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A Clinical Decision Support System Improves the Appropriate Placement of Dental Sealants
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND
Dental sealants are effective for the prevention of caries in children at elevated risk levels, and increasing the proportion of children and adolescents who have dental sealants on 1 or more molars is a Healthy People 2030 objective. Electronic health record (EHR)-based clinical decision support systems (CDSSs) have the ability to improve patient care. A dental quality measure related to dental sealant placement for children at elevated risk of caries was targeted for improvement using a CDSS.
METHODS
A validated dental quality measure was adapted to assess a patient's need for dental sealant placement. A CDSS was implemented to advise care team members whether a child was at elevated risk of developing caries and had sealant-eligible first or second molars. Data on dental sealant placement at examination visits during a 5-year period were analyzed, including 32 months before CDSS implementation and 28 months after CDSS implementation.
RESULTS
From January 1, 2018, through December 31, 2022, the authors assessed 59,047 examination visits for children at elevated risk of developing caries and with sealant-eligible teeth. With the implementation of a CDSS and training to support the clinical care team members in September 2020, the appropriate placement of dental sealants at examination visits increased from 27% through 60% (P < .00001).
CONCLUSIONS
Integration of a CDSS into the EHR as part of a quality improvement program was effective in increasing the delivery of sealants in eligible first and second molars of children aged 5 through 15 years and considered at high risk of developing caries.
PRACTICAL IMPLICATIONS
An EHR-based CDSS can be implemented to improve standardization and provide timely and appropriate patient care in dental practices.
Additional Info
Improvements in appropriate placement of dental sealants after implementation of a clinical decision support system
J Am Dent Assoc 2024 Apr 06;[EPub Ahead of Print], J Mullins, R Brandon, N Skourtes, E Kalenderian, M WaljiFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
There are many reasons for slow knowledge transfer, but regardless of the explanation, having "guidance" at the point of care, delivered through the electronic dental record, ensures the information is presented in a timely manner to the clinician at the point of care. This article confirmed that information in the form of alerts, reminders and identification of specific patient treatment opportunities is beneficial.
Clinical decision support systems (CDSS) are in wide use throughout medicine and they have improved the speed of knowledge transfer and ultimately improved care. The emergence of artificial intelligence systems in healthcare will hasten the creation of more and more diagnostic and treatment information, which in turn, will become the basis for CDSS guidance. CDSS presents a win, win opportunity. The patient wins with better care and the clinician wins by being the caregiver of warranted treatment in a timely manner.