The Big Opportunity for Oral Health to Shape Medical-Dental Integration
The oral health care system is changing. As the industry moves in the direction of integrating medical and dental care, dentists have a unique opportunity to shape that new system.
At the Dimock Community Health Center in Boston, an integrated approach to care made Dimock a leader in providing comprehensive health and human services to individuals and families within the community. The coordination between Dimock’s dental clinic and primary care was a core component of this work, which led to the more than 150 year old health center becoming a national model for the delivery of comprehensive health and human services.
Dr. Myechia Minter-Jordan, President and CEO of DentaQuest Partnership for Oral Health Advancement and Catalyst Institute, led much of that work before joining DentaQuest — first as the center’s Chief Medical Officer and then as President and CEO. Now, Dr. Minter-Jordan wants to bring the lessons learned from medical-dental integration to the broader oral health community.
Oral health’s opportunity to lead the change
“There is a really great opportunity for dentists and the oral health field to be part of systems change from the beginning — to help drive it and shape it, rather than react to it,” says Dr. Minter-Jordan. “Oral health providers have an important role here, not only in treating oral disease and promoting preventative measures for oral health, but also in treating other chronic diseases. This is an opportunity to demonstrate oral health’s place in the overall health care system.”
Dr. Minter-Jordan also points to lessons learned on the medical side that oral health can use to make a value-based, integrated system work better. For example, she believes it is critical to have agreed upon quality markers and measures. This would be a great improvement from what providers experienced in medicine, where they frequently had to adhere to several different processes, lists and requirements determined by a variety of external stakeholders.
This will be especially important as oral health providers move toward providing specific medicine functions, such as monitoring blood pressure in the dental office, to ensure patients are getting these important services even if they are not regularly seeing a primary care physician.
Shifting Training Models
As Chief Medical Officer at Dimock, one of the key aspects of Dr. Minter-Jordan’s work was training pediatricians in medical-dental coordination between pediatrics and oral health. In some cases, staff would actually walk a patient up from the pediatric clinic to the dental clinic in order to make their appointment. Dimock also secured electronic medical records in order to share information between the dental clinic and all of the medical clinics. Doing so enabled them to pull population-specific health measures (a list of all diabetic patients, for example) and send that to the dental providers and front desk staff so they could pull patients into care based upon their chronic diseases. Dimock’s OBGYN clinic and dental clinic also coordinated frequently to make sure that all of the mothers had the necessary oral health prevention.
“As we were trained historically, medical providers didn’t have much experience learning about oral health and vice versa,” says Dr. Minter-Jordan. “I think training models are beginning to change and shift, and we are seeing more team-based models where there is a shared understanding of oral health and disease.”
Improving outcomes through value-based care
Value-based care and medical-dental integration go hand and hand. As we are moving into an era where payers are beginning to shift from a focus on volume of services to the value of those services , we see how taking this wholistic, whole-body, prevention-first approach to health care will not only have greater financial benefit to providers, but will more importantly afford better access and improved health outcomes for patients.
“As we continue to push values-based care models that incorporate oral health measures, we’ll see, most importantly, improved patient outcomes,” says Dr. Minter-Jordan. “So if we consider the patient as one being, and the mouth is in the body, we have to approach treatment that way. When we apply value-based care methodology on top of that, we are concentrating our efforts to look at those metrics and improve those outcomes, and we are also reducing cost for the overall system.”
In doing so, we can transform the way people across the country access oral health care and provide better oral health, and overall health, for all.