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Integrating medical and dental records to improve care

​​​​Spotlight on Research

Part 2 of a three-part series exploring research focused on the connections that exist between oral and health care.

Imagine seamless care, where your diabetic condition is identified during a dental visit. Or, your physician's laptop computer indicates you're past due for an oral exam, and it may be adversely affecting your health.

Pioneering research at Marshfield Clinic Research Institute​​'s Biomedical Informatics Research Center (BIRC) is making this a reality by connecting electronic medical and dental records and studying ways it can improve peoples' health.

The dental informatics researchers at BIRC first surveyed and studied physicians and dentists to understand what information would benefit their patients. That allowed them to build an integrated electronic health record. With that core system now in place for nearly 60,000 patients who receive medical and dental care through the Clinic system, researchers are planning new studies to develop technology that will improve the delivery of integrated health care.

"Delta Dental and Family Health Center of Marshfield, Inc. (FHC) helped us research and build one of the first integrated medical-dental electronic health records in the United States," said Amit Acharya, B.D.S., Ph.D. "Now we're studying new, innovative ways to use these records to improve quality and reduce the cost of care for our patients."

For instance, Dental Informatics staff at BIRC are researching an oral cancer risk assessment tool accessible to both dentists and physicians. Looking at risk factors such as tobacco use, diet, age, and medical and dental history, health care providers will have a tool that helps them more accurately assess who is at highest risk for developing oral cancer.

"A tool such as the oral health risk assessment better connects a patient's health care team," Dr. Acharya said. "Physicians and dentists can then coordinate screening and treatment following an early diagnosis, which can lead to a more positive outcome for the patient."

Research integrating medical and dental records, though, isn't limited to the computer screens of health care providers. Thanks to a grant from Delta Dental of Wisconsin, dental informatics researchers now understand which medical and dental information patients can access through the online patient portal, My Marshfield Clinic.

Ultimately, everything from dental health history, dental problems and medications to appointment reminders may be packaged with medical records for patients who receive dental and medical care through the Clinic system or FHC.

"This remains a new concept, and therefore requires extensive research," Dr. Acharya said. "However, the integration of medical and dental records will lead us to new technology and tools that help physicians and dentists better treat patients."

That integration of medical and dental records is important because researchers understand oral health is connected to other diseases and conditions in the body.

Diabetes and heart disease, for example, can sometimes be linked to oral health disease. More research is needed to understand why the connections exist, but regardless, improving oral health care has shown it can improve diabetic symptoms, Dr. Acharya said.

Benefits of the integration are already evident. In 2012 more than 1,400 Marshfield Clinic patients with diabetes who were also FHC dental patients hadn't been to their dentists within the previous 12 months. Physicians, knowing this, could then refer a patient for an oral health exam, important for managing diabetic symptoms.

"That's a great example of the research we do that's touching people's lives, and it's why we come to work every day," Dr. Acharya said. "If we can better understand the data to provide valuable information to our healthcare providers and our patients, we can improve the lives of our patients."