Delivering the 18 Weeks Referral to Treatment Standard Output Report

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• Managed Clinical Networks to promote information sharing and developing andsharing good practice e.g. Tayside’s Orthodontic Managed Clinical Network.• Visioning days for Dentistry e.g. Forth Valley and Fife.• Consultants do not have to see all return patients; some patients could bereviewed by extended scope practitioners.• Increasing the number of ‘see and treat’ clinics.• Altered triage arrangements.• More regional working/services.For more examples of good practice, see the ‘Who is Doing What’ Matrix, attachedas Appendix seven.Tele-dentistryElectronic Orthodontics within the North of Scotland:Aspirations and Achievements to DateThe vision for the North of Scotland is to develop a common platform delivered onN3 to link Consultants working in hospital-based services, Primary Care DentalPractitioners, Information Services Division (ISD), the Scottish Dental Practice Board(SDPB), NHS Education Scotland and the North of Scotland’s Boards collaboratingin a Managed Clinical Network for Orthodontics. The overarching aim of the projectis to improve the quality of patient care by embracing technology, resulting in betteraccess to dental health information, ‘joined-up’ primary care and hospital servicesand quicker access to a unified dental record and imaging. However, it is not justabout technology, it is about modernising processes and encouraging new ways ofworking.Maximising existing and implementing new communication technologies to supportthe North of Scotland Managed Clinical Network (MCN) for Orthodontics is essential.Developing a system for information retrieval, collation and activity monitoring will bea high priority for the MCN and is seen as fundamental to the Network’s success.A phased approach to implementation has been agreed. The capital required for ashort pilot (proof of concept) for Stage I and II was agreed by the North of ScotlandBoards.Stage I – Electronic Triage• Triage of orthodontic referrals sent by GDPs, Experienced Practitioners (SOP),Rural Fellows, etc, to a Consultant Orthodontist.• Preferred number of trial sites: five or six.• Functions required:o e-transfer of referral letter/form and response (store and forward);o ability to attach digital images (photographs, PACS images), 3-D images, linksDental Specialties Task & Finish Group – January 2011 32
with CHI number, address book.• Information/Data Capture: Patient details including Date of Birth, address,referring clinician, demographics, etc.Timescale: Stage I has been completed.Stage II - Treatment Planning/Advice• Treatment Planning and Advice returned from a Consultant Orthodontist toexperienced practitioners, rural fellows, GDPs etc.• Preferred number of trial sites: five or six.• Functions required: as for Stage I, and to include:o video conferencing/video assessment function;o recommendations/assessment report.• Information/Data Capture: As for Stage I, plus secure electronic patient recordwhich is accessible to Consultant, Dentist, AHP and other clinicians involved indirect patient dental care, as appropriate.Timescale: To be arranged.Stage III - Training and Education• E-Orthodontics will be evaluated as a tool to support education and training atundergraduate and post graduate levels.• Interest in developing an MSc in e-Orthodontics has been expressed byProfessor James McDonald, Glasgow University.• It is envisaged that the e-orthodontics system will provide online help andtutorials• Functionality required: as for I-III above, plus:o dictionary items;o on-line help screens;o full audit trail across the spectrum of treatment modalities, by referringpractice or discipline, financial aspects etc.Timescales: To be arranged.Stage IV - EDI in Primary Care• From Primary Care to ISD and the Scottish Dental Practice Board (SDPB)• Preferred number of trial sites: five or six• Function required: As for Stage I-III and to include:o Record of Services provided;o dental claim form to include authorisations required, etc.Ultimately, the intention is to utilise the NHS Scotland building blocks; N3, SCI Store,Gateway and the Generic Clinical System to develop a multimedia, and multidisciplinarycare record from which the Information Statistics Division (ISD), theScottish Dental Practice Board (SDPB) and the North of Scotland Managed ClinicalNetwork for Orthodontics will be able to access and exchange relevant information inorder to facilitate the commissioning, monitoring and delivery of orthodontic care.Dental Specialties Task & Finish Group – January 2011 33
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Page 3 and 4: Demand is not a given 24Effective R
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