Telemedicine in Dentistry, Lessons to be Learned: A Case Study

Most of the telemedicine projects do not pass the pilot stage. A comprehensive evaluation of telemedicine pilot projects is needed in order to improve their success rate and to create a knowledge base for future projects. In this paper we address this issue through the study case on a pilot teledentistry project with 5 different implementation sites. A literature review of teledentistry and telemedicine in general, points towards a rather one sided approach when evaluating these projects. The organizational aspect does not seem to be a priority in these evaluations while we consider its crucial impact on project’s continuity and adoption. To support this assumption we use a healthcare information systems implementation perspective which allowed us to assess the adoption barriers for the teledentistry pilot. We make assumptions on how it could be used for telemedicine pilots and for telemedicine projects in general. We have collected data using qualitative methods such as semi-structured interviews and nonparticipant observation of teledentistry activities and meetings related to the project. After drawing the dental teleconsultation process and observing that most of it turns around electronic medical records(EMR) we focused to identify all potential adoption barriers and linking them with the list of EMR adoption barriers by Paré et al. (2014). We have identified 23 adoption barriers for teledentristry: 4 in 5/5 implementation sites, 1 in 4/5 sites, 6 in 3/5 sites, 2 in 2/5 sites and 10 in 1/5 sites. Out of the 23 teledentistry adoption barriers, 17 have been linked with EMR adoption barriers. By adding the remaining 6 items to the EMR adoption barriers list and adapting the items to the telemedicine context we propose a telemedicine pilot project adoption barriers list.