Link to CDI Main
Project on Clinical Data Integration
Articulating Dental and Medical Care and Data for
Patients
Located provisionally in: RMU School of
Communication and Information Systems (SCIS), Barbara Levine, PhD, Dean
Department of Computer and Information
Systems (C&IS), Robert Skovira, PhD, Head
Working informally in cooperation with
(thanks to you all!): University of Pittsburgh Center for Dental Informatics,
Titus Schleyer, DMD, PhD, Director; Edward P. Heinrichs, DMD, Periodontics
Program, University of Pittsburgh, Brian L. Mealey,
At RMU: Valerie Powell, PhD, RT(R),
University Professor, C&IS
Other Pages:
2. Page 2: Dr. Titus Schleyer, “Informatics
Agenda for Integrating Medical and Dental Care and Patient Data and Achieving
Care Quality” See: MedDentDataArtic2.htm
3. Page 3: References
on Interrelationships between Oral and Systemic Conditions, Patient Care,
Integration of Medical and Dental Care, Disparities in Care. See: MedDentDataArtic3.htm
4. Page 4: A Model for
Communication Among Dental and Medical Providers See: MedDentDataArtic4.htm
5. Page 5: Dental
Informatics: Electronic Oral Health Records (EOHRs) in Education. See: MedDentDataArtic5.htm
6. Page 6:
Medical/Dental Integration in
7. Page 7: Discrepancies between medical and
dental records at present without articulation of care and data: MedDentDataArtic7.htm
8. Page 8: Viewing (aggregate) dentogingival
epithelial surface area (DGES) as a (single) open wound: MedDentDataArtic8.htm
9. Page 9: Oral health
care is significant for care of diabetes,
other chronic conditions, prenatal care. See: MedDentDataArtic9.htm
10. Page 10: The need
to coordinate medical and dental insurance: See MedDentDataArtic10.htm
11. Page 11: A
communication model for articulation of care from medical and dental providers.
See MedDentDataArtic11.htm
12. Page 12:
Inflammation and Periodontal Disease. See:MedDentDataArtic12.htm
13. Page 13: Higher
Education Programs. See: MedDentDataArtic13.htm
14. Page 14:
International Perspectives. See: MedDentDataArtic14.htm
15. Page 15: Importance
of Oral Health in Pediatric Care. See: MedDentDataArtic15.htm
16. Page 16: White
Paper: “A Primer on Data Standards and Coded Terminologies,” by Franklin A.
Din.
17. Page 17: Examples
of Integration in EHR Standards Harmonization: MedDentDataArtic17.htm
18. Page 18: Community
Meeting on Integration of Medical and Dental Care and Data: MedDentntDataArtic18.htm
19. Page 19:
Obsolescence of the Healthcare Model used by U.S. Healthcare and its Effects on
the Future of Healthcare in the
20. Page 20: Links
between medical and dental care: Stroke, Sjögren’s
diagnosis, Metabolic syndrome,
Inflammation, Atherosclerotic
lesions: MedDentDataArtic20.htm
21. Page 21: Listings of Integrated (Medical/Dental)
EMRs/EHRs: MedDentDataArtic21.htm
22. Page 22: Integrated (medical/dental/orthodontic)
Systems in Pediatric Care: MedDentDataArtic22.htm
23. Page 23: Medcare, Medicaid, and Oral Health; Medicare Data Flawed for Certain
Health Care Research: MedDentDataArtic23.htm
Please see the web
site of the National Association for Community Health Centers, Inc. (NACHC): http://www.nachc.com/
Please see the web
site of the Institute for Oral Health: www.institutefororalhealth.org/
Please see the web
site of Software Advice: www.softwareadvice.com/
Please see the web
site of the International Association for Dental Research (IADR): http://www.dentalresearch.org/i4a/pages/index.cfm?pageid=3533
.
