Cloud-based Electronic Record System for Dental Research

The Collaboration for Health IT (Collaboration) is working to effect generational change in Electronic Health Records (EHR) software in order to advance progress in clinical care, research and education within the dental profession. Through the collaborative work as clinical educators, researchers and administrators at three top dental schools (Michigan, North Carolina & Pittsburgh) along with the member-owned advanced technology community, Internet2 and the vendor, ICE Health Systems, the Collaboration has built a secure, extensive, interoperable and high performance EHR which is delivered entirely through the Cloud.
In December 2016, the University of Michigan signed an agreement that moves the process into the implementation phase, with the launch expected in 2018. By making ICE available via Internet2’s Net+ services, the collaboration is broadening the benefits to every school that partners with Internet2. A recently released a Case Study on this Collaboration can be found here.
Prof Spallek serves as member of the Advisory Board of the Collaboration and chair of the Collaboration’s Research Working Group that is actively involved in ensuring that the new EHR supports clinical research as a design principle instead of an afterthought. Thus, starting the transformation of EHR data cemeteries into sources of knowledge. Incidentally, Dr Lynn Johnson, University of Michigan, USA; Heiko Spallek, University of Sydney, Australia; Mark Genuis, ICE Health Systems, Canada; and Nigel Pitts, Kings College London, UK presented at this year’s IADR/AADR/CADR General Session & Exhibition in San Francisco, Calif., USA presenting on how EHRs can support clinical research. The presentation was titled “How Cloud Electronic Health Records (EHRs) Support Research” and the slides can be found as PDF here. The presentation made a case for a caries standard for EHRs delivered by Nigel Pitts from Kings College London, UK who is co-Chair of the ICDAS Foundation–a non-profit charity which promotes the ICCMS, a caries management system and international harmonisation of caries detection, assessment and management systems in order to improve patient outcomes. Nigel Pitts is a collaborator of Prof Wendell Evans from the University of Sydney, Faculty of Dentistry.

Resources from Toward a Diagnosis Driven Profession 2016

The Toward a Diagnosis Driven Profession conference was held just last month in conjunction with the AADR in LA, California. Stakeholders from the Government, Dental Professional Organizations, Insurance, EHR and Academic Institutions came together for a full day of presentations and brainstorming.

The major updates from this conference include:

  • The ADA and the Harvard-led team are working together to harmonize SNODENT and the DDS terminologies. All DDS terms will be fully included and represented in SNODENT. As such, SNODENT will be renamed SNODENT Dental Diagnostic System and will function as the full reference terminology for the dental profession. The DDS has been renamed SNO-DDS – to reflect the harmonization with SNODENT – and will function as the interface terminology for the dental profession.
  • Smaller subsets of SNO-DDS are also being created to cater to the specific needs of general dentists (SNO-DDSGD), oral surgeons (SNO-DDSOS) and other sub groups. Please see the SNO-DDS news page for a visual representation of how the major terminologies now interact.
  • SNODENT, SNO-DDS and its subsets are scheduled to go through the ANSI standards process in order to become a national standard by the end of 2016.
  • To access the Speakers’ PowerPoint presentations, please click here. The video presentations of the panels will be available in the near future through the AADR website. In the meantime, you may contact josh@cadmiumcd.com for questions about the availability of these videos.
  • To view/obtain a partial list of the SNO-DDS terms, please click here.
  • Although the SNO-DDS is obtainable free-of-charge, as with other major terminologies (i.e. ICD, SNOMED-CT), they can also be obtained in a ready-to-upload format from PMIC (a third-party vendor) for a small transaction fee. Click here to obtain this version.
  • If you would like to obtain regular updates about the SNO-DDS terminology and its subsets, please sign up here via our Google forms link.
  • For more information, please visit dentaldiagnosticsystem.org and ada.org.
  • Thank you again and we look forward to future collaborations!

