Orthodontic Digest

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Why Patient Consent Needs a Digital Solution: Consultant Orthodontist Alan Gowan presents DentConsent.

Looking for a way to meet the new NHS criteria for patient consent and data control? There's an app for that. We interviewed Consultant Orthodontist Alan Gowans to explain DentConsent: An Animated Patient Information and ‘Enhancement to the Consent Process’ program designed to make life easier for all.

Sounds too good to be true? Read on…

It is true that patient consent and correct record keeping is one of the industry's hot topics right now. In a recent article "The question of consent" published in October's Scottish Dental Magazine, a roundtable discussion between members from across the dental world revealed many of the issues clinicians face including the daily tasks of recording data and the consent pathway between primary and secondary care. Since the Montgomery Ruling, clinicians have a heightened awareness of the importance of consent and note keeping.

Image provided courtesy of Alan Gowans

 Video provided courtesy of Alan Gowans

Defining Consent

The NHS website states that consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination.

    Handling time and finance pressures, language differences and a patient’s capacity for understanding are the normal challenges many orthodontists are now facing. And, as orthodontists embrace the new NHS requirements for the current retendering bid, (and data recording being a fundamental part of this), many clinicians may be left scratching their head for answers. This is where DentConsent may come in handy.

    Alan, what is DentConsent and how does it help to manage patient consent in a modern, legal and ethical way?

    DentConsent is a new dynamic multi-lingual patient information product in development, incorporating a fully animated patient information/consent program planned for release within the dental community through the University of Leeds and NHS Digital Code4Health scheme (https://code4health.org)

     

    How do clinicians and patients gain from DentConsent?

    I created it so my patients could gain information about their treatments in such a way that engaged them, could be sent out electronically, and enhanced understanding amongst my dyslexic patients as well as those who do not speak English as a first language. It provides a paperless, environmentally friendly and efficient enhanced and robust record of consent that ticks a lot of the boxes for the current retendering bid.

    (DentConsent) provides a paperless, environmentally friendly and efficient enhanced and robust record of consent that ticks a lot of the boxes for the current retendering bid.

    It has been very useful for me in my own practice and I believe provides value to

    • People who are retendering for orthodontic contracts.
    • Anyone who wants a paper-free practice environmental practice.
    • Anyone who wants to have the best level of patient information available that can be sent out before the next appointments
    • Anyone who wants a robust enhanced consent process: Anyone who wants to sleep easy at night knowing you have proof that the patient was given the best information regarding warnings of treatment, especially when in dispute.

     

     

    The program includes fully animated patient information about orthodontic treatment. It is packaged into modules, such as Removable appliances; Fixed appliances; Functional appliances; Orthodontic Extractions; Retainers; and Oral Health Education (Tooth Brushing instruction / Oral Health Instruction / Risks of treatment, dietary advice, etc).

     

    The aim of the software is to:

    • Enhance the patient experience and consent process.
    • Address issues of diversity providing multi-lingual options.
    • Be fully paper-free and environmentally friendly.
    • Be bespoke to the patient and clinician.
    • Give patient information on a web-based multi-platform as per guidance document from the NHS for Orthodontic tendering (September. 2015).

    Digital consent recording made simple. Image provided courtesy of Alan Gowans.

    Click and send the chosen video. Image provided courtesy of Alan Gowans.

     

    Our intention is to release an initial module on ‘Retainers’, and further modules will then be released when the software is adopted into the practice. The whole program can be modified to be bespoke to the individual clinicians and patients – for example, the retainer module has 6 variations available allowing the clinician to tailor the retention regime to the individual to both the clinician & patient’s needs.

    Does it test a patient's capacity for understanding?

    The program has a built-in process to test the capacity of the patient being given the information. The patient answers are retained and can then used by the clinician completing the consent to enhance the patient consent process. The consent is recorded electronically and records the individual giving the consent to prevent any ambiguity over who gave the actual consent.

    The consent is recorded electronically and records the individual giving the consent to prevent any ambiguity over who gave the actual consent.

    The program is hosted locally within the practice, and is multi-platform, allowing the animation to be displayed on any available tablet or device - I use blue-toothed sound cancelling headphones with my ipad on the clinic so that the parents and patients can watch the modules without any disturbance in the noisy clinic. There is provision for the program to be interlinked with dental practice records software if compatible.

     

    How are the videos sent to the patient?

    The animated modules can be sent to the patient before the appointment by email or to their smartphones. The module can also be sent to the patient directly after the appointment to reinforce the information given. The program can provide patients with written instructions as well as paper printed consents.

     

    How do clinicians get involved?

    I am developing the product at the University of Leeds who own all associated copyrights and IP. The University is fully supportive of making DentConsent widely available and, among other strategies, has been working in collaboration with NHS England and NHS Digital to evaluate deployment as a free open source software for all suppliers of NHS orthodontics.

    What is the cost to the NHS Practice?

    This option would enable widespread benefit to the NHS community but would require users to subscribe to a nominal maintenance and upkeep fee under a not-for-profit model. The larger the user group, the lower the maintenance fee to each user. This approach may be managed by NHS Digital and the user group who may then work to further develop DentConsent into other areas of operative dentistry.

    The University of Leeds is currently assessing the viability of this strategy to ensure widespread benefit. At this time it is keen to hear from anyone who may be interested in becoming involved in supporting the development of this software through this cost-sharing model. The cost for this per individual all depends on the number of angel investors, so it could range from £50 to £300.

    Contact Alan today

    If you are interested in becoming an angel investor with Alan Gowans or have any questions on how DentConsent can improve your working practise email denag@leeds.ac.uk

    Alan Gowans is Consultant Orthodontist at Blackpool Teaching Hospitals as well as a Visiting Clinical Research Fellow with the University of Leeds.

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