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CC BY-NC-ND 4.0 · Appl Clin Inform 2022; 13(01): 080-090
DOI: 10.1055/s-0041-1740920
Research Article

Caries Risk Documentation And Prevention: eMeasures For Dental Electronic Health Records

Suhasini Bangar   *
1   Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center, Houston, Texas, United States
,
Ana Neumann   *
1   Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center, Houston, Texas, United States
,
Joel M. White
2   Department of Preventive and Restorative Dental Sciences, University of California San Francisco School of Dentistry, San Francisco, California, United States
,
Alfa Yansane
2   Department of Preventive and Restorative Dental Sciences, University of California San Francisco School of Dentistry, San Francisco, California, United States
,
Todd R. Johnson
1   Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center, Houston, Texas, United States
,
Gregory W. Olson
1   Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center, Houston, Texas, United States
,
Shwetha V. Kumar
1   Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center, Houston, Texas, United States
,
Krishna K. Kookal
1   Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center, Houston, Texas, United States
,
Aram Kim
3   Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, United States
,
Enihomo Obadan-Udoh
2   Department of Preventive and Restorative Dental Sciences, University of California San Francisco School of Dentistry, San Francisco, California, United States
,
Elizabeth Mertz
2   Department of Preventive and Restorative Dental Sciences, University of California San Francisco School of Dentistry, San Francisco, California, United States
,
Kristen Simmons
4   Willamette Dental Group, Hillsboro, Oregon, United States
,
Joanna Mullins
4   Willamette Dental Group, Hillsboro, Oregon, United States
,
Ryan Brandon
4   Willamette Dental Group, Hillsboro, Oregon, United States
,
Muhammad F. Walji
1   Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, University of Texas Health Science Center, Houston, Texas, United States
,
Elsbeth Kalenderian
2   Department of Preventive and Restorative Dental Sciences, University of California San Francisco School of Dentistry, San Francisco, California, United States
3   Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, United States
5   Department of Dental Management, School of Dentistry, University of Pretoria, Pretoria, South Africa
› Author Affiliations Funding This study received funding from U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research, grant no.: R01DE024166.
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Abstract

Background Longitudinal patient level data available in the electronic health record (EHR) allows for the development, implementation, and validations of dental quality measures (eMeasures).

Objective We report the feasibility and validity of implementing two eMeasures. The eMeasures determined the proportion of patients receiving a caries risk assessment (eCRA) and corresponding appropriate risk-based preventative treatments for patients at elevated risk of caries (appropriateness of care [eAoC]) in two academic institutions and one accountable care organization, in the 2019 reporting year.

Methods Both eMeasures define the numerator and denominator beginning at the patient level, populations' specifications, and validated the automated queries. For eCRA, patients who completed a comprehensive or periodic oral evaluation formed the denominator, and patients of any age who received a CRA formed the numerator. The eAoC evaluated the proportion of patients at elevated caries risk who received the corresponding appropriate risk-based preventative treatments.

Results EHR automated queries identified in three sites 269,536 patients who met the inclusion criteria for receiving a CRA. The overall proportion of patients who received a CRA was 94.4% (eCRA). In eAoC, patients at elevated caries risk levels (moderate, high, or extreme) received fluoride preventive treatment ranging from 56 to 93.8%. For patients at high and extreme risk, antimicrobials were prescribed more frequently site 3 (80.6%) than sites 2 (16.7%) and 1 (2.9%).

Conclusion Patient-level data available in the EHRs can be used to implement process-of-care dental eCRA and AoC, eAoC measures identify gaps in clinical practice. EHR-based measures can be useful in improving delivery of evidence-based preventative treatments to reduce risk, prevent tooth decay, and improve oral health.

Keywords

dental quality measure - caries risk assessment - electronic health records - caries treatment

Protection of Human and Animal Subjects

Each participating institution obtained respective Institutional Review Board (IRB) approval.


* Contributed equally to this article.


Supplementary Material



Publication History

Received: 18 February 2021

Accepted: 30 October 2021

Article published online:
19 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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