Integrating medical and dental data to improve quality and safety of dental care [poster]
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Clinical decision support (CDS) software in an integrated electronic health record can inform dentists when changes in clinical protocol are needed for patients with serious chronic medical conditions. To change clinical practice, active strategies for alerting clinicians have generally been found to be more successful than passive alerts but also create more resistance and alert fatigue. Thus, the primary goal of this study is to evaluate two different types of alert mechanisms for CDS and determine if an active or passive CDS improves quality and safety of care versus a usual-care control. The study design is a three-arm, 2-year prospective group randomized clinical trial. The three arms include a passive alert CDS, an active alert CDS, and usual care with access to general guidelines through a Web link in the electronic dental record (EDR). The passive CDS utilizes dentist and staff reminders in the clinic schedule to encourage but not require reference to personalized guidelines in a linked web service. The active CDS utilizes a more obtrusive pop-up alert in the electronic dental record that requires the dentist to reference the personalized guidelines. Outcomes include how often the dentist reviews guidelines, whether they change their clinical protocols, and whether this reduces complications in patients. Patients’ electronic medical and dental records will be linked through the Minnesota’s Health Information Exchange Organization. This abstract will present the development of the clinical guidelines and how medical and dental data integrated into CDS tool. Preliminary results from focus groups show strong interest among dental providers to use the tool.