• Share
  • Add this to...
  • Favorites
  • Del.icio.us
  • Digg
  • Facebook
  • Google Bookmarks
  • Yahoo MyWeb
• 
• 
• 
• 

What are HRSA and HHS Strategic Priorities regarding oral health and how can health IT help address these priorities?

Both HRSA and HHS have current Strategic Priorities relating to oral health which emphasize the need for oral health to be included in the patient-centered medical home. Goal 1 of the HRSA Strategic Plan is to improve access to quality health care and services, and includes a sub-goal of expanding oral health services and integrating them into primary care settings. In addition, Healthy People 2020 has added a new objective to “use health communication strategies and health information technology (IT) to improve population health outcomes and health care quality, and to achieve health equity.”

HHS Strategic Goal 1 is to Transform Health Care. Objective E within this Goal focuses on quality and culturally competent care for vulnerable populations, and includes as one component an HHS-wide Oral Health Initiative for which “HHS will promote policies to integrate oral health into primary care, including prevention and improved health literacy.” Objective E specifically notes that “improved availability of oral health services, including disease prevention, treatment, and health promotion and education should be promoted for poor and underserved populations as well as for the population at large.” The Initiative's key message is that oral health is integral to overall health, and seeks to create programs that will:

• Emphasize oral health promotion/disease prevention;
• Increase access to care;
• Enhance oral health workforce; and
• Eliminate oral health disparities.

An April 2011 report from the Institute of Medicine (IOM) outlines an additional HHS strategy to improve oral health. This strategy is called the New Oral Health Initiative and is based on the following ten principles:

• Establish high-level accountability;
• Emphasize disease prevention and oral health promotion;
• Improve oral health literacy and cultural competence;
• Reduce oral health disparities;
• Explore new models for payment and delivery of care;
• Enhance the role of nondental health care professionals;
• Expand oral health research and improve data collection;
• Promote collaboration among private and public stakeholders;
• Measure progress toward short-term and long-term goals and objectives; and
• Advance the goals and objectives of Healthy People 2020.

In July 2011, the IOM released another report on oral health, this time focused on Improving Access to Oral Health Care for Vulnerable and Underserved Populations. Specifically, this report seeks to provide guidance on how oral health care in the safety net can be addressed throughout the nation.

Health IT will play a critical role in addressing HRSA and HHS Strategic Priorities. One of the major Principles listed within the HRSA Strategic Plan is to “harness technology to improve health” while another focuses on integrated approaches to meet complex needs of the populations served. These Principles are particularly relevant when it comes to implementing health IT in oral health within each of HRSA’s Strategic Goals. The specific sub-goals for which health IT may be particularly relevant in addressing HRSA’s Oral Health Strategic Priorities are discussed below:

• Improve Access to Quality Health Care and Services; Expand oral health and behavioral health services and integrate into primary care settings: Health IT can assist a provider implement a medical home for their patients and assure that the medical home includes oral health and behavioral health services. EHRs can be implemented to allow providers to share patient information, provide access to patient records, and therefore serve as a tool to assist with the integration of oral and behavioral services into primary care settings.
• Strengthen the Health Workforce; Support the development of interdisciplinary health teams to improve the efficiency and effectiveness of care: Interdisciplinary health teams including oral health providers are an important component of efficient and effective care. EHRs can be used to facilitate communication among providers.
• Build Healthy Communities; Link people to services and supports from other sectors that contribute to good health and wellbeing: Health IT can be used to link providers to each other through the use of integrated EHR systems, link patients to their providers through secure messaging and other technologies, and facilitate communication between various patients, providers and services through each.
• Improve Health Equity; Leverage our programs and policies to further integrate services and address the social determinants of health: Oral health disparities are strongly affected by social determinants of health and other factors. Safe, quality, effective oral health care can be positively impacted through the use of health IT to further integrate the services needed by vulnerable populations and ensure that individuals are treated for all components of their health and wellness.  

The HHS Strategic Goals also emphasize the importance of using health information technology to improve health care. Goal 1, Objective F focuses on promoting the adoption and Meaningful Use of health IT. HHS notes that our health IT infrastructure facilitates the flow of “data to improve healthcare quality, reduce unnecessary healthcare costs, decrease paperwork, expand access to affordable care, improve population health, and support reformed payment structures,” which is at the center of the HHS strategy to changing our health care system. HITECH has provided billions of dollars in funding to promote the adoption and Meaningful Use of health information technology systems through programs such as the Regional Extension Centers, health information exchanges, Beacon Communities, the Medicaid and Medicare EHR Incentive Programs and the development of standards for health information technology. HHS notes that “the rapid “wiring” of American health care, which will take place under the law, will do more than simply digitize paper-based work. It will facilitate new means of improving the quality, efficiency, and patient-centeredness of care.”  Throughout this process, HHS is committed to protecting the privacy and security of personal health information, and to the use of fair information practice principles (FIPPs), as adoption of health IT grows.

Goal 1, Objective E, focuses specifically on the HHS Oral Health Initiative as one component of a strategy for improved care for vulnerable populations. According to the 2010 press release, “through the initiative, the Department is increasing support for and expanding its emphasis on access to oral health care and the effective delivery of services to underserved populations.” Some of this expanded emphasis on access and delivery of services will be pursued through health IT. Other programs throughout HHS also focus on the use of health information technology to promote oral health care, including  the Centers for Medicare and Medicaid Services’ (CMS) electronic prescribing program, and the Indian Health Service’s (IHS) electronic health records system. The IHS system is continually evolving and is one of a very small number of EHR systems that contain electronic dental record components. This system can serve as a relevant example of how to use health IT in oral health as well as enhance linkages with primary care.