The primary goal of this proposal is to conduct a randomized clinical trial to evaluate the ? effectiveness of an integrated electronic health record system that includes a eMedical ? Record (EMR), eDental Record (EDR), and a Personal eHealth Record (PHR) to ? improve the quality and safety of dental care for patients with chronic illnesses. Chronic ? medical conditions such as diabetes, heart disease, pulmonary disease, and conditions ? that cause xerostomia (dry mouth) have a profound effect on the quality and safety of ? dental care if neglected. If these medical conditions are not identified and addressed in ? routine dental care, the quality and safety of the care is adversely affected. ? The emergence of EDRs in dental offices offers new opportunities for measurement and ? improvement of the quality and safety of care of by dentists. An EDR integrated with an ? EMR and PHR provides a unique opportunity to improve the dental care of patients with ? chronic conditions by both alerting patients to their special care requirements as well ? alerting dentists at the point of care. Furthermore, the integration of an EMR, PHR, and ? EDR into an integrated electronic health record system adds great potential for improved ? health information exchange, enhanced communication, and improved and cost effective ? care, particularly for patients with chronic illnesses. ? We propose a 3-arm, 2-year prospective, group-randomized clinical trial of 47 dentists in ? 17 clinics to evaluate the effectiveness of two interventions that utilize simple reminders ? within the integrated electronic health record. The study examines two interventions ? versus a usual care (UC) control. The interventions are designed to address how, and to ? whom, special dental care needs are communicated. The interventions are: 1) a ? reminder to patients delivered primarily via their PHRs through email or if email is not ? available through phone by the dental clinic staff and/or postal mail (Group A) or 2) a ? point-of-care reminder to the dentist within the EDR (Group B). These reminders reflect ? the special dental care needs of four chronic conditions: diabetes mellitus, congestive ? heart failure, chronic obstructive pulmonary disease, and xerostomia (dry mouth) as ? caused by medications or related conditions. This project demonstrates how leveraging ? an integrated electronic health record system can improve patient outcomes, increase ? awareness and improve clinical decision-making by identifying problems needing ? remediation and providing immediate evidence-based recommendations.
| Fricton, James; Rindal, D Brad; Rush, William et al. (2011) The effect of electronic health records on the use of clinical care guidelines for patients with medically complex conditions. J Am Dent Assoc 142:1133-42 |
