Medical-Dental-Behavioral Integration: One Health Center’s Example Integrating Oral Health into Primary Care Practice to Increase Access to Care Kym Taflinger, Chief Analytics Officer Beth West, DBH, LISW-S, Chief Operations Officer Health Partners of Western Ohio July 25, 2016
Objectives § Review the characteristics of health centers with successful integration § Understand the systems that support integration § Describe one model of how patient care can be structured to incorporate multiple disciplines § Give examples of how patients benefit from this care model
Background
2000 Surgeon General & 2011 IOM Reports
U. S. Preventive Services Task Force Recommendations – May 2014 § Primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride § NEW! Primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the time of primary tooth eruption to prevent dental caries in children from birth through age 5 years
Medicaid & Private Insurer Payment § Medicaid in 49 states reimburse PCPs for assessment and/or FV placement § Commercial medical insurance plans benefit
2005 - Oral Health Disparities Collaborative Pilot Implementation Manual http: //www. nnoha. org/nnoha-content/uploads/2013/09/OHDCImplementation-Manual-with-References. pdf 2011 - Oral Health & the Patient Centered Health Home: Action Guide http: //www. nnoha. org/nnohacontent/uploads/2013/09/PCHHAction. Guide 02. 12_final. pdf
2014 HRSA Integration of Oral Health and Primary Care Practice (IOHPCP) Initiative § Develop oral health core clinical competencies for primary care clinicians § Translate into primary care practice in safety net settings Goal: § Improve access for early detection and preventive interventions leading to improved oral health http: //www. hrsa. gov/publichealth/clinical/oralhealth/primarycare/integrationoforalhealth. pdf
Integration of Oral Health and Primary Care Practice Initiative § Primary Care Providers • • MD/DO Certified Nurse Midwives Nurse Practitioners Physician Assistants § Oral Health Core Clinical Competency Domains 1. 2. 3. 4. 5. Risk assessment Oral health evaluation Preventive interventions Communication & education Interprofessional collaborative practice
A User’s Guide for Implementation of Interprofessional Oral Health Core Clinical Competencies Systems that Support Integration §Training system §Health information system §Clinical care system §Evaluation system http: //www. nnoha. org/nnoha-content/uploads/2015/01/IPOHCCC-Users-Guide-Final_01 -23 -2015. pdf
Characteristics of Success § § § § Leadership Vision & Support Integrated HC Executive Team Co-location Organizational Culture of Quality Improvement Staff Buy-in: Understanding the “Why” Champions Bonus: Integrated EHR system
Health Partners of Western Ohio Integrating Oral Health into Primary Care Practice Kym Taflinger Beth West, DBH, LISW-S Chief Analytics Officer Chief Operations Officer
Health Partners of Western Ohio Bryan Community Health Center Defiance Community Health Center Dr. Gene Wright Community Health Center Kenton Community Health Center New Carlisle Community Health Center Tiffin Community Health Center - Dental Tiffin Community Health Center - Firelands Health Partners Quick Care Spartan Health Center
Health Partners of Western Ohio Number of Patients
Health Partners of Western Ohio Number of Visits
Services
Electronic Health Record
Integrated Model of Care
Why Integrated Care?
The “Triple Aim”
Dental Integration • Medical • Behavioral Health • Chiropractic
Early Childhood Oral Health Project
Oral Health Core Clinical Competency Pilot Project • Adult Fluoride Varnish Applications During Medical Visits • Dentists Providing Oral Health Education to Medical, Behavioral Health, and Pharmacy Providers • EHR Template Revisions • Policy/Standing Orders Changes • Medical Front Desk Scheduling Dental Appointments • Providing Oral Health Education to Patients in the Medical Waiting Area (Once/Month)
HPWO Medical Assistant & Dental Assistant Providing Education in Waiting Shared Room
EMR Template Revision
Additional Activities • Distributing Oral Health Kits to Patients During Medical Visit • Medical Providers and Support Staff Observing Dental Operations/Procedures in Dental Area • Dental Staff Observing Medical Operations/Procedures in Medical Areas
2014 Proportion of Medical Patients Receiving Dental Services *Based on 2014 Uniform Data System Report
2014 Percentage of Patients Receiving Depression Screenings *Based on 2014 Uniform Data System Report
Contact Information Kym Taflinger Beth West, DBH, LISW-S Chief Analytics Officer ktaflinger@hpwohio. org Chief Operations Officer ewest@hpwohio. org Website: www. hpwohio. org Like us on Facebook: www. facebook. com/hpwohio
Conclusion “You cannot have good health if you have bad teeth”
NNOHA 2016 Annual Conference Nov 6 -9 Sheraton Denver Downtown Hotel “Celebrating 25 Years of Advancing Oral Health Access” 36
Contact Us! National Network for Oral Health Access www. nnoha. org Questions?
Скачать презентацию Medical-Dental-Behavioral Integration One Health Center s Example Integrating Oral
79980b6c8f28d5d0793e74445de289bb.ppt