The Power of Integrated Care Teams in Improving Oral Health Outcomes: Lessons Learned from Community Health Center Integration Pilots
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1 The Power of Integrated Care Teams in Improving Oral Health Outcomes: Lessons Learned from Community Health Center Integration Pilots Shannon Wells, MSW Oral Health Affairs Manager MLCHC CHI May 4, 2016
2 Sharing our integration stories HRSA Linkages: 3 year oral health workforce grant that was awarded to DPH. DPH subcontracted with Mass League to pilot 7 CHC integration projects. Each site had both a medical and dental champion that developed a integration model that fit the needs of their site and community. Most sites focused on either adult diabetics or pediatric patients. Clinical Connections: Funded by DentaQuest Foundation, 5 CHCS are piloting a very specific, detailed oral health delivery framework developed by Qualis Health to address primary care s role in oral health. Specific populations of focus on adult diabetics or pediatrics.
3 Structure of the Grant
4 Multiple Goals and Objectives: Maternal & Child Health improve the oral health care of pregnant women before, during and after pregnancy through policy and practice changes that better integrate MCH and dental care. Medical-Dental Integration 7 CHCs will move toward a fully integrated health home that will improve oral health outcomes for underserved residents. Community Water Fluoridation Through the use of a community mobilization and social marketing model, by Year 3 increase by two the number of communities in Massachusetts with a fluoridated water supply
5 Integration Pilot Expected Outcomes: Short Term Outcomes: include the presence of an oral health physician champion in each participating health center, demonstrated success in integrating oral health and primary care IT components ( screening questions, referrals, etc.) an increase in oral health referrals made from the medical offices to the dental offices Long Term Outcomes: improved oral health for underserved residents pilot projects are spread to other areas within CHC and to outside CHCS.
6 What Are Sites Working On?
7 CHC Boston Health Care for the Homeless EMR- CPS EDR- Dentrix Population of Focus- all Project Focus By strengthening our oral health assessment protocol in a format that is shared by medical and dental and providing oral health trainings to all clinical staff, we will increase oral health screenings for adults and families, and more fully integrate oral health into primary care Codman Square EMR-GE Centricity EDR- Dentrix Population of Focus- Diabetics and Peds Edward M. Kennedy EMR- Next Gen EDR- QSI Population of Focus- Peds Partner with medical departments to improve the referral process for CSHC patients to receive dental care. Increase access to care by utilizing a group visit model and innovative referral methodologies. Create a dental home of CSCH patients. Target peds and diabetics. Standardize and streamline pediatric oral health services provided in the medical setting and establish a referral process to the dental department for patients without a dental home. Carved out Saturday apts for peds medical patients for dental care.
8 CHC Project Focus Family Health EMR- Next Gen EDR- QSI Population of Focus- Peds Holyoke EMR-Next Gen EDR-Dentrix Population of focus- Peds North Shore EMR-Centricity EDR- Dentrix Population of Focus- Diabetics/OBOT Outer Cape EMR- ECW EDR-Dentrix Population of Focus- Diabetics and now all. Create a formal referral process/care-stream connecting children in pediatrics without a Dental Home to the FH dental department for treatment and education. Decrease the incidence of dental caries by creating a standardized protocol where medical staff routinely provide fluoride varnish and dental referral for peds. Improve oral health for diabetics by creating a streamlined oral health questionnaire for patients, and an standardized electronic referral system for medical patients to dental. Spread will focus on substance abuse patients. Address the oral health needs of patients by identifying and internally referring patients without a dental home- specifically diabetics.
9 What happened??
10 Lessons Learned: This work is challenging but so rewarding! Development of projects took longer then originally expectedusually due to IT issues, and competing priorities Having the right team members is critical to success. There are ways to be creative around issues like capacity and work force It can t all fall to one department Integration is possible
11 Hear the Real Lessons
12 Questions? Shannon Wells, MSW Oral Health Affairs Manager
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