Research Project
7360239
The primary goal of this proposal is to conduct a randomized clinical trial to evaluate the [unreadable] effectiveness of an integrated electronic health record system that includes a eMedical [unreadable] Record (EMR), eDental Record (EDR), and a Personal eHealth Record (PHR) to [unreadable] improve the quality and safety of dental care for patients with chronic illnesses. Chronic [unreadable] medical conditions such as diabetes, heart disease, pulmonary disease, and conditions [unreadable] that cause xerostomia (dry mouth) have a profound effect on the quality and safety of [unreadable] dental care if neglected. If these medical conditions are not identified and addressed in [unreadable] routine dental care, the quality and safety of the care is adversely affected. [unreadable] The emergence of EDRs in dental offices offers new opportunities for measurement and [unreadable] improvement of the quality and safety of care of by dentists. An EDR integrated with an [unreadable] EMR and PHR provides a unique opportunity to improve the dental care of patients with [unreadable] chronic conditions by both alerting patients to their special care requirements as well [unreadable] alerting dentists at the point of care. Furthermore, the integration of an EMR, PHR, and [unreadable] EDR into an integrated electronic health record system adds great potential for improved [unreadable] health information exchange, enhanced communication, and improved and cost effective [unreadable] care, particularly for patients with chronic illnesses. [unreadable] We propose a 3-arm, 2-year prospective, group-randomized clinical trial of 47 dentists in [unreadable] 17 clinics to evaluate the effectiveness of two interventions that utilize simple reminders [unreadable] within the integrated electronic health record. The study examines two interventions [unreadable] versus a usual care (UC) control. The interventions are designed to address how, and to [unreadable] whom, special dental care needs are communicated. The interventions are: 1) a [unreadable] reminder to patients delivered primarily via their PHRs through email or if email is not [unreadable] available through phone by the dental clinic staff and/or postal mail (Group A) or 2) a [unreadable] point-of-care reminder to the dentist within the EDR (Group B). These reminders reflect [unreadable] the special dental care needs of four chronic conditions: diabetes mellitus, congestive [unreadable] heart failure, chronic obstructive pulmonary disease, and xerostomia (dry mouth) as [unreadable] caused by medications or related conditions. This project demonstrates how leveraging [unreadable] an integrated electronic health record system can improve patient outcomes, increase [unreadable] awareness and improve clinical decision-making by identifying problems needing [unreadable] remediation and providing immediate evidence-based recommendations.