“Health Care Reform Must Include
Dental Care,” by Dr. Charles N. Bertolami, Herman
Robert Fox Dean of the New York University College of Dentistry: http://www.rollcall.com/news/34231-1.html
UCLA
Contributors:
·
Franklin
A. Din, DMD, MA, Executive Director, Medical Informatics
Center of Excellence,
·
Titus Schleyer, DMD, PhD, Director,
Center for Dental Informatics, University of Pittsburgh, Pittsburgh, PA
·
Amit Acharya, BDS, MS, PhD, Marshfield Clinic Research
Foundation / Biomedical Informatics Research Center (MCRF/BIRC). Marshfield, WI
·
Allan G. Farman, BDS, MBA, Dsc, PhD, Oral Surgery & Maxillofacial
Surgery, University of Louisville, Louisville, KY
·
Valerie J.H. Powell, RT(R), PhD., Professor, Computer &
Information Systems, Robert Morris University, Moon Township, PA
·
Miguel Humberto Torres-Urquidy, DDS, MS, CDC, Atlanta, GA, and Center for Dental
Informatics, University of Pittsburgh, Pittsburgh, PA
·
Shin Mey Rose Yin Geist,
DDS, MS, ABOM (oral medicine), University of Detroit Mercy, School of Dentistry,
Detroit, MI
·
Edward P. Heinrichs, DMD, Associate
Professor of Periodontics, School of Dental Medicine,
University of Pittsburgh, Pittsburgh, PA
·
Erin O'Donnell Dotzler, Director,
Public, Practice and Scientific Affairs, American Academy for Periodontology,
Chicago, IL
·
Kerry Gutshall, Public Practice and
Scientific Affairs Program Manager, American Academy for Periodontology,
Chicago, IL
·
Peter
J. Groen, Computer & Information Science
Department, Shepherd University, Shepherdstown, WV (co-author of Medical Informatics 20/20, (Jones &
Bartlett, 2007))
·
Arden
W. Forrey, PhD, Department of Restorative Dentistry,
School of Dentistry, University of Washington, Seattle, WA
Topic: Diabetes Care and Periodontal Care (The “Periodontal Dimension” of
Chronic Care 1)
Progress on listing “was referred
for or had a dental appointment (including periodontal screening)” as a
standard measure of performance for diabetes care:
1.
American
Diabetes Association (
2. http://www.diabeteseducator.org/ProfessionalResources/AADE7/
American Association of Diabetes Educators
(AADE7) includes “saw a dentist” as a measure.
3. The National Committee for Quality Assurance (NCQA) does not yet have a
Healthcare Effectiveness Data and Information Set (HEDIS) code for "regular dental referral" for diabetes
care. According to NCQA Standards and Measures interpretation question, tracking number 29728, April 4, 2008,
"We will keep this in mind during our ongoing re-evaluation of this
measure."
·
Information on the interelationship(s)
of diabetes and periodontal diseases is available online at http://www.perio.org/resources-products/pdf/lr-diabetes.pdf
: Mealy BL and Oates TW, "Diabetes Mellitus and Periodontal
Diseases," J Periodontol 2006;77:545-56.
This is a review commissioned by the
·
Contact at the American Academy of Periodontology (AAP): Erin O'Donnell Dotzler, Director,
Public, Practice and Scientific Affairs, American Academy for Periodontology, 737 N. Michigan Ave, Suite 800, Chicago, IL 60611 ; Email: erin@perio.org
; Phone: 312.573.3247; Fax: 312.573.3234
·
Example of NQMC (National Quality
Measures Clearinghouse; AHRQ) measure that would accomplish what is needed:
Diabetes mellitus:
percent of patients who obtained a dental exam in the last 12 months. HRSA Health Disparities Collaboratives:
Diabetes Collaborative 2006 Jun NQMC:001600; see http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1344&doc=4065
.
·
See “– Diabetes also
increases the incidence of dental disease …” http://www.ahrq.gov/qual/diabqguide.pdf
Topic: Heart Disease and Periodontal Disease (The “Periodontal Dimension” of
Chronic Care 2)
·
Robert
J. Ostfeld, “Periodontal Disease and Cardiology,” “Report
of the Independent Panel of Experts of the Scottsdale Project,” Grand Rounds Supplement September 2007,
p. 3.
·
See
Consumer Reports (May 2008), page 55:
CRMay2008Page55
Topic: Stroke and Periodontal Disease (The “Periodontal Dimension” of Chronic
Care 3)
·
NewsRx (2006) (Managed Care Weekly Digest): “Earlier
periodontal treatment leads to lower medical costs.” See comments on cerebrovascular disease (
Topic: Pneumonia and Oral Health (The “Periodontal Dimension” of Chronic Care
4)
·
See
Consumer Reports (May 2008), page 55:
CRMay2008Page55
Quotes and Statements:
·
Quality of Care and Communication: “I think the healthcare system
has plenty of opportunities to improve the quality of care by simply improving
the communication among the people who provide it. However, there are several
reasons why this is not happening very much now. Many of them are historical
and ‘ingrained’ in the way each discipline practices, but others are
contemporary barriers. … we have to acknowledge that
technology is only a piece of the puzzle. It certainly will not be the silver
bullet for solving healthcare communication problems. It needs to work
hand-in-hand with efforts to (1) augment standards of care to represent the
best evidence available; (2) break down professional, systemic, cultural and
personal barriers to improved communication; and (3) make the patient the
central and focal point of healthcare.” Dr. Titus Schleyer, University
of Pittsburgh Center for Dental Informatics, January 22, 2008.
