Oral Health Goes High Tech
Social media can aid clinical efforts by helping patients comply with treatment regimens.
This course was published in the January 2015 issue and expires January 31, 2018. The authors have no commercial conflicts of interest to disclose. This 2 credit hour self-study activity is electronically mediated.
After reading this course, the participant should be able to:
- Describe Americans’ use of technology.
- Discuss how technology can help improve communication in the dental office.
- Identify the different social media platforms and smartphone apps, and how they can be used to improve patient compliance.
According to a 2014 Pew Research Internet Project, 90% of American adults own a cellphone, and more than 50% use their phones to retrieve or search for information.1 As many as 87% of adults and 97% of young adults between the ages of 18 and 29 now use the Internet, and the majority of Americans report feeling better informed because of their digital technology use (Figure 1).2 Additionally, 42% of American adults own a tablet; 67% check their phones for texts, calls, and alerts; 44% sleep with their phone next to their bed; and 29% admit that their cellphone is something they could not live without.3 Figure 2 outlines the specific activities of cellphone users in 2013.3 A study conducted in 2012 found that more than 30% of smartphone owners have looked up health information using their hand-held device. Additionally, 52% collect health information on their phones. Almost 25% of smartphone owners have utilized a health app.2
IMPROVING COMMUNICATION VIA TECHNOLOGY
Using tablets in the dental office is an innovative way to collect information and communicate with office staff. Upon arrival at the dental office, patients are often asked to update medical, insurance, or personal information, and using a tablet to collect this information is an effective alternative. Additionally, patients may be directed to answer questions such as, “How are you feeling today?” or “What concerns do you have about your oral health?” or “What do you look forward to in your visit today?” If these questions are answered ahead of time, dental hygienists can gain a better idea of what to expect from the patient before treatment (ie, anxiety, sensitivity, pain). Once the appointment is complete, asking the patient to participate in an anonymous survey may offer valuable data on aspects of the visit and allows the patient to offer suggestions to improve the provision of care.
Web-based tools are available to standardize and automate patient communication and informed consent. These systems can assist patients in understanding their treatment through a “teach-back” process. After the health professional explains the procedure or instructions, the patient recites it back in his or her own words. The patient’s interpretation is then recorded in the electronic health record, creating a more personalized record that documents the patient’s understanding.4 Oral health professionals can evaluate their patient’s health literacy with Web-based tools. These technologies enable patients to feel in control of their health and confident about the care they received.
Language apps are another tool that can improve communication when patients and clinicians speak different languages. iTranslate is a free translator and dictionary app that includes more than 80 languages. Apps incorporate images with words—as pictures can be used as a universal language. Additionally, apps may assist the hearing or visually impaired. Dragon Dictation, a free app, will transcribe words as the person is speaking. Another free app, Voice Brief, can read emails, weather, Facebook and Twitter feeds, and much more.
More than 80% of young adults age 18 to 24 share health information on social media, and almost 90% of this population trusts the information found.5 As many as 60% of medical doctors think social media improves the quality of care they provide to their patients. One-third of Americans use social media sites—such as Facebook, Twitter, YouTube, and online forums—to seek health information and share health-related conditions and treatments.6 Physicians consider social media to be an effective means for sharing new health care knowledge and improving patient care.7 A reported 61% of patients are likely to trust information posted online by health care providers.8
Patients who use social media are more likely to be engaged with their care and may actively participate in appointment reminders, diagnostic reports, and notifications for prescriptions via these formats. Social media also provides an avenue for asking general questions. Older adults also have this same benefit, as more of this patient population becomes comfortable with this technology.9
Facebook is one of the most popular and recognizable online social media platforms. Users create a profile, add friends, post status updates, and share photos. Users may also join interest groups. Dental hygienists and dentists can interact with the public by creating a Facebook account. Currently, the American Dental Hygienists’ Association (ADHA) and the American
Dental Association (ADA) have Facebook pages that post updates on new state regulations regarding practice, news on oral health around the globe, and other events occurring within their organizations. Dimensions of Dental Hygiene has an active Facebook page with more than 52,000 members. Through Dimensions’ Facebook page, dental hygienists can also join a private group in which they can post questions to other members of the group. Dental hygienists may develop accounts that focus on oral health concerns of patients, and post daily tips and facts that may influence their followers.
