The goal is to integrate oral health into primary care practices and build collaborative referral networks. Mosaic Medical's dental program would like to participate in the MoreCare cohort to improve our efficiencies that will support timely access to care and the long term sustainability of our dental program. We started offering imbedded dental services three years ago, but it wasn't until last year that our first dental suite was imbedded into one of five primary care clinics. With that expansion came new operations and opportunity. Our program plans to grow across central Oregon. This cohort will allow us to preform integrative services at a national standard for oral health integration. We hope to maximize our ability to deliver quality care to our pediatric patients and ensure the continuity of care with our external referral entities.
There is a need for training for providers, MA's and support staff on the relationship between dental care and health care, as well as training on oral health assessments, assistance with standardized screening forms and proper documentation in EMR to include appropriate coding. We would like to assist with development of literature for patients to help education them on the importance of oral health care and the relationship to improved overall health.
“As our obstetric patient population was one of our focus' for screening, referrals and fluoride application, we had a mother present to our clinic who had not yet had an obstetric appointment, and she was presumed to be late in her second trimester. As the Medical Assistant was helping this mother complete her intake forms, she found out that this patient had not seen a dentist in years. Because we had recently had a MORECare meeting, as well as the all-staff training "Maternal Teeth for two" the Medical Assistant was able to help the mother identify who she was assigned to as a DCO, initiate a dental referral with a risk assessment and oral screening from her new PCP, and a fluoride varnish treatment from the Medical Assistant. Our new patient left the clinic with a dental appointment, and a follow up obstetric appointment. She was so thankful as she ‘hadn't thought this appointment would also include her teeth!'"
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- The project of implementing "MORECare" into primary care practice was to develop an oral health referral network, integrate preventive oral health practices into our routine primary care appointments, and educate both staff and patients on the importance of whole body care. A primary activity in this project included a lot of training- across the entire staff, from front desk to clinical, administrative, billing etc.
- This project was implemented by Advantage Dental by DentaQuest, Mosaic Medical, St. Charles Health System, and Weeks Family Medicine.
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The project attempted to:- Develop effective and efficient oral health referral networks
- Integrate preventive oral health practices into primary care
- Develop and test solutions for the challenges of interprofessional practice
- Complete Oral Health Evaluation/Risk Assessment at All Well-Child Visits - Follow/Implement Primary and Secondary Prevention
- Manage Self-Management Goals
- Develop Dependable Dental Referral Networks
Increased the percent of patients in the target population with review of self-management oral health goals (SMG) documented at current medical visit during the measurement month from 0% to a regular workflow established and overall percentage of 81.53%.
Increased the percent of at-risk patients in the target population referred to dentist who receive a documented treatment completion verification from dental provider at the primary care office to 52.17%.
Increased the number of patients in the target population who have oral health risk factors identified and are referred to the dentist. The target were children ages 0-17, a total of 335 total patients were seen, and 64 of them were identified as High Risk. All were referred to a dentist.
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- We currently have 100% of patients between the age of 1-6 with a documented oral health assessment and documented SMGs. Increased the percent of at-risk patients in the target population referred to the dentist who receive a documented treatment completion verification from dental provider in the primary care office.
- The challenge we faced was COVID. The program officially ended at the end of March 2020, but Mosaic plans to take our learnings and build upon them when we open our new dental clinic in Madras in the spring of 2022.
This project has been incredible to point out the need for the acceptance of "whole body care" being initiated, managed, and followed up with, by the patient’s primary care physician, for both the patient and PCP.
Adding the oral health screenings, as well as self-management goals and fluoride varnishes were relatively easy to implement for certain departments, while others had challenges mainly due to time restrictions.
Implementing oral health awareness has made it easier and more routine to also discuss nutrition goals, exercise goals, behavioral health barriers and other "whole body care" management goals.