Earlier this year, Sound Family Medicine partnered with Qualis Health to pilot a new care management strategy to provide more comprehensive care for our diabetic patients. In partnership with Dr. Marc Aversa, Dr. Edward Pullen, Dr. Garrett Jeffery and our Sunrise location, we found that integrating oral health into our diabetic care planning had a significant impact on the health of our diabetic patients. This change in our approach not only proved to provide better care for our patients but was recognized in a recent case study Qualis Health produced for other health practices to consider.
Below is a transcript and link to the video published last month featuring interviews with Dr. Jeffery, his medical assistant Josh Schneck and quality improvement manager Beth Rose. Sound Family Medicine is very proud of this innovative and enthusiastic team!
If you have questions about your oral health as part of your diabetes care plan, we encourage you to talk to your Sound Family Medicine provider. They can help you incorporate this into your health plan and even refer you to a local dentist.
Oral Health Interview Transcript
Jeff Hummel, medical director at Qualis Health: Hi, I’m Jeff Hummel. I’m the medical director at Qualis Health for healthcare informatics. Oral health is a major unmet need. Oral health impacts patients’ quality of life, their ability to find work, and it adds to the total cost of healthcare. At the same time, primary care has the skills to manage oral health. There’s a proven action plan for integrating oral health into primary care. Let’s see how one practice does it.
Dr. Garrett Jeffery: We serve a wide demographic of patients. We have a big population of private insurers, as well as Medicaid, state, and Medicare services also. So integrating oral healthcare was a very exciting initiative for our practice to take on. It’s very representative of the culture here at Sound Family Medicine. I like to think of our leadership and our providers as cutting edge innovators. We started with one provider team, and we’ve moved on, I believe we have close to ten providers now that have adopted this workflow. We’re very close to rolling it out organization-wide.
Dr. Garrett Jeffery: Some of the simple questions that we really capitalize on are, what kind of water source are you using, are you getting fluoride, are you having any symptoms such as pain, bleeding from your gums, dry mouth? And when have you seen your dentist? And some of those trigger a response. When we look into the mouth, we’re looking for things such as cavities, exposed roots, are they having spots of thinning of the enamels. Sometimes you can see that on the exam if it’s very obvious.
Dr. Garrett Jeffery: To integrate oral health, it’s actually been much easier than I initially perceived it. We have an excellent team of medical assistants that, from the ground up, as soon as the patient hits the door, they’re addressing these as part of their intake into the exam room.
Josh Schneck, medical assistant: I feel like my role as the MA has been particularly important because we’re the first line of screening to make sure that the oral health screening gets done. We have to ask all the questions, appropriate questionnaires (dry mouth, bleeding), ask them if they have any current cavities that they’re aware of, to make sure that that gets addressed at their office visit with the provider.
Beth Rose, quality improvement manager: It’s really important to make sure that you put tools in place for your providers to take on this additional work. That’s one of the challenges in family practice is that our providers are taking on more and more work, and there aren’t any more hours in the day to do that. So providing tools to shorten those visits, to streamline those workflows is critical in this.
Dr. Garret Jeffery: Having the medical record set up to do this made the work in the patient room very achievable.
Beth Rose: Our data shows that we started out with a small percentage of our population at the beginning of the project, and as we adopted and more providers took on the workflow, we saw that trend increase steadily over time.
Dr. Garret Jeffery: Since starting with the project, I have seen a tremendous change in working with my diabetic patients and actually realizing this is an important part of their care. Getting them in to see their dentist, they’re seeing benefits. And actually seeing that being a part of their care tells me that I’m doing a better job at encompassing their whole health, as opposed to just their diabetes.
Josh Schneck: A lot of our patients, you know, they’ve never been asked that question before, so it was kind of new to them. And then that really sparked the interest in them, saying, wow, I’ve never seen the dentist in the last year or so, maybe I should go get this checked.
Dr. Garret Jeffery: The learning curve, although it may feel a little different up front, is really something that hasn’t affected my time with my patients in a negative way. In response to any colleagues that are interested in, or maybe thinking about doing this, I would say that my transition from not doing it in the prior experience to doing it now at Sound Family Medicine has been a very easy transition, and I feel like the benefit is very rewarding, particularly influencing the futures of these patients. I think that the return on investment, so to speak, is phenomenal.
Jeff Hummel: The framework for oral health integration that this group used was developed at Qualis Health, and has been published as an implementation guide and toolset. These resources are available at no cost if your practice would like to try this.