1. A Healthy Mouth at All Ages Åke Hellström

2. Public Dental ServicesYr 1940 - 2010 Yr 1940 Major health problem Yr 2010 < 1% adult population 80+ years – 6% Age16-22 Wedding present Military service Åke Hellström

3. Today caries is a disease among children and elderly people Åke Hellström

4. Oral health today • 19 years old • 25% all teeth intact • Average 3 fillings • Adult recalls (6-36 months) 50% without remarks • Risk Assessment/prevention Åke Hellström

5. Public Dental Services 560 Employees total 20 Specialists 120 Dentists 90 Dental hygienists 35 Clinics Market: >95 % 0-19 years 65% adults Fee-for-service or capitation Centre of Competence in Luleå with almost all specialists Challenge: Deliver safe care of equally high standars to all inhabitants regardless of where they live in the county. 500 km 200 km Åke Hellström

6. Supporting ICT-systemsHardware Lumiora high speed internet and NLLnet Server-cluster Work-stations in every treatment room Åke Hellström

7. Supporting ICT-systems - Software Standards and rules Balanced scorecard ”The roadmap” Datawarehouse Key indicators Voice activation Patientcentered EHR Accessible at any workstation in the county Intranet Mobility 3G Videoconference Streaming video Helpdesk SMS Åke Hellström

8. Patientcentered EHR Åke Hellström

9. Development Partners Åke Hellström

10. Distance spanning technics with EHR videoconference and streaming video • Education • Administrative meetings • Patient consultations – ”Store and forward” • Evaluation • Diagnosis • Treatment plans • Average 15% working hours for specialists Åke Hellström

11. Value of distance spanning technics Åke Hellström

12. Value of distance spanning technicsSummary Åke Hellström

13. What is next • Better services over the internet bookings etc. • Implementation of digital jaw-models • Cognitive-Behavioral Therapy against dental fobia over the Internet • Lifestyle programs over the Internet Åke Hellström

14. With ICT improving health with lesser recources Åke Hellström