Development and evaluation of patient medical summary from health information exchange to improve dental care

Document text

Principal Investigator: Thankam P Thyvalikakath
Organization: INDIANA UNIVERSITY INDIANAPOLIS
Fiscal Year: 2024
Award: $648,647
Funding agency: National Institute of Dental and Craniofacial Research

Project Summary
To avoid potential harm and improve dental treatment success, dental clinicians (DCs) must obtain an up-to-
date medical and medication history of their patients. Recent studies have reported discrepancies with patient-
reported medical histories in electronic dental records (EDRs), and inconsistencies in physicians’ responses to
DCs’ medical consults leading to delayed dental care. Large healthcare organizations (HCO) such as dental
schools and health management organizations implemented integrated medical-dental electronic health record
(EHR) (integrated EHR-EDR) to improve communication and referral between medical and dental
professionals. However, deploying such systems alone will not resolve the current barriers because the
relevant patient-specific information may be fragmented across different HCOs, stored in various EHR
sections. Besides, most dental professionals are not credentialed with HCOs to have access to an integrated
EHR-EDR system. The emergence of community and vendor-supported health information exchanges (HIEs)
and the development of technologies and standards to exchange and display pertinent information is an
opportunity for DCs to establish an integrated care delivery model regardless of their practice setting.
The long-term goal is to improve communication and referrals between dental clinicians and medical
professionals to improve patient care and promote screening and preventive management of chronic diseases.
This proposal aims to develop and evaluate a usable patient medical summary (PMS) imported from the state-
wide community Indiana Health Information Exchange (IHIE) that updates a dental clinician about their
patients’ medical history and can be used even in solo- and small group dental practice settings. The central
hypothesis is that the PMS will have a higher percentage of complete and up-to-date medical information,
which will reduce the average time required to assess a dental patient case and determined by DCs to be
clinically useful. The three specific aims are: 1) Validate the relevance and timeliness of information items that
contribute to the PMS to assess a patients’ medical status; 2) develop prototypes that integrate the PMS with
an EDR through user-centered design methods; 3) evaluate the effectiveness and efficiency of the PMS with
general and specialist dentists. The two primary outcomes are a Fast Healthcare Interoperability Resources
(FHIR)-based PMS application and a reconfigured Consolidated Clinical Document Architecture (C-CDA) that
reduce dental clinicians’ reliance on patients and physicians’ office for information and reduce patients’ burden
to share information with DCs. The proposed study will lay the foundation for an interprofessional dental-
medical care delivery that enhances dental and overall care among the US population, promotes preventive
management, and reduces dental care costs.

Terms: <Address><Adverse Experience><Adverse event><Affect><Architecture><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Caring><Chronic Disease><Chronic Illness><Clinical><Communication><Communities><Community Health><Consult><Dental><Dental Care><Dental General Practice><Dental Group Practice><Dental Hygienists><Dental Procedure><Dental Records><Dental Schools><Dentistry><Dentists><Development><Disease><Disorder><Drugs><Electronic Health Record><Electronics><Engineering / Architecture><Evaluation><FHIR><Fast Healthcare Interoperability Resources><Focus Groups><Foundations><Goals><Health><Healthcare Delivery><History><Indiana><Interview><Medical><Medical History><Medication><Medicine><Methods><Oral><Oral health><Outcome><Patient Care><Patient Care Delivery><Patients><Personal Medical History><Personal Medical History Epidemiology><Pharmaceutical Preparations><Physicians><Physicians' Offices><Population><Preventive><Protocol><Protocols documentation><Provider><Questionnaires><Recording of previous events><Reporting><Research Design><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Scanning><Service delivery model><Service model><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Specialist><Study Subject><Study Type><System><Time><Update><Vaccination><Vendor><assess effectiveness><care coordination><care costs><care delivery><care delivery model><care for patients><care of patients><caring for patients><chronic disorder><clinician communication><communicable disease transmission><communicate to clinicians><communicate to providers><communicate with clinicians><communicate with doctors><communicate with providers><community-based health><computer-based representation><consults><coordinating care><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><dental health><dental practice><dental service><design><designing><determine effectiveness><developmental><disease transmission><doctor communication><drug/agent><effectiveness assessment><effectiveness evaluation><electronic><electronic device><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><evaluate effectiveness><examine effectiveness><frame-based representation><health and care delivery><health care delivery><health care delivery model><health care management><health care organization><health care service organization><health delivery systems><health management><health services delivery><healthcare delivery model><healthcare management><healthcare organization><healthcare service organization><histories><improved><infectious disease transmission><informant><information organization><innovate><innovation><innovative><integrated care><integrated model of care><knowledge representation><new technology><novel technologies><patient population><patient safety><population health><practice setting><prevent><preventing><primary outcome><prototype><provider communication><response><screening><screenings><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><study design><success><tech development><technology development><usability><user centered design>