Top

BMC Health Services Research

Published in:

Open Access 01-12-2024 | Telemedicine | Research

Legal issues in digital oral health: a scoping review

Authors: Rodrigo J. Mariño, Carlos Zaror

Published in: BMC Health Services Research | Issue 1/2024

Abstract

Background

This scoping review aims to systematically and critically describe the numerous legal challenges brought about by the utilization of digital oral health in the delivery of oral healthcare.

Methods

A systematic search was conducted. The following electronic databases were reviewed from inception up to March 2023: MEDLINE, Embase, Scopus, and LILACS. The search included any scientific document and paper in English, Spanish, or Portuguese on legal issues raised using digital health in oral healthcare delivery. Two reviewers conducted the selection process and data extraction. Legal issues raised concerning the adoption of digital health technology were analysed using the modified Mars’ framework.

Results

Seventeen studies were included. Most of the documents identified and covered generic aspects of delivering digital oral healthcare (n = 11) without explicitly referring to any dental specialty. The most mentioned legal issues were data security (n = 15); liability and malpractice (n = 14); consent (n = 12); and confidentiality (n = 12). To a lower extent, patient-practitioner relationship (n = 11); and license and jurisdiction (n = 11) were also covered. These were followed by privacy of information (n = 10); adequacy of records (n = 9); and e-referrals (n = 8). On the other hand, fewer studies commented on social media use (n = 3), authentication (n = 2); or e-prescriptions (n = 2). Before implementing any digital health solution, practitioners need to be aware of the many legal issues that the introduction of these technologies involves, be clear where the responsibility lies, and apply extreme caution in following national guidelines. Current literature concentrates on a few well-known legal issues. Issues around authentication, use of social media, and e-prescriptions received less attention.

Iorgulescu G, Cristache CM, Burcea CC, Ionescu I, Perieanu VS, Marcov N, Burlibasa M. Ethical and medico-legal aspects behind the use of digital technologies in dentistry. Rom J Leg Med. 2020;28:202–7.CrossRef

Mariño R, Chinnasamy A. e-Oral health tools. In Giraudeau N, editor. e-Health Care in Dentistry and Oral Medicine. Springer. 2018:15–28. https://doi.org/10.1007/978-3-319-69450-4_2

Kaplan. Revisiting health information technology ethical, legal, and social issues and evaluation: telehealth/telemedicine and COVID-19. Int J Med Inf. 2020;143:104239. https://doi.org/10.1016/j.ijmedinf.2020.104239CrossRef

Walker TWM, Chadha A, Rodgers W, Mills C, Ayliffe P. Electronic Follow-Up of developing World Cleft patients: a Digital dream? Telemed J E Health. 2017;23:847–51. https://doi.org/10.1089/tmj.2017.0012CrossRefPubMed

The World Health Organization’s World Health. Assembly WHA58.28/2005 Resolution recommends the adoption of e-health by health systems of State Members.

Birnbach JM. The future of teledentistry. J Calif Dent Assoc. 2000;28:141–3.PubMed

Goriuc A, Sandu D, Tatarciuc M, Luchian I. The impact of the COVID-19 pandemic on Dentistry and Dental Education: a narrative review. Int J Environ Res Public Health. 2022;19:2537. https://doi.org/10.3390/ijerph19052537CrossRefPubMedPubMedCentral

Australian Health Practitioner Regulation Agency (AHPRA). Telehealth guidance for practitioners. 2022. [cited 2023 Mar. 15]. Available from: https://www.ahpra.gov.au/News/COVID-19/Workforce-resources/Telehealth-guidance-for-practitioners.aspx

Medical Board of Australia. Medical Board of Australia Guidelines: Technology-based patient consultations. 2012. [cited 2023 Mar. 15]. Available from: https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Technology-based-consultation-guidelines.aspx

10.

Australian Dental Association. Guidelines for Teledentistry. 2022. [cited 2023 Mar. 15]. Available from: https://www.ada.org.au/Covid-19-Portal/Cards/Dental-Profesionals/Practice-Policies/ADA-Guidelines-for-Teledentistry

11.

Raucci-Neto W, de Souza Pereira M, Cerqueira NM, Louzada VG, de Castro Raucci LMS, Leoni GB. Knowledge, perception, and experience of dentists about Teledentistry. Int Dent J. 2022;72:456–62. https://doi.org/10.1016/j.identj.2021.07.007CrossRefPubMed

12.

Singhal S, Mohapatra S, Quiñonez C. Reviewing teledentistry usage in Canada during COVID-19 to determine possible Future opportunities. Int J Environ Res Public Health. 2021;19:31. https://doi.org/10.3390/ijerph19010031CrossRefPubMedPubMedCentral

13.

