Telemedicine in dentistry, lessons to be learned: a case study

Résumé En

Most of the telemedicine projects do not pass the pilot stage. A comprehensive evaluation of telemedicinepilot projects is needed in order to improve their success rate and to create a knowledge base for futureprojects. In this paper we address this issue through the study case on a pilot teledentistryproject with 5 different implementation sites.A literature review of teledentistry and telemedicine in general, pointstowards a rather one sided approach whenevaluating these projects. The organizational aspect does not seem to be a priority inthese evaluationswhile we consider its crucial impact on project’s continuity and adoption. To support this assumption we usea healthcare information systems implemen-tation perspective which allowed us to assess the adoption barriersfor 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 non-participantobservation of teledentistryactivities and meetings related to the project. Afterdrawingthe dental teleconsultation process and observing that most of it turns around elec-tronic medical records(EMR)wefocusedto identifyall potential adoption barriers and link-ing them with the list of EMR adoption barriersby 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 sitesand 10 in 1/5sites. Out of the 23teledentistry 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 pro-posea telemedicine pilot project adoption barriers list.