Online case collaboration provides key information

Dr. Bryan Laskin discusses how to eliminate frustration in communicating with referring clinicians


The world of case collaboration can be frustrating to say the least. Tracking down misplaced faxes, snail mail, and unreadable “chicken scratch” handwriting prolongs and complicates the overall process. Knowing there is an all-in-one online HIPAA-compliant solution to correspond with specialists, labs, and patients alleviates the pains of collaboration and streamlines the entire process. Using OperaDDS can solve the problems in collaborating cases resulting in better patient care, better preparedness, and better efficiency.

To demonstrate the benefits of online case collaboration, let’s explore a less than ideal, but certainly not uncommon case.  A patient presents to the clinic with a dull ache on the lower left, no obvious trauma with the exception of 19 MOD composite done approximately 6 years prior. The patient indicates the filling was done to replace a DO amalgam and repair mesial caries. After diagnostic testing and inconclusive results, a 6-mm pocket is found, indicating a potential periodontal abscess. The clinician has a conversation with the patient and recommends that the patient sees a periodontist to evaluate and treat the area in question.

A written referral to the periodontist is completed, and radiographs are sent with the patient, per his/her request, indicating the requested treatment for the patient. After the patient leaves, the GP creates an online referral prescription via Chorus and instantly uploads the radiograph to the periodontist, ensuring the information will be ready and waiting when the patient arrives. The patient is then seen at the periodontist with the expectation that all the information he/she needs is in the specialist’s hands. Unfortunately, it is extremely common for the referred office to not have the information necessary when the patient presents for treatment. With online, secure case collaboration, the periodontist is able to acquire any missing information by accessing the patient’s Chorus referral and seeing the findings from the GP. In this case, the periodontist evaluates the tooth in question and finds the tooth to be vital with no significant findings, and the patient is referred back to the general dentist to further evaluate with a suggestion that he/she see an endodontist. The periodontist returns to Chorus to input his/her findings and recommendations, instantly being available to the GP.

The saga continues when the patient realizes that the periodontist and his/her general dentist are just down the block from each other — why not pop right in for a quick look, right? A walk-in consult appointment can throw a kink in any schedule, especially a consult with no communication from the specialist. Now it is in the hands of the patient to relay the findings of the periodontist, and we all know how that goes. As the general dentist continues to gather the information and recall the previous findings of the case, he/she obtains the information from the specialist via Chorus and has the auxiliary staff relay the next route is to see an endodontist. No need for the patient to set foot in the operatory. The information is added to the existing referral with all the correspondences, and the endodontist’s contact information is printed directly from the online referral and delivered to the patient.

The communication continues to snowball when the patient presents to the endodontist with a referral from the general dentist requesting the evaluation of tooth No. 19. The endodontist has viewed the Chorus referral and knows that this patient is frustrated with the runaround and continued pain. The patient communicates that he/she has no information to relay because there have been numerous visits and inconclusive results. Unbeknown to the patient, the communication is there and complete. The endodontist informs the patient of the previous findings and recommends the following treatment: Proceed with RCT to alleviate pain, knowing it may not be the source, or return to the GP for antibiotics and wait it out. The patient has had enough of the pain and wants the treatment done but is indecisive on the best course of treatment, looking to the endodontist for recommendations. The endodontist directs to the online case portal and informs the general GP of recommendations for the patient. With the easy ability to communicate with the GP at his/her fingertips, the endodontist is confident that the patient will receive the care he/she is seeking. Within minutes, the endodontist returns to the patient with the recommendations of the GP and discusses what is in the patient’s best interest. Together they proceed with the root canal therapy, confident the patient will be pleased with the results.

Unfortunately, the outcome is unfavorable; the tooth appears to have vertical root fracture, and the tooth is unrestorable. The endodontist informs the patient and proceeds with adding the information to the Chorus referral. There is no need for the patient to contact the GP because the information is already available to him/her and he/she can call the patient with the oral surgeon contact information. In addition, the GP emails the patient via secure email the recommended treatment and patient education forms regarding the procedures.

The dentist contacts the patient to relay the contact information to the oral surgeon and the recommended treatment by the endodontist and himself/herself. As the patient presents to the oral surgeon’s office for evaluation, he/she is again presenting with limited information to hand over to the surgeon. The oral surgeon, well versed on the case attributable to the thorough collaboration of the online portal, is recommending an implant be placed to restore the missing tooth and is confident that the patient is aware of the situation. The patient is apprehensive because of the multiple appointments and specialists, but through the real-time information, the oral surgeon quickly reviews the case findings with the patient and eases his/her mind. Feeling confident with the information given, the patient agrees to proceed with treatment.

Months later, the GP contacts the patient to restore the implant. The oral surgeon added the implant information to the Chorus case, enabling the GP to be prepared for the restorative phase. The patient presents with flawless sequencing, all because the information was thoroughly and cleanly provided to the dentist in a timely manner. There is in no deciphering poor penmanship as to what type or size of implant parts are needed. Additionally, the GP uses Chorus to write a lab prescription and inform them the case is ready for pickup. The lab is notified of the case and hurries over to receive it and begin working on it. Using Chorus takes the guesswork out of case returns; utilizing the status update feature allows the dental office to see in real time that the case is on the way back from the lab, and the receptionist is able to call the patient to schedule and expedite the crown seat appointment. The patient is finally complete. While the diagnosis and treatment planning were less than ideal in this case, it could have been a much lengthier and messier collaboration if the information was passed in a more traditional phone and snail-mail manner.

As illustrated with this case, communication is key to providing excellent patient care, especially when it involves case collaboration. A breakdown in communication between the primary dentist and the specialists can be unfavorable to patients’ overall dental care. Utilizing the latest technology to communicate with all parties regarding a patient case will streamline the case process, in turn providing better patient care. With online case collaboration tools, the collapse in communication can be avoided. Utilizing OperaDDS to orchestrate the complicated world of case collaboration is the solution to providing excellent and thorough dentistry to your patients.

laskin_headshotBryan Laskin, DDS, is a 1999 graduate of the University of Minnesota Dental School. He operates Lake Minnetonka Dental, a successful private practice in Wayzata, Minnesota, that has a keen focus on efficient, esthetic restorative dentistry. The goal of the practice is to exceed expectations, using the latest technology in a friendly, comforting environment. Dr. Laskin is an advanced Patterson-certified CEREC trainer and founder of the Minnesota CEREC and Galileos Study Club, as well as developer of the OperaDDS suite of communication tools — bringing secure email, collaboration, smooth intra-office messaging, and simplified patient recall to dental offices affordably.

Disclosure: Dr. Laskin is the founder and CEO of Prehensile Software, the company that makes OperaDDS.

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