Teledentistry System in Dental Health Public Services: A Mixed-Methods Intervention Study

Introduction: Health information and communication technologies, such as Teledentistry, can help expand access to dental health public services making it more effective. Objective: To analyze the factors that affect the implementation of a Teledentistry system in dental health public services. Methods: The study follows the Implementation Research methodological framework. A mixed-method approach was applied using a triangulation design-sequential model to collect, analyze, and interpret qualitative and quantitative data about the implementation of a Teledentistry system. A compulsory teleconsultation from the general dentist was planned to access periodontics specialized care. The study was developed in a South Brazilian capital city and the platform of the Santa Catarina Telehealth Center was used. Qualitative and quantitative data were collected sequentially to achieve a better understanding of implementation research issues. Results: In seven months, 68 teleconsulting was performed by 22% of the general dentists, prior to the referrals on periodontics. Only one reported not needing to refer the patient to the periodontist as a result of the teleconsulting guidance. Teledentistry system implementation and usage were influenced by the managers' political and administrative awareness to deploy and maintain the intervention. Lack of sufficient resource investment, lack of system integration, and internet failures were relevant limiting factors. The teleconsultant guidelines contributed to general dentistry's better decision-making regarding treatment, urgency of case management, and prioritization of referrals to the periodontists Conclusion: Identifying the factors that influence the implementation and finding solutions to overcome them, can prevent future failures and improve usage of the system