111 - Utilization of Dental Consultation in a Novel Medical Inter-Specialty Service

Title: Utilization of a Novel Inter-Specialty Consultation Service with Dentistry

Authors: Hall B, Townsend J, Azadani E, Peng J, Claman D

Purpose: The goal of this study was to describe an innovative peer support program offered by a major children’s hospital that utilizes provider-to-provider communication for direct medical professional consultation with other medical professionals and specialists, including dentistry. This program is known as Physician Direct Connect (PDC). The objective of this study was to describe the utilization patterns and patient outcomes with the goal of identifying areas for improvement of future medical training.

Methods: Data collection involved a search of electronic medical records from 2009-2023 for all patients whose providers utilized the PDC service through NCH to communicate with a dental provider. Validity of data collection was confirmed with manual chart review by the primary investigator. Descriptive analysis of all data was completed following collection.

Results: In total, there were 1155 individual patient encounters identified as using this service. The majority of consultation requests were placed by outside physicians. Urgent Care facilities were responsible for most consultation requests. Nearly 50% of the consultations were resolved with provider discussion alone with no recommendation for ED or clinic follow up. Of those which required referral to the ED, over 50% of referrals were for dental trauma, which was also the most common dental problem associated with the requests. Of the nearly 300 patients that were recommended to be transferred to the hospital, 185 of them were for dental trauma, 66 were for infection, and the remaining were for pathology or pain.

The demographic data demonstrated that fewer than 30% of the patient's receiving consultation had private/commercial insurance, and nearly half had Medicaid. This helps to demonstrate the importance of the cost-saving abilities of this service for both the patient and the health care system.

Conclusions: This type of peer-to-peer consultation program can provide increased health equity through ease of access to specialist recommendations, decrease overall healthcare costs for the patient and provider, and minimize unnecessary hospital transfers. This may lead to a better understanding of knowledge gaps within the medical field that could be improved with additional education while in school or training.