OHPE Team at Harvard

Agenda for AADR-sponsored conference “Toward a Diagnosis Driven Profession 2016”

Researchers from Harvard School of Dental Medicine, the University of Pittsburgh School of Dental Medicine and The University of Sydney, Faculty of Dentistry have been planning with support from the IADR Global HQ staff, Practice Management Information Corporation (PMIC) and Delta Dental a conference about the adoption of standardized diagnostic terminologies (DxTMs) by dental professionals to improve oral health.

Agenda

Time Event
8:00 – 8:30 am Check In
8:30 – 8:45 am Welcome Address
Paul Krebsbach
8:45 – 9:30 am Keynote
James Cimino
9:30 – 10:30 am Session 1
Panel Discussion on Terminologies: Reference terminologies, interface terminologies – roles and how they complement each other
Vimla Patel, Dave Preble, Bedirhan Ustun, Daniella Meeker
10:30 – 11:00 am Break
11:00 – 11:45 am Session 2
EHR User Interface and use of DxTMs
Jan Horsky, John Halamka, Muhammad Walji
11:45 – 12:30 pm Session 3
Diagnostic documentation and impact on quality of patient care
Khalid Moidu, Lyle McClellan, Joel White
12:30 – 1:30 pm Lunch
1:30 – 2:15 pm Session 4
Implication of widespread diagnostic term implementation for insurance companies
Bill Kohn, Mary Lee Conicella, Adele Towers
2:45 – 4:00 pm Breakout sessions – EHR vendors, Payors, Providers, Professional Organizations, Students
4:00 – 4:15 pm Break
4:15 – 4:50 pm Closing Remarks
Lynn Mouden
4:50- 5:00 pm Summary and Post-Survey

Please join us in shaping the future of diagnostic terminology in dentistry, its usability in the EHR, and in discussing the roles of ICD, SNODENT and DDS, the diagnostic terminologies increasingly utilized by dentists globally.

WHEN
Saturday, March 19, 2016 from 8:00 AM to 5:00 PM (PDT) – Add to Calendar

WHERE
JW Marriott Platinum Ballroom C – 900 West Olympic Boulevard Los Angeles, CA 90015 – View Map

REGISTER
https://diagnosisdriven2016.eventbrite.com

Stay tuned to learn here at the DIOC blog more about the conference.

We are looking forward to see you in Los Angeles,
Elsbeth and Heiko

Elsbeth Kalenderian, DDS, MPH, PhD, Chair, Oral Health Policy and Epidemiology, Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine

Heiko Spallek, DMD, PhD, MSBA, Professor and Pro-Dean, The University of Sydney, Faculty of Dentistry

Invitation to AADR-sponsored conference “Toward a Diagnosis Driven Profession 2016”

Researchers from Harvard School of Dental Medicine and the University of Pittsburgh have been planning with support from the IADR Global HQ staff, Practice Management Information Corporation (PMIC) and Delta Dental a conference about the adoption of standardized diagnostic terminologies (DxTMs) by dental professionals to improve oral health in the United States. The conference will be held on March 19, 2016 in Los Angeles, CA, at the JW Marriott Los Angeles L.A. LIVE. in conjunction with the annual conference of the American Association for Dental Research (AADR). Many speakers have accepted the invitation: among them are numerous players in the terminology research arena, such as keynote speaker Dr. James Cimino, (Chief, Laboratory for Informatics Development, NIH Clinical Center & Prof, Biomedical Informatics, Columbia College of Physicians and Surgeons), important representatives from organized dentistry, such as Dr. Dave Prebble (Vice President, Practice Institute, American Dental Association), nationally renowned interoperability specialists for large scale hospital information technology, such as Dr. John Halamka (CIO, Beth Israel Deaconess Hospital, Co-Chair of the HIT Standards Committee, Professor of Medicine, Harvard Medical School), leading representatives of the dental insurance industry, such as Dr. Bill Kohn (Vice President, Dental Science and Policy, Delta Dental Plans Association), and opinion leaders from large group practices, such as Dr. Lyle McClellan (Director of Doctor Development, Willamette Dental Group).

