Integrating telemedicine into dental workflows for medically complex patients: An exploratory pilot feasibility and care coordination study.

OBJECTIVE: This pilot study evaluated the operational feasibility, workflow integration, and care coordination of an on-site telemedicine clearance pathway (the Medically Integrated Oral Health Program) for medically complex dental patients presenting with hypertension and/or diabetes mellitus. METHODS: A non-randomized, two-arm interventional (quasi-experimental) pilot study was conducted with a pragmatic sample of 20 adult dental patients (11 Telemedicine group, 9 Conventional referral group). Allocation was participant selected. Evaluated feasibility metrics included protocol adherence, missed appointments, and data completeness across a 12-month period. Descriptive clinical and laboratory parameters, including Oral Health Risk Assessment Value Index (OHRAVI) scores, body mass index (BMI), blood pressure (BP), and HbA1c, were tracked longitudinally at approximately three-month intervals. RESULTS: The in-office telemedicine protocol was successfully executed at baseline. However, substantial patient attrition was observed over time, with retention dropping to 54.5% in the Telemedicine group and 44.4% in the Conventional group by the first follow-up. Descriptive observations indicated stable median OHRAVI scores and relative stability in median BMI within the telemedicine cohort, whereas the conventional cohort exhibited slight increases in weight metrics. Blood pressure data demonstrated high variability across both groups. Follow-up HbA1c data were heavily limited by missing data and sparse reporting, which precluded statistical or causal interpretation. Total appointment non-adherence was comparable between groups. CONCLUSION: The on-site telemedicine clearance pathway was operationally feasible at initial presentation. However, severe attrition and incomplete longitudinal data prevented reliable evaluation of comparative clinical effectiveness or sustained care coordination. These findings primarily identify implementation and data-collection challenges that should inform a future adequately powered study.