Number of Pregnant Women at Four Dental Clinics and the Care They Received: A Dental Quality eMeasure Evaluation

Neumann, Ana; Obadan‐Udoh, Enihomo; Bangar, Suhasini; Kumar, Shria; Tokede, Oluwabunmi; Kim, Aram; Yansane, Alfa; Mertz, Elizabeth; Panwar, Sapna; Gharpure, Arti; Kookal, Krisha Kumar; Mullins, Joanna; Even, Joshua; Simmons, Kristen; White, Joel M.; Walji, Muhammad F.; Kalenderian, Elsbeth

doi:10.21815/jde.019.123

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…Electronically derived dental quality of care measures includes caries risk and appropriate care, as discussed in this paper, also include a wide variety of dental applications such as sealants, 18,37 tobacco cessation, 16 dental patients with diabetes, and pregnancy. 38 A critical aspect of the EHR is a robust dental diagnostic interface terminology 39 for providers to select diagnosis and pair the diagnosis to the procedure performed. 40,41 A robust EHR with dental diagnosis, clinic decision support, and electronic quality measures will allow for patient care data to be used for research, patient care, and education purposes including the expansion of quality improvement in dentistry.…”

Section: Discussionmentioning

confidence: 99%

Caries Risk Documentation And Prevention: eMeasures For Dental Electronic Health Records

et al. 2022

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Background Longitudinal patient level data available in the electronic health record (EHR) allows for the development, implementation, and validations of dental quality measures (eMeasures). Objective We report the feasibility and validity of implementing two eMeasures. The eMeasures determined the proportion of patients receiving a caries risk assessment (eCRA) and corresponding appropriate risk-based preventative treatments for patients at elevated risk of caries (appropriateness of care [eAoC]) in two academic institutions and one accountable care organization, in the 2019 reporting year. Methods Both eMeasures define the numerator and denominator beginning at the patient level, populations' specifications, and validated the automated queries. For eCRA, patients who completed a comprehensive or periodic oral evaluation formed the denominator, and patients of any age who received a CRA formed the numerator. The eAoC evaluated the proportion of patients at elevated caries risk who received the corresponding appropriate risk-based preventative treatments. Results EHR automated queries identified in three sites 269,536 patients who met the inclusion criteria for receiving a CRA. The overall proportion of patients who received a CRA was 94.4% (eCRA). In eAoC, patients at elevated caries risk levels (moderate, high, or extreme) received fluoride preventive treatment ranging from 56 to 93.8%. For patients at high and extreme risk, antimicrobials were prescribed more frequently site 3 (80.6%) than sites 2 (16.7%) and 1 (2.9%). Conclusion Patient-level data available in the EHRs can be used to implement process-of-care dental eCRA and AoC, eAoC measures identify gaps in clinical practice. EHR-based measures can be useful in improving delivery of evidence-based preventative treatments to reduce risk, prevent tooth decay, and improve oral health.

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Section: Discussionmentioning

confidence: 99%

Caries Risk Documentation And Prevention: eMeasures For Dental Electronic Health Records

et al. 2022

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“…The results of our study bolster the usefulness of the EHR while supporting accurate measurement of dental quality. 26 – 29 In 2012, the DQA similarly proposed an e-measure for sealants for 6- through 9-year-old children. 36 We hope that with the increased adoption of EHRs in practice and the collection of key data such as structured diagnoses, 24 dental clinics will be prompted to systematically measure the quality of care provided.…”

Section: Discussionmentioning

confidence: 99%

“…Step 2b: Validation of the automated query Similar to our previous studies, 15,[26][27][28][29] we trained and calibrated 2 reviewers from each site to audit sampled charts. The first 50 charts from a randomized list of patients were analyzed by each of the reviewers for interrater reliability to establish calibration.…”

Section: Study Populationmentioning

confidence: 99%

Measuring sealant placement in children at the dental practice level

Kumar¹,

Yansane²,

Neumann³

et al. 2020

The Journal of the American Dental Association

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Background. Although sealants are an established and recommended caries-preventive treatment, many children still fail to receive them. In addition, research has shown that existing measures underestimate care by overlooking the sealable potential of teeth before evaluating care. To address this, the authors designed and evaluated 3 novel dental electronic health recordebased clinical quality measures that evaluate sealant care only after assessing the sealable potential of teeth. Methods. Measure I recorded the proportion of patients with sealable teeth who received sealants. Measure II recorded the proportion of patients who had at least 1 of their sealable teeth sealed. Measure III recorded the proportion of patients who received sealant on all of their sealable teeth. Results. On average, 48.1% of 6-through 9-year-old children received 1 or more sealants compared with 32.4% of 10-through 14-year-olds (measure I). The average measure score decreased for patients who received sealants for at least 1 of their sealable teeth (measure II) (43.2% for 6through 9-year-olds and 28.4% for 10-through 14-year-olds). Fewer children received sealants on all eligible teeth (measure III) (35.5% of 6-through 9-year-olds and 21% of 10-through 14-yearolds received sealant on all eligible teeth). Among the 48.5% who were at elevated caries risk, the sealant rates were higher across all 3 measures. Conclusions. A valid and actionable practice-based sealant electronic measure that evaluates sealant treatment among the eligible population, both at the patient level and the tooth level, has been developed. Practical Implications. The measure developed in this work provides practices with patientcentered and actionable sealant quality measures that aim to improve oral health outcomes.

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“…BigMouth has been used to support, or refute, hypotheses of research proposals by generating preliminary data for funding applications and has therefore influenced the direction of oral health research. Moreover, BigMouth has been used to assess the quality of health intervention for specific patient populations, for example, providing dental care to women while pregnant, 11 patients with diabetes, 12 or children receiving sealants. 13 , 14 Importantly, to date, the 11 participating BigMouth institutions are all academic—but vary in clinic size and resources for conducting research, and the results generated by BigMouth studies have started to illustrate that dental treatments in these educational settings are safe, effective, and cost-efficient.…”

Section: Main Purpose Of Bigmouthmentioning

confidence: 99%

BigMouth: development and maintenance of a successful dental data repository

Walji

Spallek

Kookal

et al. 2022

Journal of the American Medical Informatics Association

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Few clinical datasets exist in dentistry to conduct secondary research. Hence, a novel dental data repository called BigMouth was developed, which has grown to include 11 academic institutions contributing Electronic Health Record data on over 4.5 million patients. The primary purpose for BigMouth is to serve as a high-quality resource for rapidly conducting oral health-related research. BigMouth allows for assessing the oral health status of a diverse US patient population; provides rationale and evidence for new oral health care delivery modes; and embraces the specific oral health research education mission. A data governance framework that encouraged data sharing while controlling contributed data was initially developed. This transformed over time into a mature framework, including a fee schedule for data requests and allowing access to researchers from noncontributing institutions. Adoption of BigMouth helps to foster new collaborations between clinical, epidemiological, statistical, and informatics experts and provides an additional venue for professional development.

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Number of Pregnant Women at Four Dental Clinics and the Care They Received: A Dental Quality eMeasure Evaluation

Cited by 6 publications

References 22 publications

Caries Risk Documentation And Prevention: eMeasures For Dental Electronic Health Records

Caries Risk Documentation And Prevention: eMeasures For Dental Electronic Health Records

Measuring sealant placement in children at the dental practice level

BigMouth: development and maintenance of a successful dental data repository

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