Integration of Oral Health for Diabetic Patients: Role of Clinical Informatics
Amit Acharya, BDS, MS, PhD
Director, Institute for Oral and Systemic Health
Director, Dental Informatics Postdoctoral Training Program
Dental Informatics Scientist | Associate Research Scientist
Marshfield Clinic Research Foundation
Abstract: In 2000, Surgeon General David Satcher’s report entitled “Oral Health in America” focused attention on a national problem which had gone largely unrecognized for decades: the oral health crisis. He summarized the existing evidence that points to important links between oral disease, such as periodontal disease, and systemic diseases such as diabetes, heart disease and stroke, respiratory health and fetal health (miscarriage and stillbirth).
Dr. Satcher further exposed access disparity to dental health care encountered by disparity-prone populations including low income individuals, those with no insurance, children, the elderly, handicapped and institutionalized patients who experience what he dubbed the “silent epidemic” when referencing the high rate of oral disease prevalent among these populations.
A chasm currently persists between our perceptions, financing and delivery of oral health services and general medical services. The elderly where chronic disease is more prevalent, have the lowest rate of dental insurance of any age group. There is growing interest among large regional healthcare organizations like Marshfield Clinic Health System (MCHS) to bring research-driven innovations in patient-centered approaches to care, prevention and disease management, into community-based clinical practice.
In an effort to increase awareness of the oral-systemic health connections and better integrate medical-dental care delivery model, MCHS is piloting an effort designed to improve oral health of people with diabetes through application of clinical informatics, health information technology and population health management to achieve better quality of care and reduce the cost of services. This initiative is focused on provider and patient education, development of health information technology infrastructure to support the clinical decision making/care co-ordination as well as developing an electronic framework for monitoring quality improvement.
The talk will focus on:
- Utilization of Marshfield Clinic’s integrated medical-dental electronic health record environment to achieving the oral-systemic integration.
- Opportunities and challenges in managing the oral health of patients with diabetes.
- Application of clinical informatics, health information technology and population health management:
- To support oral health management of patients with diabetes between medical and dental providers;
- To support screening of undiagnosed diabetic patients at the dental centers;
- To develop quality improvement dashboards to better monitor and coordinate care for diabetic patients.