Twitter is an online microblogging social networking service that allows users to send and read 140-character messages, called tweets. This social media platforms has 115 million active users per month, and is one of the top 10 most visited Internet sites.4 Twitter is also available as an app on mobile devices; 43% of users tweet using their smartphones.4 Twitter also has a popular “hashtag” feature that allows users to label, or tag, their tweets. Participants can also interact with others by using “@” to reply to or mention another user. When placing the “@” symbol in front of a username, the other user is notified of a message and can respond.
Similar to Facebook, Twitter is another way for dental hygienists and dentists to provide health information. The ADHA, ADA, and Dimensions of Dental Hygiene have Twitter accounts that tweet updates similar to the messages shared via Facebook. Dental hygienists may develop accounts that focus on oral health concerns of patients and tweet daily tips and facts that may influence their followers. Users are also welcome to use “@” to mention the account and ask quick questions that dental hygienists can answer publicly while refraining from posting personal information—which would violate Health Insurance Portability and Accountability Act (HIPAA) laws.
Spring.me is a forum-based website that focuses on user-to-user questions and answers. Members can also interface with other social networking sites, such as Facebook and Twitter. The benefit of this Website is that questions and answers can be conducted anonymously. Users have the ability to hide their names and photos. The questions and answers appear publicly, but the user remains unknown. This feature may provide patients with an extra layer of comfort, knowing their identity is protected when asking a question they—and possibly others—have been too embarrassed to ask in person.
Pinterest is another popular social networking site, and it reached 10 million viewers faster than all other social media sites.10 Pinterest focuses on a highly visual audience with content that easily engages the attention of its followers. The unique feature of this website is that it allows users to bookmark items into categories or “boards,” including health, recipes, fashion, art, etc. Users may have followers who see a “pinned” item, and followers can, in turn, pin the item to their own board to be shared.
An account made by dental hygienists may inspire other users to realize the importance of oral health. Boards may feature flossing products and their alternatives, including pictures and links to brushes, floss threaders, toothpick holders, and other interdental aids. Another board may present different brands of toothpaste products or fluoride mouthrinses. Some Pinterest users also like to bookmark certain quotations, facts, and statistics. Short, brief, and visual images with quotations may captivate users, who may then pin the message to their followers.
Youtube.com is a popular streaming video website. Educational videos, including lectures, are commonly used in classrooms. At more than 6 billion hours of viewership per month,11 this online platform is ideal for dental professionals to post engaging videos that can provide educational material to the public.
How-to videos on the different techniques of toothbrushing, flossing, and using oral hygiene aids may be beneficial. Another use may be to better explain the science behind oral diseases, with close-up animation accompanied by clear, easy-to-comprehend explanations. This assists patients in understanding the importance of self-care and keeping routine dental appointments—and may even lead to improved patient compliance for treatment plans.
For example, the explanation of the caries process can further emphasize the importance of radiographs, as not all caries are easily detected. Dental hygienists may also post videos on nutrition, detailing how diets that include excessive consumption of sugar can cause caries, and then provide healthy alternatives to sugary foods and drinks. YouTube is a virtually limitless gateway for patient education outside of the dental office.
A relatively new Internet tool, infographics present information through data-driven visuals. These brief presentations of facts and figures are popularly bookmarked to Pinterest, and would be an effective aid when presenting oral health data to patients (Figure 3).12
PRIVACY AND DATA MANAGEMENT
Mobile device users store an astonishing amount of personally identifiable data. Although there are many benefits to using social media and technology in patient health care, associated burdens of HIPAA compliance and ethical issues cannot be ignored.
HIPAA regulations protect individual health care information in oral, written, and electronic forms. The HIPAA Privacy Rule defines the circumstances in which health care information may be disclosed, while the HIPAA Security Rule defines the requirements that must be met to send the information electronically.13 Health care providers must take caution not to disclose or remotely refer to any patient information in electronic formats. While there are benefits of social media in health care, legal and ethical standards must be upheld.
More people than ever have mobile access, whether via smartphone or tablet.2 Dental hygienists can reach a wide population by following this trend and creating an app for smartphone and tablet users.
