Dental hygienists are specialists in preventive care, and one of the most important tasks we have is the gathering and recording of patient information (data) before we perform preventive therapies. Updating a patient’s medical history is important because the changes in someone’s health history can impact their oral health. Part of our job is to educate patients on how dental health directly influences systemic health.
What if we could use this data to demonstrate to patients the systemic link, instead of just talking about it? What if this data could be used to benefit population health within a community, or population health within the state, or within the nation? Understanding the information that we collect, and its value, could influence population health in many ways. One of the ways of making sense of this information is by performing an analysis of the data.
What is data and analytics?
Data analytics is a process of taking information, drawing conclusions and gaining insights, and leveraging that information in meaningful ways. For example, hygienists know that there is a direct systemic correlation between diabetes and periodontal disease, and that poor oral hygiene can contribute to the development of heart disease. As health-care providers, hygienists perform preventive therapy and educate patients in the hope of seeing improvement in periodontal scores and possibly a reduction in someone’s A1c.
Our therapy stops there, and sometimes we see an improvement and other times we see a decline. Likewise, other conditions are known to have relationships to dental health, such as pulmonary disease, atherosclerosis, preterm birth, and low birth weight.1 So, how do we optimize the overall goal of health? The short answer is dental and medical provider partnerships. However, there is a gap in interprofessional collaboration. How do we get on the same page? It’s all in the analysis of the data.
The tie that binds
Considering that approximately 9% of patients visit a dentist but not a physician, it is evident that dentists and hygienists could play a significant role in screening for common chronic diseases, and this can reduce gaps in preventive care.2 Ultimately, health-care provider collaboration would lead to information that could impact patients’ health in a positive way.1 As the demand for electronic health record (EHR) adoption affects dentists across the country, more dental practices and dental schools are implementing EHR systems and health information exchanges than ever before.3
Since dentistry is using information technology to meet its clinical, administrative, research, and educational needs, it is imperative that providers across the health-care spectrum consider oral health just as important as systemic health.3 Linking dental and medical data impacts health care in ways that provide many opportunities in the health-care sector, such as creating standards for dental records, protocols for implementation and integration, and policies and legislative developments related to privacy and security of integrated dental and medical data.4
Integrating dental with medical information can result in analysts using data to better understand patterns of disease and conditions.5 Large data sets can assist dental and medical health-care providers toward developing insights into how each patient is progressing along some of the most common disease routes. Subsequently, oral health status can be taken into account and interventions can be planned accordingly.5 In a nutshell, that’s data analytics, and as hygienists, we should know how the information we collect is helping to shape the health-care infrastructure.
The good news is that dental insurance companies are already performing statistical analysis on dental data as claims are being analyzed for population health initiatives. Analytic resources and technologies are proving to increase access to care, lower costs, and improve the quality of health-care delivery.6 At any rate, dental health data should be highly prioritized considering that 90% of diseases show signs and symptoms in the mouth.7
First things first
To manage population health and accomplish interprofessional collaboration, a robust dental public health infrastructure needs to exist in the public and private sectors.3 Doing so will ensure that the entire profession of dentistry is working toward common goals to improve public health through strategies that include improved health literacy, efficient and effective delivery systems to meet the public’s oral health-care needs, and building upon the scientific body of knowledge related to oral and systemic health.3
The challenge for dental public health, and dentistry in general, is to create a shared vision of optimal oral health for widely diverse groups, and to inform and educate these groups as to their potential roles in improving oral health and how to be better stewards of their own oral health.3 Providers across the health-care spectrum must work together to assess the oral health status of differing communities of interest, and then design, implement, and coordinate activities and programs and evaluate outcomes.3
In addition to analyzing data and population health incentives, leading the way is the Healthy People 2020 project, a federal initiative that charts the nation’s public health issues and develops action plans to overcome them.8 Healthy People 2020 identifies oral health as one of the key indicators of a healthy population, linking good dental care to reduced risk of diabetes, heart disease, stroke, premature birth or low birth weight, and chronic oral pain.8 Adding oral health care to the list of population health management priorities may help providers at all points of the care continuum achieve the goals of value-based care while cutting costs, improving outcomes, and delivering comprehensive care services to their most vulnerable and high-risk patients.8
Assuring optimal oral health for all Americans requires close collaboration between the public and private sectors of dentistry.3 Every dentist, regardless of the type of practice, location, or any other variable, is part of the dental public health infrastructure. While linking dental data to medical data is still a work in progress, it all starts with health-care providers collecting data.3 As a dental hygienist, you are an extremely important piece to the population health puzzle. Collecting accurate and complete data is vital, as insurance companies are now using data analytics for patient awareness and population health.
In the future, your knowledge and understanding of the oral-systemic link and the data you collect will provide an overall picture of a patient’s health and will be used in your patients’ continuity of care between dental provider and medical provider, thus contributing to the mission and goals of population health initiatives and agendas. And it will all be done through data!
References
1. Kane S. The effects of oral health on systemic health. General Dentistry. November 2017. Accessed March 8, 2020. https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf
2. Leader D, Vujicic M, Harrison B. Could dentists relieve physician shortages, manage chronic disease? Health Policy Institute Research Brief. American Dental Association. December 2018. Accessed February 26, 2020. http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1218_1.pdf?fbclid=IwAR01Nvqk8rpqP_HkqXcVllPpmBecq8GHzIbScp03NJl0N0lBbay0gFvXKns
3. ADA Center for Informatics and Standards: What is dental informatics? American Dental Association. Accessed March 3, 2020. https://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics
4. Rudman WJ, Hart-Hester S, Jones WA, Caputo N, Madison M. Integrating medical and dental records: A new frontier in health information management.” J AHIMA. 2010;81(10):36-39.
5. Bresnick J. Using risk scores, stratification for population health management. Health It Analytics. December 16, 2016. Accessed February 26, 2020. https://healthitanalytics.com/features/using-risk-scores-stratification-for-population-health-management
6. Kent J. BCBS announces finalists of claims data analytics challenge. Health It Analytics. September 10, 2019. Accessed February 26, 2020. https://healthitanalytics.com/news/blue-cross-blue-shield-launches-claims-data-analytics-challenge
7. Towers S. Why connect dental data to population health? AHIP blog. June 15, 2017. Accessed February 29, 2020. https://www.ahip.org/why-connect-dental-data-to-population-health/
8. Bresnick J. Dental care is the missing piece of population health management. Health It Analytics. December 28, 2016. Accessed March 3, 2020. https://healthitanalytics.com/news/dental-care-is-the-missing-piece-of-population-health-management
SHANNON SOMMERS, MSHI, BTDH, RDH, has a bachelor of technology in dental hygiene from the State University of New York at Canton, and a master of science in health informatics from the Medical University of South Carolina. She has more than 20 years of experience in dentistry and has been a dental hygienist since 2006. She aims to use her dental background and informatics skills to influence population health by promoting and advancing the use of dental informatics.
ALICIA WEBB, MSHI, BTDH, RDH, has been a clinician in dentistry since 2006 and has experience as an educator in a dental hygiene program. As one of the few registered dental hygienists to graduate with a master of science in health informatics, she wants to use her informatics knowledge and her dental background to improve population health by developing and analyzing data-driven solutions to improve the delivery of quality dental care.