Wolf TG, Schulze RKW, Ramos-Gomez F, Campus G. Effectiveness of Telemedicine and Teledentistry after the COVID-19 pandemic. Int J Environ Res Public Health. 2022;19:13857. https://doi.org/10.3390/ijerph192113857CrossRefPubMedPubMedCentral

14.

American Dental Association (ADA). ADA Policy on Teledentistry. 2020. [cited 2023 Mar. 15]. Available from: https://www.ada.org/en/about-the-ada/ada-positions-policies-andstatements/statement-on-teledentistry

15.

Australian Digital Health Agency. My Health record. 2023. [cited 2023 Mar. 15]. Available from: https://www.myhealthrecord.gov.au

16.

Department of Health and Aged Care. Medical devices regulation basics. 2021. [cited 2023 Mar. 15]. Available from: https://www.tga.gov.au/medical-devices-regulation-basics

17.

Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13:141–6.CrossRefPubMed

18.

Mars. 2020. Medicolegthical, and regulatory guidelines pertaining to telehealth. Fundamentals of Telemedicine and Telehealth. 2020, Pages 297–303. https://doi.org/10.1016/B978-0-12-814309-4.00013-6

19.

Bhargava A, Sabbarwal B, Jaggi A, Chand S, Tandon S. Teledentistry: a literature review of evolution and ethicolegal aspects. J Global Oral Health. 2019;2:128–33.CrossRef

20.

Jampani ND, Nutalapati R, Dontula BS, Boyapati R. Applications of teledentistry: a literature review and update. J Int Soc Prev Community Dent. 2011;1:37–44. https://doi.org/10.4103/2231-0762.97695CrossRefPubMedPubMedCentral

21.

Iyer N, Bali A, Ahluwalia SS, Kaur S. Lawsuit and dental profession. UJMDS. 2013;1:17–20.

22.

Morey A, Boradkar V, Chhabra KG, Reche A, Madhu PP, Date A, Rohankar D. Medicolegal issues in Teledentistry in India. Int Pharm Res. 2021;33(50A):106–12. https://doi.org/10.9734/jpri/2021/v33i50A33386CrossRef

23.

MacDonald-Jankowski DS, Orpe EC. Some current legal issues that may affect oral and maxillofacial radiology: part 1. Basic principles in digital dental radiology. J Can Dent Assoc. 2007;73:409–14.PubMed

24.

Cartes-Velásquez Ricardo B-LA. Teleodontología: Conceptos, experiencias y proyecciones. Odontoestomatol. 2012;14:17–25. [cited 2022 Oct. 04]. Available from: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-93392012000200003&lng=es.

25.

Fahim A, Saleem Z, Malik KA, Atta K, Mahmood R, Alam MK, Sethi A. Exploring challenges and mitigation strategies towards practicing Teledentistry. BMC Oral Health. 2022;22:658. https://doi.org/10.1186/s12903-022-02685-2CrossRefPubMedPubMedCentral

26.

Sykes LM, Harryparsad A, Evans W, Gani F. Social Media and Dentistry: part 8: ethical, legal, and professional concerns with the use of internet sites by health care professionals. SAJD. 2017;72:132–6.

27.

Asociación Latinoamericana de Odontopediatría. Teleodontología: aplicación a la odontopediatría durante la pandemia COVID-19. Rev Odontopediatr Latinoam. 2021;10. https://doi.org/10.47990/alop.v10i2.192

28.

Park JH, Kim JH, Rogowski L, Al Shami S, Howell SEI. Implementation of teledentistry for orthodontic practices. J World Fed Orthod. 2021;10:9–13. https://doi.org/10.1016/j.ejwf.2021.01.002CrossRefPubMed

29.

Sfikas PM. Teledentistry: legal and regulatory issues explored. J Am Dent Assoc. 1997;128:1716–8. https://doi.org/10.14219/jada.archive.1997.0137CrossRefPubMed

30.

Golder DT, Brennan KA. Practicing dentistry in the age of telemedicine. J Am Dent Assoc. 2000;131:734–44.CrossRefPubMed

31.

Peltier B, Curley A. The ethics of social media in dental practice: ethical tools and professional responses. J Calif Dent Assoc. 2013;41:507–13.PubMed

32.

Simon L, Friedland B. Interstate Practice of Dental Teleradiology in the United States: the Effect of Licensing requirements on oral and maxillofacial radiologists’ practice patterns. Telemed J E Health. 2016;22:541–5. https://doi.org/10.1089/tmj.2015.0162CrossRefPubMed

33.

Flores APDC, Lazaro SA, Molina-Bastos CG, Guattini VLO, Umpierre RN, Gonçalves MR, Carrard VC. Teledentistry in the diagnosis of oral lesions: a systematic review of the literature. J Am Med Inform Assoc. 2020;27(7):1166–72. https://doi.org/10.1093/jamia/ocaa069CrossRefPubMedPubMedCentral

34.