“Brush DJ” is an app that reminds patients to brush and floss daily. This app can send a reminder to the patient’s phone about brushing during preset times or any time of the patient’s choosing. This can also time the length of brushing with a visual countdown or can be paired with songs already on the mobile device.
The “Doctors Appointment Reminder” app keeps track of health-related appointments and notifies the user of upcoming appointments. Patients may record what occurred during their appointment, such as what radiographs were taken, what treatment they received, and if a referral to a specialist was provided. Additionally, patients can record any instructions or goals given by health care providers. This app may help patients become more proactive and organized with their oral health care.
Children may also benefit from using apps to improve oral health. “Brusheez—The Little Toothbrush Timer” is a free interactive app that motivates children to brush. Users select a monster pal and make their icon jump and wiggle to brush. “Toothbrush Time with Icky” is another child-friendly educational app geared for young children. These are just two examples of the many apps available for both children and adults.
Oral health professionals need to investigate thoroughly any app they recommend to patients to ensure accurate and appropriate information is being presented by the app developers. Several dental manufacturers have apps with extensive information geared toward dental professionals to educate patients about oral health and common oral conditions. Additionally, Web-enabled toothbrushes are available that provide users with data on their brushing habits via their smartphones. Clinicians can also develop their own unique apps through sites such as Appypie.com.
With the transformation in how information is communicated and sought, oral health professionals can reach patients in a brand new way and educate them on an array of topics when utilizing available technology. The profession must embrace digital technologies that make patients’ lives easier and health professionals’ work more efficient. Social media and portable devices are new and exciting ways people search and receive information, including health and oral health-related issues. Dental hygienists should consider publishing and creating ways for patients to find accurate and easy-to-understand material concerning oral health. The more ways clinicians can share their knowledge, the more patients are informed and aware of their oral and systemic health.
- The Pew Research Internet Project. The Web at 25 in the US. Available at: pewinternet.org/2014/ 02/27/the-web-at-25-in-the-u-s/. Accessed December 19, 2014.
- The Pew Research Internet Project. Mobile Health 2012. Available at: pewinternet.org/2012/11/08/ mobile-health-2012/. Accessed December 19, 2014.
- The Pew Research Internet Project. Mobile Technology Fact Sheet 2014. Available at: pewinternet.org/fact-sheets/mobile-technology-fact-sheet/. Accessed December 19, 2014.
- HealthcareIT News. Technology Boosts Doctor-Patient Communication. Available at: healthcareitnews.com/news/technology-boosts-doctor-patient-communication. Accessed December 19, 2014.
- HealthcareIT News. Rising Use of Social Media in Healthcare. Available at: healthcareitnews.com/ infographic/rising-use-social-media-healthcare. Accessed December 19, 2014.
- Mayo Clinic. Health Care Social Media List, November, 2012. Available at: network. socialmedia.mayoclinic.org/. Accessed December 19, 2014.
- McGowan BS, Wasko M, Vartabedian BS, Miller RS, Freiherr DD, Abdolrasulnia M. Understanding the factors that influence the adoption and meaningful use of social media by physicians to share medical information. J Med Internet Res. 2012:14;e117.
- Hitech Answers. Social Media Likes Healthcare: PwC Report on the Impact of Social Media in Healthcare. Available at: hitechanswers.net/social-media-likes-healthcare. Accessed December 19, 2014.
- Househ M, Borycki E, Kushniruk A. Empowering patients through social media: the benefits and challenges. Health Informatics J. 2014;20;50‒58.
- SocialMediaToday. 25 amazing Pinterest facts for your small business. Available at: socialmediatoday.com/sarah-mincher/1879726/25-amazing-pinterest-facts-your-small-business. Accessed December 19, 2014.
- YouTube. Statistics. Available at: youtube.com/yt/press/statistics.html. Accessed December 19, 2014.
- American Academy of Pediatric Dentistry. Active Kids, Healthy Teeth. Available at: mouthmonsters.mychildrensteeth.org/active-kids-healthy-teeth. Accessed December 19, 2014.
- US Department of Health and Human Services. Summary of the HIPAA Privacy Rule. Available at: hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html. Accessed December 19, 2014.
From Dimensions of Dental Hygiene. January 2015;13(1):66–69.