Between the fax and the scanner
When a dental clinic needs information from a patient's physician, the request and the reply can pass through a form, a printer, a fax and a scanner. At one academic clinic in Indiana, a review of 240 requests from 2015 to 2017 found the reply took 19.6 calendar days, on average, to become available to the team.
A dentist reads through a patient's medical history and reaches a question only the patient's physician can answer. A consult form is filled in on the clinic's computer, printed and faxed. Somewhere else, someone reads it, writes a reply and sends it back. At the clinic, the reply is scanned into the patient's record, and only then can the team see it.
Every step is ordinary. What matters is what the steps add up to, and one study measured that in one clinic.
What the records showed
Li, Williams, Medam, Patel, Gonzalez and Thyvalikakath reviewed records at the academic dental clinic of Indiana University. They examined 240 medical consult requests for 179 adult patients, made between 2015 and 2017. The process included a form in the electronic record, printing, fax, and scanning the reply into the record. The study was published in Frontiers in Digital Health in 2022.
In that review of 240 requests at the Indiana clinic (2015–2017), the mean time from request until the reply was scanned and available to the team was 19.6 days, with a standard deviation of 36.6. Of the consults, 57.1% were completed within ten days and 13.8% took more than 30 days. About 45% involved several requests, to the same recipient or to different ones.
Reading the number correctly
The figure needs careful handling. These are calendar days until the reply was available, not hours of staff work, and not delay caused by the physician alone. The study covers only cases that required a consult, in a single academic setting, and does not describe dental visits in general.
Within those limits, the shape of the data is the useful part: a long tail of slow replies, and a large share of consults that needed more than one request. A single average hides that shape, which is why the spread and the tail are worth reading alongside it.
The resend is part of the map
A second paper from the same year, with some of the same authors, looks at the problem from further back. Li, Rajapuri, Felix Gomez, Schleyer, Mendonca and Thyvalikakath reviewed 47 full-text articles from a PubMed search covering January 2013 to November 2020.
From that review, they modelled three ways dental clinicians obtain an up-to-date medical history: the patient's own report together with a medical consult, an integrated medical and dental record, and sharing through a health information exchange.
In those models, the steps include requesting information, sending the request again when no reply arrives in time, moving between parties, and sometimes arranging an extra appointment. Domain experts carried out an initial validation.
It is a modelling study built on a review, with no meta-analysis and no new sample of observed patients. Its proposals for improvement were not tested in an intervention, so they are not evidence of savings, and the studies it draws on should not be counted again as separate proof.
Keeping the answer within reach
Neither paper tells a private practice how long its own consults take. That is something each practice can find in its own records: when a request went out, how many times it was sent, and when the answer could actually be read.
SoliumOS offers quiet help with work like this. It prepares the administrative side of care and keeps what arrives in the place where the team already works, in the clinic's own cloud. The team keeps the final say on every step.
Sources
- Li, Williams, Medam, Patel, Gonzalez and Thyvalikakath (2022). Retrospective Study of the Reasons and Time Involved for Dental Providers' Medical Consults. Frontiers in Digital Health, 4:838538.
- Li, Rajapuri, Felix Gomez, Schleyer, Mendonca and Thyvalikakath (2022). How Do Dental Clinicians Obtain Up-To-Date Patient Medical Histories? Modeling Strengths, Drawbacks, and Proposals for Improvements. Frontiers in Digital Health, 4:847080.