Mariño R, Merolli M, Capurro D. A pre-post-test evaluation of a telehealth course for health professions students. [cited 2022 Oct. 04]. Available from: https://iadr.abstractarchives.com/abstract/23iags-3878739/a-pre-post-test-evaluation-of-a-telehealth-course-for-health-professions-students

35.

Institute of Medicine (IOM). Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, D.C: National Academy Press; 2001.

36.

Crowder L. Can teledentistry - in particular, photographs - be used to accurately diagnose caries and healthy teeth? Evid Based Dent. 2022;23:154–5. https://doi.org/10.1038/s41432-022-0848-4CrossRefPubMed

37.

Thomas N, Kay E, Witton R, Quinn C. Comparison of a full arch digital photographic assessment of caries prevalence in 5-year-old children to an established visual assessment method: a cross-sectional study. BDJ Open. 2021;7:32. https://doi.org/10.1038/s41405-021-00087-0CrossRefPubMedPubMedCentral

38.

Australian Commission on Safety and Quality in Health Care. Fact sheet: Informed consent in health care. 2020. [cited 2023 Mar. 15]. Available from: https://www.safetyandquality.gov.au/sites/default/files/2020-09/sq20-030_-_fact_sheet_-_informed_consent_-_nsqhs-8.9a.pdf

39.

Barry Nilsson, How Do I, Obtain Informed Consent to a Telehealth Consultation. 2020. [cited 2023 Mar. 15]. Available from: https://bnlaw.com.au/knowledge-hub/insights/how-do-i-obtain-informed-consent-to-a-telehealth-consultation/

40.

Almeida SM, Carvalho SM, Radicchi R. Legal aspects of dental records: a review about legality, privacy and acceptance in the legal environment. Rev Bras Odontol Leg RBOL. 2017;4:55–64.

41.

Australian Digital Health Agency. e-Referrals. 2023. [cited 2023 Mar. 15]. Available from: https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record/whats-inside/information-healthcare-providers-can-upload/e-referrals

42.

Ooi HL, Kelleher MGD. Instagram Dentistry. Prim Dent J. 2021;10:13–9. https://doi.org/10.1177/2050168420980964CrossRefPubMed

43.

Macnamara J, Zerfass A. Social Media Communication in Organizations: the challenges of Balancing Openness, Strategy, and management. Int J Strateg Commun. 2012;6:287–308. https://doi.org/10.1080/1553118X.2012.711402CrossRef

44.

Madi M, Kumar M, Pentapati KC, Vineetha R. Smartphone based telemedicine: instant messaging application as a platform for radiographic interpretations of jaw pathologies. J Oral Biol Craniofac Res. 2021;11:368–72. https://doi.org/10.1016/j.jobcr.2021.04.003CrossRefPubMedPubMedCentral

45.

Garbin AJ, Pacheco Filho AC, dos Santos Pacheco KT, Garbin CA. O uso de whatsapp® na relação dentista-paciente: uma revisão de literatura. Rev Bras Odontol Leg. 2019;6:73–81. https://doi.org/10.21117/rbol.v6i3.279CrossRef

46.

World Medical Association. WMA Statement on Guiding Principles for the Use of Telehealth for the Provision of Health Care. 2022. [cited 2023 Mar. 15]. Available from: https://www.wma.net/policies-post/wma-statement-on-guiding-principles-for-the-use-of-telehealth-for-the-provision-of-health-care/

47.

World Medical Association. WMA statement on the ethics of telemedicine. 2018. [cited 2020 May 05]. Available from: https://www.wma.net/policies-post/wma-statement-on-the-ethics-of-telemedicine/

48.

Australian Health Practitioner Regulation Agency (AHPRA). Social media: How to meet your obligations under the National Law. 2019. [cited 2023 Mar. 15]. Available from: https://www.ahpra.gov.au/publications/social-media-guidance.aspx

49.

What is a Social Media Will? [cited. 2023 Mar. 15]. Available from: https://www.argonlaw.com.au/articles/what-social-media-will

50.

Tran D. Judge allows Melbourne dentist to try new tactic to more quickly unmask negative online reviewer. [cited 2023 Mar. 15]. Available from: https://www.abc.net.au/news/2020-02-14/small-business-launches-anonymous-google-review-defamation-case/11963250

51.

Hamm MP, Chisholm A, Shulhan J, Milne A, Scott SD, Klassen TP, Hartling L. Social media use by health care professionals and trainees: a scoping review. Acad Med. 2013;88:1376–83. https://doi.org/10.1097/ACM.0b013e31829eb91cCrossRefPubMed

52.

Ferguson A. Instagram influencers under scrutiny for teeth straightener push. 2019. [cited 2023 Mar. 15]. Available from: https://www.smh.com.au/business/consumer-affairs/instagram-influencers-under-scrutiny-for-teeth-straightener-push-20191002-p52x31.html

53.

