Li Shuning, Williams Karmen S, Medam Jayanth Kumar, Patel Jay S, Gonzalez Theresa, Thyvalikakath Thankam P
Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN, United States.
Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, United States.
Front Digit Health. 2022 May 12;4:838538. doi: 10.3389/fdgth.2022.838538. eCollection 2022.
Patient-reported medical histories and medical consults are primary approaches to obtaining patients' medical histories in dental settings. While patient-reported medical histories are reported to have inconsistencies, sparse information exists regarding the completeness of medical providers' responses to dental providers' medical consults. This study examined records from a predoctoral dental student clinic to determine the reasons for medical consults; the medical information requested, the completeness of returned responses, and the time taken to receive answers for medical consult requests.
A random sample of 240 medical consult requests for 179 distinct patients were selected from patient encounters between 1 January 2015 and 31 December 2017. Descriptive statistics and summaries were calculated to determine the reasons for the consult, the type of information requested and returned, and the time interval for each consult.
The top two reasons for medical consults were to obtain more information (46.1%) and seek medical approval to proceed with treatment (30.3%). Laboratory and diagnostic reports (56.3%), recommendations/medical clearances (39.6%), medication information (38.3%), and current medical conditions (19.2%) were the frequent requests. However, medical providers responded fewer times to dental providers' laboratory and diagnostic report requests (41.3%), recommendations/medical clearances (19.2%), and current medical conditions (13.3%). While 86% of consults were returned in 30 days and 14% were completed after 30 days.
The primary reasons for dental providers' medical consults are to obtain patient information and seek recommendations for dental care. Laboratory/diagnostic reports, current medical conditions, medication history, or modifications constituted the frequently requested information. Precautions for dental procedures, antibiotic prophylaxis, and contraindications included reasons to seek medical providers' recommendations. The results also highlight the challenges they experience, such as requiring multiple attempts to contact medical providers, the incompleteness of information shared, and the delays experienced in completing at least 25% of the consults.
The study results call attention to the importance of interdisciplinary care to provide optimum dental care and the necessity to establish systems such as integrated electronic dental record-electronic health record systems and health information exchanges to improve information sharing and communication between dental and medical providers.
患者自述的病史和医疗咨询是在牙科环境中获取患者病史的主要途径。虽然据报道患者自述的病史存在不一致之处，但关于医疗服务提供者对牙科服务提供者的医疗咨询的回复完整性的信息却很少。本研究检查了一所博士前牙科学生诊所的记录，以确定医疗咨询的原因、所请求的医疗信息、返回回复的完整性以及收到医疗咨询请求答案所需的时间。
从2015年1月1日至2017年12月31日期间的患者就诊记录中随机抽取179名不同患者的240份医疗咨询请求。计算描述性统计数据和摘要，以确定咨询的原因、所请求和返回的信息类型以及每次咨询的时间间隔。
医疗咨询的前两大原因是获取更多信息（46.1%）和寻求医疗批准以进行治疗（30.3%）。实验室和诊断报告（56.3%）、建议/医疗许可（39.6%）、用药信息（38.3%）和当前医疗状况（19.2%）是常见的请求。然而，医疗服务提供者对牙科服务提供者的实验室和诊断报告请求（41.3%）、建议/医疗许可（19.2%）和当前医疗状况（13.3%）的回复次数较少。虽然86%的咨询在30天内得到回复，14%在30天后完成。
牙科服务提供者进行医疗咨询的主要原因是获取患者信息并寻求牙科护理建议。实验室/诊断报告、当前医疗状况、用药史或调整构成了常见的请求信息。牙科手术的预防措施、抗生素预防和禁忌症是寻求医疗服务提供者建议的原因。结果还凸显了他们所面临的挑战，例如需要多次尝试联系医疗服务提供者、所共享信息的不完整性以及至少25%的咨询出现延迟。
研究结果提醒人们注意跨学科护理对于提供最佳牙科护理的重要性，以及建立诸如集成电子牙科记录 - 电子健康记录系统和健康信息交换等系统以改善牙科和医疗服务提供者之间的信息共享和沟通的必要性。
