Health Care Integration: Improving Oral Health Through Systemic Change

Interprofessional Healthcare Delivery Models

At Still University of Health Sciences “Arizona School of Dentistry & Oral Health (ATSU-ASDOH) requests funding to pilot a cost-effective and viable solution to healthcare challenges by embedding a faculty physician assistant (PA) up to 1 day/week within the Advanced Care Clinic (ACC). The PA will work directly with patients and supervise Arizona School of Health Sciences (ASHS) campus-based PA students, thereby expanding the PA’s reach and the number of patients seen. The PA providers and students will work alongside ASDOH students and residents to provide diabetes screenings, exams, lifestyle counseling, health education, laboratory testing, medication management, required prescriptions, evaluations for sedation/general anesthesia, and any additional needed care. In addition to working collaboratively with the dental team, PA providers will also have access to private exam rooms for clinical use and will document patient encounters in ASDOH’s cloud-based electronic patient health records, creating shared access to care.

Embedding healthcare professionals into a non-traditional setting is a growing trend in interprofessional healthcare delivery models. For example, dental hygienists are now providing preventive services in pediatric medical offices and community health settings throughout the country. It is less common, however, to see medical providers embedded within dental clinics. Barriers to integration may include a lack of knowledge/capability to schedule and bill for medical services in dental clinics. The proposed innovative approach to embedding primary healthcare professionals in a non-traditional setting has the potential to become a national model for improving oral health through systemic change. This model will create an opportunity to assess the number and type of patient encounters and related reimbursement needed for successful implementation in practice. The ACC has partnered with Triton Medical Solutions for total revenue management. Triton currently serves as the ACC’s billing team and has developed replicable best practices to address medical reimbursement. Embedding medical providers is based on the concept of the quadruple aim in health care: better health outcomes, reduced cost, and improved patient and provider satisfaction.

Dental and PA providers will gain support via opportunities to share essential health messaging while caring for mutual patients. Peer-assisted learning between PA students and dental students increases their knowledge of issues about both oral and general health.

Trackable metrics for this project include but are not limited to, the number of patients: 1) seen by a PA in the dental clinic, 2) who complete laboratory tests after seeing a PA in the dental clinic, 3) who can proceed with dental care as a result of seeing a PA, 4) who are evaluated for sedation/general anesthesia, and 5) the number and type of medical services provided and reimbursed (cost analysis). In addition, patient satisfaction and provider satisfaction will be evaluated using validated survey instruments.