The case for integrated oral and primary medical health care delivery: Permanente Dental Associates

MacNeil, R. Lamont; Hilario, Helena; Snyder, John J.

doi:10.1002/jdd.12284

Cited by 3 publications

(6 citation statements)

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“…It was anticipated that providers will be more motivated to pursue innovative care strategies if they can witness the results of these efforts in improved quality care metrics. One example was the demonstrated ability by one organization to close gaps in certain medical preventive care protocols by the engagement of the dental team [ 22 ]. Those interviewed expressed that dental providers must feel comfortable and confident in accessing these analytic tools and in interpreting the data.…”

Section: Resultsmentioning

confidence: 99%

“…The three entities selected for reporting were Permanente Dental Associates (PDA) in Portland Oregon, Marshfield Clinic Health System in Marshfield, Wisconsin and HealthPartners in Minneapolis, Minnesota. The organizational construct, care philosophies and other characteristics of these three organizations are fully described in previous publications [22][23][24]. Following the site visits with these entities, summary notes taken by (RLMN) were shared with those interviewed to confirm accuracy.…”

Section: Study Constructmentioning

confidence: 99%

“…Conclusions and recommendations relative to new dentist preparedness and other aspects pertinent to dental education were then drafted, shared and finalized. A full description of these interviews and recommendations has been previously reported in a five-part Special Report in the Journal of Dental Education [22][23][24][25][26].…”

Section: Study Constructmentioning

confidence: 99%

“…The following is a summary of the most common findings and suggestions gained through site visits at the three organizations described above and reported in greater detail in a special report of the Journal of Dental Education [22][23][24][25][26].…”

Section: Perspectives and Recommendations From The Fieldmentioning

confidence: 99%

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Input From Practice: Reshaping Dental Education for Integrated Patient Care

MacNeil

Hilario

2021

Front. Oral. Health

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Among the primary challenges in advancing the practice of integrated primary dental and medical health care is the appropriate educational and clinical preparation of a dental workforce that can function and flourish within integrated care environments. Most dental schools teach to traditional concepts and standards of dental care delivery which may be inconsistent with those of integrated care and could deter the entry and retention of graduates in contemporary, non-traditional practice models. To better understand how the dental school curriculum should be modified to accommodate integrative care models, a number of patient care organizations actively engaged in dental-medical integration were site visited to gain insight into the readiness of newer graduates, with emphasis on the US DMD/DDS graduate, to function in integrated practice. Leaders, practicing clinicians and staff were interviewed and common observations and themes were documented. This manuscript will focus on those educational components that integrated care organizations identify as absent or inadequate in current dentist education which must be addressed to meet the unique expectations and requirements of integrated patient care. These changes appear pivotal in the preparation of a dental clinician workforce that is respectful and receptive to new practice concepts, adaptative to new practice models, and competent in new care delivery systems.

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Section: Resultsmentioning

confidence: 99%

Section: Study Constructmentioning

confidence: 99%

Section: Study Constructmentioning

confidence: 99%

Section: Perspectives and Recommendations From The Fieldmentioning

confidence: 99%

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Input From Practice: Reshaping Dental Education for Integrated Patient Care

MacNeil

Hilario

2021

Front. Oral. Health

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“…Even though a fully integrated medical and dental EHR would be a long-term goal, there are some examples of innovation in this area where 3 engaged health care entities have begun to integrate oral and primary medical health care delivery. [14][15][16][17] Entities like Permanente Dental Associates, the Marshfield Clinic Health System, and Health Partners, each based on unique health care delivery models, reflect the goals of Berwick's Triple Aim (better care, better health, and reduced cost) toward integration of dental and medical care providers through a common EHR. [15][16][17][18][19]…”

Section: Application Of Health Informatics In Medicine and Dentistrymentioning

confidence: 99%

COVID-19 provides an opportunity for integration of dentistry into the health informatics system

London¹,

Fontelo²,

Boroumand³

et al. 2022

The Journal of the American Dental Association

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How Do Dental Clinicians Obtain Up-To-Date Patient Medical Histories? Modeling Strengths, Drawbacks, and Proposals for Improvements

Rajapuri

Gomez

et al. 2022

Front. Digit. Health

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BackgroundAccess to up-to-date patient medical history is essential for dental clinicians (DCs) to avoid potential harm to patients and to improve dental treatment outcomes. The predominant approach for dental clinicians (DCs) to gather patients' medical history is through patient-reported medical histories and medical consults. However, studies reported varied concordance and reliability of patient-reported medical conditions and medication histories compared to the patient medical records and this process also places a significant burden on patients. Information technology tools/platforms such as an integrated electronic health record containing an electronic dental record module may address these issues. However, these integrated systems are expensive and technically complex and may not be easily adopted by DCs in solo and small group practice who provide the most dental care. The recent expansion of regional healthcare information exchange (HIE) provides another approach, but to date, studies on connecting DCs with HIE are very limited. Our study objectives were to model different aspects of the current approaches to identify the strengths and weaknesses, and then model the HIE approach that addresses the weaknesses and retain the strengths of current approaches. The models of current approaches identified the people, resources, organizational aspects, workflow, and areas for improvement; while models of the HIE approach identified system requirements, functions, and processes that may be shared with software developers and other stakeholders for future development.MethodsThere are three phases in this study. In Phase 1, we retrieved peer-reviewed PubMed indexed manuscripts published between January 2013 and November 2020 and extracted modeling related data from selected manuscripts. In Phase 2, we built models for the current approaches by using the Integrated DEFinition Method 0 function modeling method (IDEF0), the Unified Modeling Language (UML) Use Case Diagram, and Business Process Model and Notation (BPMN) methods. In Phase 3, we created three conceptual models for the HIE approach.ResultsFrom the 47 manuscripts identified, three themes emerged: 1) medical consult process following patient-reported medical history, 2) integrated electronic dental record-electronic health record (EDR-EHR), and 3) HIE. Three models were built for each of the three themes. The use case diagrams described the actions of the dental patients, DCs, medical providers and the use of information systems (EDR-EHR/HIE). The IDEF0 models presented the major functions involved. The BPMN models depicted the detailed steps of the process and showed how the patient's medical history information flowed through different steps. The strengths and weaknesses revealed by the models of the three approaches were also compared.ConclusionsWe successfully modeled the DCs' current approaches of accessing patient medical history and designed an HIE approach that addressed the current approaches' weaknesses as well as leveraged their strengths. Organizational management and end-users can use this information to decide the optimum approach to integrate dental and medical care. The illustrated models are comprehensive and can also be adopted by EHR and EDR vendors to develop a connection between dental systems and HIEs.

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The case for integrated oral and primary medical health care delivery: Permanente Dental Associates

Cited by 3 publications

References 0 publications

Input From Practice: Reshaping Dental Education for Integrated Patient Care

Input From Practice: Reshaping Dental Education for Integrated Patient Care

COVID-19 provides an opportunity for integration of dentistry into the health informatics system

How Do Dental Clinicians Obtain Up-To-Date Patient Medical Histories? Modeling Strengths, Drawbacks, and Proposals for Improvements

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