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INTEGRATING ORAL HEALTH AND PRIMARY CARE A COLLABORATION BETWEEN APPLE TREE DENTAL AND CHI ST. GABRIEL’S HEALTH

Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

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Page 1: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

INTEGRATING ORAL HEALTH AND PRIMARY CAREA COLLABORATION BETWEEN APPLE TREE DENTAL AND CHI ST. GABRIEL’S HEALTH

Page 2: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

PRESENTERS

Rhonda Buckallew, Clinic Administrator

Family Medical Center, Little Falls, MN

Page 3: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

APPLE TREE DENTAL PRESENTERS

Karen Engstrom, RDH, COO Brenda Prosa, IS Director

Page 4: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

THE PURPOSE OF THIS WORK

Missions alignedBoth organizations understand that health care is more than the treatment of disease. Family Medical Center’s patient-centered approach to care: “whole”

person care rather than care based solely on a specific condition.

Apple Tree Dental seeks to improve the oral health of all people, including those with special access needs who face barriers to care.

Page 5: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

THE PURPOSE OF THIS WORK GOALS

Our Goals Increase access to oral health care for underserved populations Integrate preventative oral health care into primary care Increase referrals for oral health care-especially care coordinated patients Develop a system/process for bi-directional exchange of medical and dental

health information (manual then electronic) Provide education about mouth-body connection, prevention, and treatment

Page 6: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

IDENTIFYING THE NEED

Patients travelling long distances to find an oral health provider

Back-log for appointments

Low percentage of dental claims for those on medical assistance

Emergency department usage for dental pain

Page 7: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

PLAN OF ACTION

Expanding access (increasing days/hours)

Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care

Integrating preventative services into primary care (fluoride varnishing)

Establishing process for referrals

Developing systems for information exchange

Providing oral health education and mouth-body connection

Page 8: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

QUESTION

What difference has this grant made to increase access to care in Morrison County?

a) Little Falls area residents now have increased access to care.

b) More medical assistance patients are receiving the care they need.

c) More patients do not have to drive long distances to receive care.

d) All of the above.

Page 9: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ANSWER

# 4 – All of the above!

Page 10: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

EXPANDING ACCESS

What we did – SCHA request to provide on-site services

Successes – eliminated travel barriers for patients

Challenges – dentist recruitment; high demand and high needs

Page 11: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ASSESSING ORAL HEALTH BEHAVIORS AND BARRIERS TO CARE

Brushing Frequency

Page 12: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ASSESSING ORAL HEALTH BEHAVIORS AND BARRIERS TO CARE 1

Toothache in the past 12 months

Page 13: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ASSESSING ORAL HEALTH BEHAVIORS AND BARRIERS TO CARE 2

Needing dental care but unable to see a dentist

Page 14: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ASSESSING ORAL HEALTH BEHAVIORS AND BARRIERS TO CARE 3

Barriers to accessing care-Apple Tree Dental patients

Page 15: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ASSESSING ORAL HEALTH BEHAVIORS AND BARRIERS TO CARE 4

Barriers to accessing care-Family Medical Center patients

Page 16: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ASSESSING ORAL HEALTH BEHAVIORS AND BARRIERS TO CARE 5

Asked about oral health by a doctor

Page 17: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

REFERRAL PROCESSES

What we did

Successes

Challenges

Page 18: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

FLUORIDE VARNISHING IN PRIMARY CARE

What we did

Successes

Challenges

Page 19: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

PROVIDING EDUCATION

Page 20: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

PROVIDING EDUCATION 2

Page 21: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

QUESTION 1

How many patients have been seen at the Little Falls Outreach Clinic between January 23 to September 30, 2017

a) 155

b) 274

c) 380

d) 525

Page 22: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ANSWER 2

c) 380

Page 23: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

PROVIDING EDUCATION 1

Waiting room banners

Page 24: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

HEALTH INFORMATION EXCHANGE

What we did – Paper exchange; Summary of Care; Referral

Successes – Both have EHR

Challenges – Exchange determined: Direct Messaging

Page 25: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

OUTCOMES

Clinic days: 61

Patients seen: 380

Appointments: 958

Services provided: preventative, restorative, oral surgery, prosthodontics

Service value: $359,290

Page 26: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

OUTCOMES 1

Oral health needs are assessed at Family Medical Center

Processes for referrals and manual paper exchange of information has been established with progress towards electronic exchange

Family Medical Center is providing fluoride varnishing to pediatric patients

Social worker connecting patients to community services and resources to address unmet social needs

Page 27: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

OUTCOMES 2

Victoria’s story

Page 28: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

QUESTION 3

What was the #1 reason residents did not visit a dentist regularly? (of the Apple Tree Dental patients surveyed)

a) work schedule

b) dentists not accepting Medical Assistance plans

c) transportation problems

d) teeth seemed OK

Page 29: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

ANSWER 4

b) dentists not accepting Medical Assistance plans

Page 30: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

NEXT STEPS

Renovation of space

Increase days and hours of operation

Expand to include sedation services

Fluoride varnishing for Child and Teen Check-up patients at FMC

Page 31: Integrating oral health and primary care · Assessing patient oral health behaviors and attitudes, and barriers to accessing oral health care Integrating preventative services into

THANK YOU!

Rhonda Buckallew

Family Medical Center

[email protected]

Karen Engstrom, RDH

Apple Tree Dental

[email protected]

Brenda Prosa

Apple Tree Dental

[email protected]

mailto:[email protected]
mailto:[email protected]
mailto:[email protected]

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