Objective: There are both opportunities and challenges with the implementation of oral health value-based care (OHVBC). To tackle concerns and advance conversation, a symposium was convened with subject matter experts to develop a gap analysis and capture insights into professional readiness for value-based care design. Methods: The symposium was convened as a private event for 46 participants over the course of one and a half days in December 2019. Thematic analyses utilized the OHVBC Readiness Framework (DentaQuest Partnership, 2019) to further codify conversations as part of the gap-analysis process. Poll Everywhere, a text messaging application that allows participants to answer questions in real time, was also employed to solicit responses. Results: Attendees of the symposium felt that OHVBC would have a large portion of market share within the next 10 years. A qualitative assessment of multiple table discussions determined that the participants developed more consensus around themes for the current state and the future-desired state than the actionplanning needed to close the gap between the two. This may relate to individual ideology, and the siloed environment is still prevalent in the oral health realm. In a postsymposium survey, respondent attendees did not perceive that COVID-19 would delay or negatively impact the adoption of OHVBC and may result in accelerating its utilization. Conclusion: The oral health community is experiencing multiple drivers to adopt more OHVBC within business and care models. However, there is still a lack of uniformity on how to execute this delivery model.
Several years after the inception of the hospitalist movement, hospitalist roles have evolved in breadth and sophistication. Although public health is not formally recognized or previously described as an arena for hospitalists, hospitalists are often engaged in public health practice. This article attempts to alert hospitalists to the potential to make contributions to the field of public health and defines the public health skills that can positively affect the lives of their patients and the communities they serve. In a public health role, hospitalists may improve the quality of inpatient care. This article reviews how public health and hospital-based practices have already intersected and proposes further development within this discipline. In our ever-changing health care system, hospitalists play key roles in the central public health domains of assessment, assurance, and policy development. Insightful hospitalists will recognize and embrace these responsibilities in caring for patients and society. Journal of Hospital Medicine 2007;2:93-101.
BackgroundIn 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers.MethodsThe AoC is modeled in the form of a ‘grants challenge’, offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation.ResultsOur evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program.ConclusionsBased on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.
People who are poor or members of communities of color face inequitable oral disease burden. Continued separation of dental and oral health from general medical care exacerbates inequity and forces members of underserved communities to seek nontraumatic dental emergency care in hospital emergency departments. This trend is unnecessarily costly and results in antibiotic prescriptions and pain management that are neither restorative nor responsive to patients' primary complaints. Value-based approaches to health care need to unify mouth care with general medical care, motivate medical-dental interprofessional practice, promote oral disease prevention, and support restorative dental care. Value-based approaches to health care must also innovate fiscal structures (eg, payment models, data sharing) to improve health outcomes for everyone.Weekend Mouth Pain Imagine it's Saturday evening at 6 pm, and you find yourself in pain-a pain not from a hurt foot or shoulder, but a throbbing, radiating pain in your mouth that feels as if your head and ears are on fire. You cannot sleep or eat. Previously, the pain was dull and only bothered you when you ate something sweet or cold. But now, at 6 pm on a Saturday, you find yourself in extreme pain and unable to function. While you are employed, your minimum wage job does not provide dental insurance and you live in a state that does not provide comprehensive, adult dental benefits through Medicaid. Consider also that when you saw your physician 3 months ago for your check-up to renew your blood pressure prescription, you mentioned the tooth bothering you. It is likely that your physician did not examine your mouth or refer you to a dentist for care. You thought the tooth could wait! To make things worse, because of your lack of dental coverage and your inability to pay for the out-of-pocket expense of dental care in a private practice office, you do not have a dental home to call for an emergency appointment. The last time you saw a dentist was at a charity dental event in the local college's gymnasium several years ago. In the United States, where should you go and what should you do?
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