142nd APHA Annual Meeting and Exposition

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303984
Developing a Clinical Decision Support System for Dental Providers for Integrated Care at Chairside

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Ariel Port, DMD, MPH , Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY
Stefanie L. Russell, DDS, MPH, PhD , Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY
Matt McGuirk , Informatics and Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY
Janet Mark, MA , Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY
Cynthia Golembeski, MPH , Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY
Donna Shelley, MD, MPH , NYU Cancer Institute, New York University Langone Medical Center, New York, NY
Danni Gomes, RDH , Department of Dental Hygiene, New York University College of Dentistry, New York
Elise Eisenberg, DDS, MA , Informatics and Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY
Mary E. Northridge, PhD, MPH, Editor-in-Chief , Epidemiology and Health Promotion, New York University College of Dentistry and APHA (Editor-in-Chief, AJPH), New York, NY
Introduction: The goal of this project was to develop a web-based clinical decision support system (CDSS) for screening and care coordination by dental hygienists at chairside for four general health issues (diabetes, hypertension, tobacco use and nutrition counseling) to improve patient health.

Methods: We modified a smoking cessation CDSS designed for dentists for use by dental hygienists; diabetes, hypertension, and nutrition modules were developed and incorporated into the tool. First, we appraised education and scope of practice requirements with input from health experts, and reviewed current professional guidelines and best practices for diabetes and hypertension screening, tobacco use, and nutrition counseling at chairside. Second, we created algorithms for the four health issues (diabetes, hypertension, tobacco use and nutrition counseling). Third, an IT specialist incorporated them into the tool using an iterative process to refine the CDSS, with input from a panel of experts. Finally, data from 16 semi-structured, in-depth interviews with dental hygienists (n=10) and dentists (n=6) were used to guide the project.

Results: A web-based CDSS for use in private dental offices by dental hygienists at chairside was developed. The tobacco use CDSS was field tested by dental hygienists working in private dental offices, and qualitative data are currently being analyzed. Preliminary findings indicate the need for increased guidance and support of dental hygienists in caring for their patients at chairside.

Conclusions: Electronic medical and dental records may usefully be supported by CDSS technology to improve primary care coordination by dental hygienists at chairside, leading to improved patient health.

Learning Areas:

Administer health education strategies, interventions and programs
Communication and informatics
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Assess the needs of dental hygienists and dentists regarding systems to better integrate dental and medical care. Analyze evidence-based approaches to implementing dental office system changes considering office workflow, time and resource constraints, and office staffing concerns.

Keyword(s): Oral Health, Workforce

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am presently the project coordinator on a federally funded grant and have training in both dentistry and public health. My work focuses on reducing health disparities and improving access to care for populations at need, including both the elderly and children.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.