Together, the participants will explore the three critical challenges to enable the widespread use of DxTMs: (1) improve clinicians’ awareness of the relationship between structured diagnostic data and the ability to monitor quality and costs in their dental practices; (2) enable the interoperability of EHR systems by using mapped DxTMs; and (3) enhance the ease of entering diagnostic terms in EHRs at the point of care.

The conference will try to achieve the following goals:

  • increase understanding of DxTMs and acceptance of their key role in improving health care outcomes,
  • explore the logistical and financial impact of implementing DxTMs on EHR vendors, payers/insurers, and providers,
  • create a working group composed of EHR vendors and informaticians tasked with developing clinician-friendly interfaces for entering diagnostic terms into EHR systems.

Please join us in shaping the future of diagnostic terminology in dentistry, its usability in the EHR, and in discussing the roles of ICD, SNODENT and DDS, the diagnostic terminologies increasingly utilized by dentists globally.

WHEN
Saturday, March 19, 2016 from 8:00 AM to 5:00 PM (PDT) – Add to Calendar

WHERE
JW Marriott Platinum Ballroom C – 900 West Olympic Boulevard Los Angeles, CA 90015 – View Map

REGISTER
https://diagnosisdriven2016.eventbrite.com

Stay tuned to learn here at the DIOC blog more about the conference.

We are looking forward to see you in Los Angeles,
Elsbeth and Heiko

Elsbeth Kalenderian, DDS, MPH, PhD, Chair, Oral Health Policy and Epidemiology, Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine

Heiko Spallek, DMD, PhD, MSBA Associate Professor, Dental Public Health Associate Dean for Faculty Affairs and Executive Director, Center for Informatics in Oral Health Translational Research School of Dental Medicine, University of Pittsburgh

JDE Article published “Social Media in the Dental School Environment”

I had the privilege to work with a group of dedicated dental educators on the topic of social media and its impact on dental education. The authors represent seven U.S. academic dental institutions who have attempted to design “these articles to serve as blueprints for educational and policy development around social media use.” [Bulletin of Dental Education].

The articles appear in the October 2015 issue of the Journal of Dental Education with the titles “Social Media in the Dental School Environment—Part A: Benefits, Challenges and Recommendations for Use,” and “Social Media in the Dental School Environment—Part B: Curricular Considerations.” Having worked with these collaborators for more than a year on the project, we attempt to show how the world of social media has changed dental education and how dental educators can foster professionalism regarding the use of social media.

Happy reading! Download the articles for free before November 10—or anytime with a JDE subscription.
Heiko Spallek, DMD, PhD, MSBA (CIS)
Associate Dean, Office of Faculty Affairs, School of Dental Medicine
Executive Director, Center for Informatics in Oral Health Translational Research
Associate Professor, Dental Public Health, School of Dental Medicine

Dental Quality Alliance (DQA) – The Measurement Challenge

The Dental Quality Alliance (DQA) hosted its 2015 conference titled The Roles of Quality Measurement at the ADA Headquarters Building in Chicago on May 1-2, 2015. The goal of the Conference is to develop dental quality ambassadors who can help lead change within the profession.

I gave a presentation titled “Dissemination and Implementation – Routine Practice“ at the Conference. Please find my slides and the references here as PDF. Several speakers during the conference raised the “lack of diagnostic coding available in dental claims limits the ability to collect and report this type of data” as identified in the 2010 NQF report “Oral Health Performance Measurement Technical Report.” This topic will be explored further during the planned dental diagnostic terminology conference titled “Toward a Diagnosis-Driven Profession” which will be held in March 2016 in Los Angeles immediately following the annual conference of the International Association for Dental Research (IADR). If you want to receive further information about the conference please contact Dr. Elsbeth Kalenderian or myself.

