Northridge Mary E, Weiserbs Kera F, Sabounchi Shabnam Seyedzadeh, Torroni Andrea, Mohadjeri-Franck Nathalie S, Gargano Steven, George Eliot, Littlejohn Tina C, Troxel Andrea B, Wu Yinxiang, Testa Paul A, Wismer Jennifer, Zaremba Kiah, Tylawsky Peter, Bina Babak
Department of Dental Medicine, NYU Langone Health, New York, NY, USA.
Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY, USA.
J Public Health Res. 2022 Aug 30;11(3):22799036221115778. doi: 10.1177/22799036221115778. eCollection 2022 Jul.
To examine the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions at the dental clinics of a Federally Qualified Health Center network.
General Practice Residency faculty and residents completed research ethics courses and trained dentists to use intra-oral cameras at chairside to photograph oral lesions of patients at routine dental visits. These images were then uploaded into the patient electronic health records (EHRs) with attendant descriptions and an oral surgeon was notified, who reviewed the charts, placed his observations in the EHR, and communicated his findings via secure e-mail to the involved residents, who in turn contacted their patients regarding follow-up actions. Feasibility was assessed via checklists completed by provider participants and semi-structured interviews. Acceptability was assessed via brief exit interviews completed by patient participants.
All 12 of the dentist participants reported that they had successfully provided the tele-mentoring intervention, and that the process (from EHR data entry to interaction with the oral surgeon over findings to patient referral) was clear and straightforward. Of 39 patient participants, most strongly agreed or agreed that the use of an intra-oral camera by their dentists helped them to better understand oral cancer screening (94.9%) and that dentists answered their questions about oral cancer and were able to provide them with resources (94.8%).
Findings support further implementation research into adapting tele-mentoring using intra-oral cameras for training dental residents to detect and identify oral lesions and educating patients about oral cancer across settings.
探讨在联邦合格健康中心网络的牙科诊所中,将远程指导组件整合到口腔病变识别工作中的可行性和可接受性。
全科医学住院医师培训教员和住院医师完成了研究伦理课程,并培训牙医在椅旁使用口腔内摄像头,为常规牙科就诊患者的口腔病变拍照。然后将这些图像上传到患者电子健康记录(EHR)中,并附上描述,同时通知口腔外科医生。口腔外科医生会查看病历,将他的观察结果记录在EHR中,并通过安全电子邮件将其发现传达给相关住院医师,住院医师再就后续行动联系他们的患者。通过提供者参与者填写的检查表和半结构化访谈来评估可行性。通过患者参与者完成的简短退出访谈来评估可接受性。
所有12名牙医参与者均报告称,他们已成功提供远程指导干预,且该过程(从EHR数据录入到就检查结果与口腔外科医生互动,再到患者转诊)清晰明了。在39名患者参与者中,大多数人强烈同意或同意他们的牙医使用口腔内摄像头有助于他们更好地理解口腔癌筛查(94.9%),并且牙医回答了他们关于口腔癌的问题,并能够为他们提供相关资源(94.8%)。
研究结果支持进一步开展实施研究,采用口腔内摄像头进行远程指导,以培训牙科住院医师检测和识别口腔病变,并在不同环境中对患者进行口腔癌教育。