The HRSA UDS Sealants Measure

Transcription

1 The HRSA UDS Sealants Measure Documenting Moderate & High Risk Kansas and Nebraska PCA Sealant Learning Collaborative Learning Call #2 Irene Hilton, DDS, MPH NNOHA Dental Consultant December 12, 2017

2 Objectives Understand why we assess risk for disease List common dental caries risk assessment tools Learn how to document Moderate & High caries risk in different EDRs for 2018

3 Measure Overview: Sealants 6-9 Years NUM: How many received a sealant on a permanent first molar in the reporting year % DEN: Of dental patients, aged 6-9 years at elevated caries risk, of record in the practice in the reporting year, who needed a sealant in a permanent first molar = Denominator Exclusions (subtract from denominator): All four molars are not candidates for sealants Dental Quality Alliance

4 Calculating the HRSA UDS Sealant Measure for 2017

5 Breaking Down the Denominator Criteria: Overview DEN: Dental patients, aged 6-9 years at elevated caries risk, of record in the practice in the reporting year who needed a sealant in a permanent first molar 6-9 years of record in the practice elevated caries risk For CY 2017 UDS reporting: date of birth between January 1, 2008 December 31, 2010 had an oral assessment (CDT D0191) OR a comprehensive or periodic oral evaluation visit (CDT D0120, D0145, D0150, or D0180) at moderate to high caries risk (CDT D0602 or D0603) based on caries risk assessment

6 Caries Risk Assessment

7 Why Assess Caries Risk The majority of dental caries is caused by risk factors that can be controlled or modified Factors identified through assessment Inform self-management/patient education

8 Why Assess Caries Risk?

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10 CVD Risk Factors Smoking Age ETOH Diet Physical activity Weight Cholesterol Genetics Periodontal disease Dental Caries Risk Factors Smoking Bacterial counts Diet Fluoride exposure Dental visits Previous caries Less saliva Poor tooth morphology Heavy plaque

11 Risk Assessment & Etiology Host (tooth) Caries Bacteria Substrate

12 Determine Appropriate Treatment Level/number of interventions Recall intervals Materials selection

13 Risk Assessment Tools

14 CRA Tools: CAMBRA

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17 AAPD 17

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19 Chat in! What CRA Tool do you use? CAMBRA- full or modified ADA AAP AAPD PreViser Other

20 Chat in! Who completes the CRA in your office? Dentist Dental Hygienist Dental assistant or other support staff

21 Chat in! How is CRA done? Internal- EDR has a built-in CRA tool that we can check off/fill in External- paper CRA or other template used, then results documented or scanned in Other

22 Talk in! What have been some challenges in consistently performing caries risk assessment?

23 Documenting CRA

24 Entering CDT Risk Assessment Codes Electronically D601 Low Risk D602 Moderate Risk D603 High Risk

25 For 2017 UDS If you entered CDT codes D601, D602, D603 during 2017 run a query for D602, D603. If not, then chart audit looking for proxies for elevated risk for caries. Previous caries Poor OH High sugar diet Special needs

26 For 2018: Documenting CRA Paper Encounter Form Add the 3 CDT codes D601, D602, D603 to your encounter form Assign fee $0 Check off with 0150, 0120, 0191, 0145, 0180

27 Implementing CRA Documentation Start with one provider, on one patient Tests, trials, drafts of everything: Clinic flow, EDR or encounter form revisions Reporting validity

28 Chat in! How do you document risk status? EDR auto-scores & enters CDT code We must document and enter code separately

29 How to Document CRA in EDRs

30 Caries Risk Assessment Dentrix Dental Provider Workflow Patient is seated in exam room and RDH/DA begins clinical assessment ADA CRA Guidelines RDH/DA uses ADA CRA guide to draw out information on risk and protective factors Key information is utilized to determine CRA and confirmed by DDS/DMD to determine risk level CRA is documented in Dentrix both in patient chart and patient procedures for that day Based on risk level, treatment, OHI, nutritional counseling and recare interval are determined

31 Documentation Docume nted in Notes Document ed in Procedure s

32 CRA Documentation NextGen/QSI CRA performed for ages 5-10 Completed by DA, RDH, DDS Built into the clinical note Dummy / Smart code appear on the visit based on caries risk Reported UDS Sealant Measure based on the dummy codes

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35 Talk in! Questions about using the built-in Dentrix & QSI CRA?

36 Resources HRSA UDS Sealants Measure FAQ Webinar: HRSA UDS Sealants Measure Update Register at: Friday January 5 th, amPST/10amMST/11amCST/noonEST Webinar ID:

37 In conclusion Do the best you can! Next call Tuesday, 2/20/ :15CST: Exclusions the FINAL FRONTIER!!!

38 Contact Us! Candace Owen, RDH, MS, MPH NNOHA Education Director Irene V. Hilton, DDS, MPH, FACD NNOHA Dental Consultant National Network for Oral Health Access 181 E 56th Avenue, Suite 501 Denver, CO Phone: (303) Fax: (866) info@nnoha.org