The Right Care, at the Right Place, at the Right Time

A 19-year-old male returned repeatedly to a hospital emergency department because of dental pain, but was never linked to a definitive site for dental care and would leave the ER with only his symptoms treated. His last visit to the ER was not to manage dental pain, but because of severe headache, concussion, vomiting, nausea, confusion and epileptic seizures resulting from untreated endocarditis.

“Unfortunately this individual now has become a ward of the state with uncontrollable epileptic seizures,” said Frank Beck, D.D.S., inaugural dean of the Bitonte College of Dentistry at NEOMED, and recent VITALS speaker.

While the case is an extreme one, it illustrates the issue of the lack of access to regular dental care for many people, who then may rely on the ER to manage untreated dental issues.

On March 2 VITALS program, Dr. Beck shared what he calls “a disruptive strategy to address a long, longstanding practice pattern of behavior of patients utilizing hospital emergency departments to receive non-emergent services rendered by the physicians in the emergency department rather than at a lower acuity center.”

Dr. Beck and colleagues developed an application called Definitive Care Solutions to divert patients presenting at the ER with non-emergent conditions to a more appropriate setting.

“Simply stated, patients receive the right care in the right setting at the right time,” Dr. Beck said.

A recent study found that non-emergent dental conditions were three of the top 20 diagnoses for level-one and level-two emergency room visits. A visit to the ER can cost $580 to $1,800 more than a comparable visit to the dentist’s office.

Dr. Beck noted, “Patients would present to the hospital emergency department receiving symptomatic non-definitive care — more oftentimes than not, an analgesic opioid and an antibiotic and a discharge instruction to follow up with the dental provider.

But no linkage to a dental provider was made.”

The linkage to dental care in Definitive Care Solutions has had positive outcomes “for the patient, care compliance, cost savings, cost avoidance and mitigation of patient culminating pathologies,” Dr. Beck said.

A Q&A, moderated by WKYC senior health correspondent Monica Robins, followed Dr. Beck’s remarks.

Watch VITALS with Frank Beck, D.D.S., FAAHD

Sign up for next VITALS program with Michael Forbes, M.D., FAAP, FCCM, chief academic officer and William H. and Rebecca D. Considine Endowed Chair for Pediatric Research at Akron Children’s Hospital.

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