Oral Health

Wisconsin State Dental Director Dunkel Shares How the Pandemic Has Affected Dentistry

An article in the December issue of the American Dental Association ADANews discussed how the pandemic has affected dentistry from the perspective of five state dental directors. Russell Dunkel, DDS, the Wisconsin State Dental Director, was one of the people interviewed for the article. In the ADA article, Dr. Dunkel talked about the history of dentistry being siloed from other health care entities and the need to break down the barriers and work together.

WCHQ staff had the opportunity to meet with Dr. Dunkel to explore the topic further. Speaking to WCHQ’s Jen Koberstein, Dr. Dunkel noted that the pandemic created many challenges, but one of the major ones was that patients were not able to or hesitant to access dental services for several months in 2020.

“When patients are not coming in for regular preventive visits, their issues became urgent and some progress to require immediate attention,” according to Dr. Dunkel. “This can be a stressful and oftentimes painful situation for the patients as they may seek care in a health system’s emergency department. This care can be expensive and emergency departments are not always equipped to treat dental pain.”

While patient volumes are still lower than normal, dental offices are seeing patients return for routine care. This is important, according to Dr. Dunkel, as it demonstrates that people in the community have confidence that their dentist is controlling the environment in accordance with evidence-based practices that reduce the potential for exposure to COVID.

The pandemic has triggered some practice changes around infection prevention and protecting patients and staff. Prior to the pandemic, dental offices were discussing increasing the use of personal protective equipment. Those modifications have now been made, along with how patients check in for an appointment, which will likely continue post-pandemic.

Dr. Dunkel said he is currently working with the Wisconsin Department of Health Services (DHS) and the Department of Safety and Professional Services (DSPS) on the issue of whether Wisconsin dentists can be one of the professions approved to administer the COVID-19 vaccine. He also said that dentists are on Group 1A for receiving the vaccine.

“The pandemic has changed the relationship between dental and medical professionals by highlighting the importance of the dental and whole-body connection,” Dr. Dunkel said. “That said, the reimbursement system should also recognize greater equity between medical and dental services.”

Some of the issues involved in coordinating medical and dental care in the past are being addressed through technology, such as the ability to share records, and a better understanding of the connection between oral and physical health.

The pandemic has accelerated the adoption of new protocols and will forge new relationships among providers. Dunkel concludes, “As we continue to navigate the challenges the pandemic heaps upon us, it’s important to remember, we’re a TEAM – Together Everyone Accomplishes More.”

Chronic Disease

This year WCHQ’s chronic disease work will continue with a grant from the Wisconsin Department of Health Services, Division of Public Health. The work under this grant aligns with WCHQ’s members’ priorities. They include diabetes blood sugar, A1c control and hypertension blood pressure control.

The Chronic Disease Learning Collaborative will continue to meet to share and discuss best practices and resources to improve chronic disease health outcomes. A new resource released by the American Heart Association and the American Medical Association is a compilation of evidence-based activities health systems can implement to help patients achieve better blood pressure control. The resource can be found here.

The format of the Chronic Disease Learning Collaborative will make a slight shift starting in July. WCHQ will be creating two new workgroups, one on diabetes and the other on hypertension. Both workgroups will have overarching themes of team-based care and reducing disparities. Separately, the workgroups will convene quarterly between July 2021 and June 2022 to discuss diabetes or hypertension improvement strategies. Each health system participating in one or both workgroups will create their own improvement goal to be achieved by the end of June 2022. The larger Chronic Disease Learning Collaborative will convene at least twice in that timeframe to discuss chronic disease resources, education, and update the diabetes and hypertension toolkits.

To learn more about this group or to join the Chronic Disease Learning Collaborative or either of the workgroups, contact Sarah Sky.

Behavioral Health

The Behavioral Health Improvement Team met in early January to set the WCHQ health system goals for 2021. The WCHQ Improvement Advisory Committee (previously the Quality Planning Committee) recommended a performance goal of 79% for health systems’ Screening for Clinical Depression measure. During the last reporting period, the WCHQ rate of screening for clinical depression was 75.68%. The Behavioral Health Improvement Team will work with members to identify ways to achieve this goal in 2021. Team members will also focus on depression response and remission.

The Improvement Team will also address access to care issues, which include telehealth and integrated behavioral health. Members are particularly interested in ensuring that telehealth is used appropriately, and that protocols are developed to help determine who can benefit from telehealth services and who should be seen in person at the clinic. Members also requested information on the foundational practices of suicide prevention. Suicide prevention has been a long-standing issue in Wisconsin and is even more important as the effects of the pandemic exacerbate this issue.

If you are interested in joining the Behavioral Health Improvement Team, contact Jen Koberstein.

Adolescent and Child Health

The Adolescent and Child Health Improvement Team is excited to continue its informational and in-depth meetings in 2021. WCHQ has a new scope of work with the Wisconsin Department of Health Services, under the Maternal and Child Health grant, which funds the Improvement Team’s work. The goal is to improve the quality of care and health outcomes for children and adolescents in Wisconsin.

This coming year, members will review current and new measures, particularly those that align with The Centers for Medicare & Medicaid Services’ (CMS) Child Health Core Set. The team will also monitor and discuss performance data to achieve statewide goals, which include developmental screenings, adolescent well visits and immunization status. One of the greatest benefits for members by participating in this year’s Adolescent and Child Health Improvement Team will be sharing best practices to improve adolescent and child health outcomes. This sharing will be encouraged from member health systems, partners and statewide experts. Tools and resources will then be translatable to day-to-day practices within individual health systems.

WCHQ is actively recruiting members to join this Improvement Team. To join or to learn more, contact Sarah Sky.