About the DQA
In 2008, the Centers for Medicare and Medicaid Services proposed that the American Dental Association take the lead in establishing a Dental Quality Alliance to develop performance measures for oral health care. The DQA is an organization of major stakeholders in oral health care delivery that will use a collaborative approach to develop oral health care measures.

The DQA Guidebook succinctly states why self-evaluation is an important part of dentistry: “The dental profession is taking the lead in developing mechanisms for self evaluation. Self-evaluation will ensure that dentistry as a profession can provide evidence to the community at large that its members are responsible stewards of oral health. A culture of self-evaluation is the key to fostering the best healthcare for our patients ensuring transparency of health care quality and maintaining the credibility of the dental profession.”

However, there are huge barriers in dentistry when it comes to measuring health outcomes: “There is limited knowledge of true oral health outcomes, which occurs in part because dentistry does not have a tradition of formally reporting specific diagnoses or associating such diagnoses with specific services, (ref) especially through the claims process. Further, most dental practices and dental plans lack information systems capable of capturing and transmitting the information necessary for measurement (ref). Although retrospective claims data have many

Big Data for Oral Health Knowledge: Second Installment of Resources

Dr. Elsbeth Kalenderian, Associate Professor and Chair Oral Health Policy and Epidemiology Department and Chief of Quality at the Harvard Dental Center, presented “Standardized Diagnostic Terminology for Dental Research.”

Dr. Gil Alterovitz, Assistant Professor at Harvard Medical School in the Center for Biomedical Informatics, and Director of the Biomedical Cybernetics Laboratory presented about the “SMART Platform and API for Clinical Genomic Apps.” Remember, he also suggested this video that shows an external site (Vanderbilt) creating an app using the SMART on FHIR Genomics API that my team developed.

Dr. Helen Whelton who is Dean at the University of Leeds presented ADVOCATE, the Added Value Oral Care project for developing and comparing new models for safe and efficient, prevention-oriented and patient-centered health care systems.

Dr. Michael Sullivan, updated us on the “Global Collaboration in the Cloud,” reminding us to think globally in the cloud and to consider global collaborations.

IADR-I2 Workshop 3-14-2015
Figure 1: Participants interact during the Big Data for Oral Health Knowledge and get the work that lies ahead started.

Please stay tuned for more information from the Workshop and the next steps.

Chris, Khalil, Lynn and Heiko

Christopher H. Fox, DMD, DMSc Executive Director International & American Associations for Dental Research

Khalil Yazdi, PhD CIO in Residence, Cloud Services Program Development at Internet2

Lynn Johnson, PhD Professor of Dentistry, School of Dentistry Associate Dean for Faculty Affairs and Institutional Effectiveness Clinical Professor, School of Information The University of Michigan

Heiko Spallek, DMD, PhD, MSBA Associate Professor, Dental Public Health Associate Dean for Faculty Affairs Executive Director, Center for Informatics in Oral Health Translational Research School of Dental Medicine, University of Pittsburgh

Big Data for Oral Health Knowledge; How to get the Big Answers–Successful Completion of the Workshop

After successful completion of the Workshop Big Data for Oral Health Knowledge; How to get the Big Answers that occurred in conjunction with 2015 IADR/AADR/CADR General Session & Exhibition in Boston on March 14, 2015, the participants sensed that there is still a lot of work ahead of the community.

This blog post will share a first batch of resources that were mentioned during the workshop by some of the presenters.

The organizers would also like to use the opportunity to thank all presenters as well as the participants for their time and efforts. Special thanks goes to IADR and Internet2, both have contributed substantial resources to make this event happen.

Dr. Charles Friedman’s Learning Health System (LHS): In addition to his presentation, he shared several resources that I list here: Brett James video “We Count Our Successes in Lives” for full version and here excerpts.

LHS case example Pancreatic Cancer
LHS case example Hypertension

Essential Standards to Enable Learning (ESTEL)

Department of Learning Health Sciences (DLHS)

Dr. Muhammad Walji’s presentation “Big Mouth Dental Data Repository”:

Big Mouth Data Repository:
A while ago, I interviewed Muhammad as part of our COHRI outreach efforts.