Australian Health Practitioner Regulation Agency (AHPRA). Testimonials in health advertising. 2021. [cited 2023 Mar. 15]. Available from: https://www.ahpra.gov.au/Publications/Advertising-hub/Resources-for-advertisers/Testimonial-tool.aspx

54.

Fejerskov O, Uribe S, Mariño RJ. Dentistry in a Historical Perspective and a Likely Future of the Profession. In Mariño R, Morgan M, Walmsley D, editors. Career Paths in Oral Health 2018. p. 3–19. [cited 2022 October 7]. Available from: https://link.springer.com/book/https://doi.org/10.1007/978-3-319-89731-8

55.

Bauer JC, Bauer JC, Brown WT. The digital transformation of oral health care. Teledentistry and electronic commerce. J Am Dent Assoc. 2001;132:204–9. https://doi.org/10.14219/jada.archive.2001.0156CrossRefPubMed

56.

Christensen R, Knezek G. Validating the Technology Proficiency Self-Assessment Questionnaire for 21st Century Learning (TPSA C-21). J Digit Learn Teach Educ. 2017;33:20–31.CrossRef

57.

Mariño R, Merolli M, Capurro D. A pre-post-test evaluation of a telehealth course for health professions students. J Dent Res 2023;102(Spec Iss B):0808.

58.

Glueck D. Establishing therapeutic rapport in telemental health. In: Myers K, Turvey CL, editors. Telemental health. Clinical, technical, and administrative foundations for evidence-based practice. Amsterdam: Eslevier Inc; 2013. pp. 29–46. [cited 2023 Mar. 15]. Available from: https://books.google.com.au/books?hl=en&lr=&id=K3H4nwl4-gUC&oi=fnd&pg=PA29&dq=therapeutic+relationship+using+telehealth&ots=BiIsE1fNN-&sig=XK-DiOXpGS4pstftux9VCaazds0&redir_esc=y#v=onepage&q=therapeutic%20relationship%20using%20telehealth&f=false

59.

Wilkinson JR, Spindler M, Wood SM, Marcus SC, Weintraub D, Morley JF, Stineman MG, Duda JE. High patient satisfaction with telehealth in Parkinson Disease: a randomized controlled study. Neurol Clin Pract. 2016;6:241–51.CrossRefPubMedPubMedCentral

60.

https://dataconomy.com/2022/10/medibank-private-data-breach-what-to-do/

61.

General Dental Council (GDC). Guidance on using social media. [Internet]. London; GDC;2016. [cited 2020 April. 18]. Available from: https://www.gdc-uk.org/docs/default-source/guidance-documents/guidance-on-advertising.pdf?sfvrsn=a5540520_2

62.

Krupinski EA. Artificial Intelligence: lessons learned from Radiology. Healthc Transformation. 2019;4:5–10.CrossRef

63.

Australian Digital Health Agency. CLOUD SERVICES Considerations for healthcare organisations. 2021. [cited 2023 Mar. 15]. Available from: https://www.digitalhealth.gov.au/sites/default/files/2020-11/Cloud_services-Considerations_for_healthcare_organisations.pdf

64.

Currie G, Hawk KE. Ethical and legal challenges of Artificial Intelligence in Nuclear Medicine. Semin Nucl Med. 2021;51:120–5. https://doi.org/10.1053/j.semnuclmed.2020.08.001CrossRefPubMed

65.

Kichloo A, Albosta M, Dettloff K, Wani F, El-Amir Z, Singh J, Aljadah M, Chakinala RC, Kanugula AK, Solanki S, Chugh S. Telemedicine, the current COVID-19 pandemic, and the future: a narrative review and perspectives moving forward in the USA. Fam Med Community Health. 2020;8:e000530. https://doi.org/10.1136/fmch-2020-000530CrossRefPubMed

66.

United Nations. Digital Human rights. [cited 2022 October 7]. Available from: https://www.un.org/techenvoy/content/digital-human-rights

Title: Legal issues in digital oral health: a scoping review
Authors: Rodrigo J. Mariño
Carlos Zaror
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Telemedicine
Published in: BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-023-10476-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Legal issues in digital oral health: a scoping review

Abstract

Background

Methods

Results

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Please log in to get access to this content

Other articles of this Issue 1/2024

Mid-level healthcare workers knowledge on non-communicable diseases in Tanzania: a district-level pre-and post-training assessment

Delegating care as a double-edged sword for quality of nursing care: a qualitative study

Cancer screening programs in South-east Asia and Western Pacific

Value-based pricing of cognitive behavioral therapy for depression in primary care: an economic evaluation

A spatial feature analysis of primary health care utilization in a large city in China and its implications for family doctor contract service policy

High-risk pooling for mitigating risk selection incentives in health insurance markets with sophisticated risk equalization: an application based on health survey information