protected with a secure blend of encrypted software.

 

Better care for all

Standards in other areas of dentistry have already been raised to meet those in place in the general health care industry. As radiographs play an important role in dentistry, it follows that they should be examined with the same level of care as those in a medical setting. By ensuring specialist radiograph reporting, the standards in dental imaging can be raised to meet those present in the medical world, ensuring effective, uniform care for all.

 

For more information, please visit www.prodentalradiology.comor email  sales@prodiagnostics.co.uk

 

 

[i]Laurance, Jeremy. The Independent. Link: https://www.independent.co.uk/life-style/health-and-families/health-news/number-of-claims-against-dentists-has-quadrupled-774283.html[Last accessed May 18].

 

 

Author

 

With Danish origin Claus joined The Queens Royal Guards in Denmark immediately after high school. Following his time in the army his bachelor degree specialising in International Export and Marketing . Claus took up a position with the leading aquaculture company that funded his main thesis  with a mandate to set up their Scottish and Irish operations.  Following a successful establishment and integration of the business in Scotland and Ireland over 1.5 years Claus was headhunted to a exciting opportunity  in Far East. Based in Hong Kong as Area Manager for a leading fashion eyewear manufacturer  Claus was covering Distribution and M&A in Asia, Pacific and Duty Free EU and Middle East. After 4 years in Hong Kong Claus moved to Australia and successfully built and sold an import and distribution business  servicing the health care industry. Since then he has invested in PRO which is a  global specialised tele-radiology provider servicing the allied and general health industry where he is also an active partner.

Claus is a dedicated father and husband to his Danish wife and their 6 year old Australian born daughter and 4 year old son. He is also a keen outdoors enthusiast who is passionate about fly fishing, general fitness and a healthy lifestyle.     


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