Purpose

To ensure that all patient related IT services share information so it is entered once and viewed in all connected systems.

Background

With few exceptions, there is no connection between dental and medical EHR systems, depriving dentists from the rich information stored in medical records and physicians from learning about the oral health status of their patients. This lack of interoperability has been recognized as a deficit of the electronic health record revolution of the past decades.

One of the strategic goals for the Collaboration for Health Information Technology (Collaboration) is to have dental a unified health record to be used for education and research. The Collaboration’s long-term goal is to promote the meaningful integration of information derived from the medical EHR into the dental EHR and vice versa to provide point-of-care clinical decision support helping all members of the health care team. This meaningful integration should shift current practice of obtaining medical history information by dentists and learning about oral health status by physicians by providing meaningful interoperability between medical and dental EHRs.

It is anticipated that a large number of external services will be integrated with ICE, an e-prescription service and electronic medical records are two examples. Because the hospitals associated with all three of the Collaboration founding members have Epic as their electronic medical record, and because integration with electronic medical record is an initial strategic goal, Epic integration is the first service to be be integrated with ICE.

It is anticipated that the ICE/Epic integration will take place in multiple phases. The initial phase will define and prioritize the data to be shared and subsequent phases will address the technical integration.

Charge

For the Integration: Epic, Phase 1, oral health providers should:

  1. Determine the data elements contained in both medical and dental records that if shared would improve patient care. Examples of data elements might include: demographic data, scheduling data, billing data, medical and dental history elements, etc. The University of Sydney is collaborating with others to conduct a study that may help answer this question.

  2. Once the elements are defined, recognizing that integration of data from dental and medical records is difficult, the same oral health providers should prioritize the data elements into the following categories: Critical & Simple for improving patient care, and Important for improving patient care and research. The Critical & Simple data elements should also be prioritized if there are more than 5 data elements.

Chair

Roger Gillie, U-M Heiko Spallek, co-chair

Composition

One oral health provider, e.g., from Oral Medicine, Pathology or Surgery, from up to six schools and a non-voting liaison(s) from ICE Health Systems will comprise the Oral Health Provider Integration Working Group. Once their recommendations are accepted by the Advisory Board their work will be completed. Individual schools may re-engage this group to test or pilot the integration.

Consultants

Additional persons may attend meetings for advice as required.

Timeframe

The Advisory Board requests that final recommendations by the oral health professionals be made by July 1, 2017. At that time the technical timeframe will be set.

Reports

The Working Group should give quarterly updates to the Advisory Board. Reports should also include recommendations for next steps.

Acceptance

The Collaboration for Health IT approved this charge on February 21, 2017.