COVID-19 has challenged the public dental workforce in their ability to continue providing routine oral health care services. To mitigate the risk of COVID-19 transmission to staff and patients, Teledentistry was implemented in many parts of the world, mainly to provide remote consultations, undertake triage, and offer preventive educational sessions. The aim of this paper is to describe Dental Health Services Victoria’s (DHSV) patient-initiated Teledentistry model of care implemented during peak COVID transmission in Victoria. The Teledentistry model supported patient-centered care involving active collaboration and shared decision making between patients, families, and clinicians in designing and managing remote care plans. DHSV’s eligible patient cohort includes disadvantaged population groups with greater oral health needs. Strong emphasis was placed on the simplicity and user friendliness of the Telehealth platform, as well as the support for patients with low technology literacy. Consumers and dental workforce were consulted and modifications to the use of language and services were undertaken before the launch. A total of 2492 patients accessed Telehealth services between May 2020 and April 2021. Approximately 39% of patients were born in a country other than Australia. A total of 489 patient-reported experience measures (PREMs) were received. Patients agreed or strongly agreed that the care they received met their needs (87%); they received answers to their questions (89%); they left their visit knowing what is next (87%); they felt they were taken care of during their visit (90%); and they felt involved in their treatment (89%). Teledentistry enabled patients to initiate access to care and consult with dental workforce remotely and safely during peak pandemic.

Objective: This study aimed to describe the development and implementation of a co-designed value-based healthcare (VBHC) framework within the public dental sector in Victoria. Methods: A mixed-method study was employed. Explorative qualitative design was used to examine patient, workforce and stakeholder perspectives of implementing VBHC. Participatory action research was used to bring together qualitative narrative-based research and service design methods. An experience-based co-design approach was used to enable staff and patients to co-design services. Quantitative data was sourced from Titanium (online patient management system). Results: Building a case for VBHC implementation required intensive work. It included co-designing, collaborating, planning and designing services based on patient needs. Evidence reviews, value-stream mapping and development of patient reported outcomes (PROMs) and patient reported experience measures (PREMs) were fundamental to VBHC implementation. Following VBHC implementation, a 44% lower failure to attend rate and 60% increase in preventive interventions was reported. A higher proportion of clinicians worked across their top scope of practice within a multi-disciplinary team. Approximately 80% of services previously provided by dentists were shifted to oral health therapists and dental assistants, thereby releasing the capacity of dentists to undertake complex treatments. Patients completed baseline International Consortium for Health Outcomes Measurement PROMs (n = 44,408), which have been used for social/clinical triaging, determining urgency of care based on risk, segmentation and tracking health outcomes. Following their care, patients completed a PREMs questionnaire (n = 15,402). Patients agreed or strongly agreed that: the care they received met their needs (87%); they received clear answers to their questions (93%); they left their visit knowing what is next (91%); they felt taken care of during their visit (94%); and they felt involved in their treatment and care (94%). Conclusion: The potential for health system transformation through implementation of VBHC is significant, however, its implementation needs to extend beyond organisational approaches and focus on sustaining the principles of VBHC across healthcare systems, policy and practice.