My presentation “Converting Data Cemeteries into Sources of Knowledge”:
The link that includes all the references is here.

Please stay tuned for more presentation slides and notes about the Workshop.

Chris, Khalil, Lynn and Heiko

Christopher H. Fox, DMD, DMSc Executive Director International & American Associations for Dental Research

Khalil Yazdi, PhD CIO in Residence, Cloud Services Program Development at Internet2

Lynn Johnson, PhD Professor of Dentistry, School of Dentistry Associate Dean for Faculty Affairs and Institutional Effectiveness Clinical Professor, School of Information The University of Michigan

Heiko Spallek, DMD, PhD, MSBA Associate Professor, Dental Public Health Associate Dean for Faculty Affairs Executive Director, Center for Informatics in Oral Health Translational Research School of Dental Medicine, University of Pittsburgh

Big Data for Oral Health Knowledge: SMART Platform

Dr. Gil Alterovitz, Assistant Professor at Harvard Medical School in the Center for Biomedical Informatics, will speak about the “SMART Platform and API for Clinical Genomic Apps.”

Gil is Director of the Biomedical Cybernetics Laboratory and core faculty member of the Children’s Hospital Informatics Program. He is also affiliated with the Department of Electrical Engineering and Computer Science at the Massachusetts Institute of Technology.

Gill will explain how a standard can spark innovation and expand Big Data usage. SMART accelerates medical application innovation and research removing roadblocks for developers. He suggested that we watch the video below that shows an external site (Vanderbilt) creating an app using the SMART on FHIR Genomics API that his team developed:

Please feel free to share your thoughts with us.

Chris, Khalil, Lynn and Heiko

Christopher H. Fox, DMD, DMSc Executive Director International & American Associations for Dental Research

Khalil Yazdi, PhD CIO in Residence, Cloud Services Program Development at Internet2

Lynn Johnson, PhD Professor of Dentistry, School of Dentistry Associate Dean for Faculty Affairs and Institutional Effectiveness Clinical Professor, School of Information The University of Michigan

Heiko Spallek, DMD, PhD, MSBA Associate Professor, Dental Public Health Associate Dean for Faculty Affairs Executive Director, Center for Informatics in Oral Health Translational Research School of Dental Medicine, University of Pittsburgh

Big Data for Oral Health Knowledge: BigMouth for BigData?

Dr. Muhammad Walji, Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services & Informatics at the School of Dentistry, University of Texas Health Science Center at Houston, will present about BigMouth.

BigMouth is a unique dataset that has been developed by dental schools who are part of the Consortium for Oral Health Research and Informatics (COHRI). BigMouth currently contains data from over one million patients derived from electronic health records from five dental institutions. BigMouth contains demographics, diagnoses, procedures, periodontal measurements, odontogram/tooth measurements, medical and dental histories, medications, insurance and information about the provider type (hygienist, dentist, dental student, resident). In his presentation, Muhammad will review how these institutions came together, developed a data governance framework that promotes data sharing, and some of the benefits and challenges of using EHR data for secondary research.

A while ago, I interviewed him as part of our COHRI outreach efforts: http://vimeo.com/89624410

Please feel free to share your thoughts with us.

Chris, Khalil, Lynn and Heiko

Christopher H. Fox, DMD, DMSc Executive Director International & American Associations for Dental Research

Khalil Yazdi, PhD CIO in Residence, Cloud Services Program Development at Internet2

Lynn Johnson, PhD Professor of Dentistry, School of Dentistry Associate Dean for Faculty Affairs and Institutional Effectiveness Clinical Professor, School of Information The University of Michigan

Heiko Spallek, DMD, PhD, MSBA Associate Professor, Dental Public Health Associate Dean for Faculty Affairs Executive Director, Center for Informatics in Oral Health Translational Research School of Dental Medicine, University of Pittsburgh