·
“[Powell]
would also like to see dental referrals for patients with diabetes so that they
will be screened for periodontal disease. Diabetes can lead to gum disease,
which may impede a person's ability to follow a prescribed diet,” Dr. Valerie Powell, Robert
Morris University. Source: http://www.rmu.edu/OnTheMove/wpnews.full_story?inws_seqno=15390&it=&icalledby=umbraco&iattr=
·
Dr. Titus Schleyer,
·
Dr. Arden W. Forrey, School of Dentistry, University of Washington: “I am a contributor to
the new HITSP Education, Communication and Outreach -
·
“We have not thought through and have
not provided for the integrated process of communication that would support
coordinated care for a patient by a family physician and a periodontist,
for example. Periodontists communicate typically
within the dental "silo," such as with dentists, and rarely with
healthcare professionals in the medical "silo." The report that a periodontist might send to the patient's family physician,
endocrinologist, diabetologist or cardiologist might
not be the same as a report intended for the patient's dentist. Dr.
Valerie Powell, Robert Morris University, ” Source: Modern Healthcare,
Links:
·
American
Diabetes Association (
1. ADA:
http://www.diabetes.org/diabetesnewsarticle.jsp?storyId=17322801&filename=20080402/comtex20080402pr00000898adacolgatepartnerEDIT.xml
(Oral Care)
2.
http://www.ada.org/prof/resources/topics/science_perio_pancreatic.asp
- Periodontal disease and
pancreatic cancer risk in men
3.
A
search of the ADA site for articles on diabetes and periodontal disease
produces at least 103 results.
4.
http://care.diabetesjournals.org/content/vol31/suppl_1/
includes 2008 ADA Standards of Care (
·
University of
Washington
course: “Department of Pediatrics
Conjoint 516, Spring Quarter 2006: What Every Physician Should Know About
Oral Health,” http://courses.washington.edu/ohcourse/index.html
- see also regarding this course Mouradian, WE,
Reeves, A, Kim, Sara, Lewis, C, Keerbs, A, Slayton,
RL, Gupta, D, Oskounian, D, Kalet,
T, and Marshall, SG, “A New Oral Health Elective for Medical Students at the
University of Washington,” Teaching and Learning in Medicine 18, 4 (October
2006):336-342.
·
Consumer
Reports (May
2008) on dental care and diabetes, heart disease, and pneumonia: CRMay2008Page55
.
·
NewsRx (2006) (Managed Care Weekly
Digest): “Earlier periodontal treatment leads to
lower medical costs.”
·
American
Dental Association (ADA) Standards
Committee on Dental Informatics (SCDI):
http://www.ada.org/prof/resources/standards/informatics.asp
·
·
http://www.ada.org/prof/resources/topics/cdt/index.asp
·
DICOM Working Group 22 (Dentistry; 2005):
http://medical.nema.org/Dicom/minutes/Committee/2005/2005-09-29/WG-22_Report_2005-08-27.doc
·
ADEA: http://www.adea.org/Pages/default.aspx
See Dominick P. DePaola,
Harold C. Slavkin, “Reforming Dental Health
Professions Education: A White Paper”
·
HITSP
·
Journal
of Contemporary Dental Practice: http://www.thejcdp.com/issue009/index.shtml
DISLAIMER: No information on these pages should be necessarily
construed as a position of Robert Morris University, of the University of
Pittsburgh or its Center for Dental Informatics, of the American Academy of Periodontology, of the American Association of Diabetes
Educators, of the University of Washington, or of the Governor’s Commission on
Chronic Care Management, Reimbursement, and Cost Reduction, Pennsylvania.
Updated:
August
14, 2010
Project
established early 2008.
Contact:
Valerie J.H. Powell, RT(R), PhD, C&IS Department, phone: 412-397-3467; fax:
412-397-2481; e-mail: powell@rmu.edu