Current through September 24, 2024
No person shall engage in the practice of dentistry, either in
person or remotely using information transmitted electronically or through
other means, on a patient within the state of Tennessee unless duly licensed by
the Board in accordance with the provisions of the current statutes and rules.
Teledentistry shall not alter or amend the supervision requirements or
procedures that are authorized for licensed dental hygienists or registered
dental assistants as stated by T.C.A §
63-5-115,
0460-03-.09 and
0460-04-.08.
(1) Treatment and the Practice of
Teledentistry
(a) A teledentistry encounter
entails the rendering of a documented dental opinion concerning evaluation,
diagnosis, and/or treatment of a patient whether the dentist is physically
present in the same room or in a remote location within the state or across
state lines.
(b) Teledentistry as
practiced under T.C.A §
63-5-108(b)(16)
is not an audio only telephone conversation, email/instant messaging
conversation or fax. At a minimum it shall include the application of secure
video conferencing or store-and-forward technology to provide or support dental
care delivery by replicating the interaction of a traditional encounter between
a provider and a patient.
(c) If
the information transmitted through electronic or other means as part of a
patient's encounter is not of sufficient quality or does not contain adequate
information for the dentist to form an opinion, the dentist must declare they
cannot form an opinion to make an adequate diagnosis and must request direct
referral for inspection and actual physical examination, request additional
data or recommend the patient be evaluated by the patient's primary dentist or
other local oral health care provider.
(d) No patient seeking care via teledentistry
who is under the age of eighteen (18) years of age can be treated unless there
is a parent or guardian present, except as otherwise authorized by
law.
(2) Dental Records
and Informed Consent when Practicing Teledentistry
(a) For patient encounters conducted by
teledentistry, the dentist shall have appropriate patient records or be able to
obtain the patient's prior treatment information during the teledentistry
encounter.
(b) Secure electronic
records of the patient are to be kept at all locations where the patient is
seen physically and at the location where the dentist is if the dentist is not
present at the time of the visit. Dental records established for the purposes
of teledentistry must contain the same information as required by Rule
0460-02-.12.
(c) Store-and-forward technology as used in
(1)(b) above is the use of asynchronous electronic communications between a
patient and dentist at a distant site for the purpose of diagnostic and
therapeutic assistance in the care of patients, including the transferring of
dental data from one site to another through the use of a device that records
or stores images that are sent or forwarded via electronic communication to
another site for consultation.
(d)
The dentist engaging in teledentistry is responsible for ensuring that the
dental record contains all pertinent data and information gleaned from the
encounter. Any dentist conducting a patient encounter via teledentistry must so
document by an informed consent form which shall be added in the patient record
and must state the technology used.
(e) Informed consent forms shall be signed by
the patient or parent/guardian describing the information to be transmitted
and/or shared with a dentist who is at a different geographical
location.
(f) A dentist who
provides information regarding healthcare services on an internet website that
is directly controlled or administered by the dentist or the dentist's agent,
shall prominently display on the internet website the dentist full name and
type of license.
(3)
Supervision
(a) Patient encounter with
hygienist - Any licensed dental hygienist who assists the dentist in providing
dental health services or care using teledentistry is only authorized to
perform those services that the dental hygienist is authorized to perform
during an in-person patient encounter under general supervision as defined by
T.C.A §
63-5-108(c)(5).
Authority: T.C.A. §§
63-1-155,
63-5-105,
63-5-108,
and 63-5-115.