DCMH West Elk Clinic in Hotchkiss Participates in Medical Oral Expanded Care

The Delta County Memorial Hospital West Elk Clinic in Hotchkiss is making strides to improve access to oral health in the North Fork through participation in the Medical Oral Expanded Care (MORE) Care Program.

The DCMH West Elk Clinic has been working on this health initiative since May of this year. Providers and clinical staff who are actively participating in the second cohort of the MORE Care Program through the Colorado Rural Health Center include: Dr. Marie Matthews, Meisha Parham, CMA, Phyllis Pene and Clinic Manager Rae Sanchez.

Since this program has been started the West Elk Clinic has expanded well child checks to include an oral health assessment, oral health goals and dental varnish if deemed appropriate. During the six months since initiating the MORE Care program, the West Elk Clinic in Hotchkiss has improved statistics from 0% to about 55%.

The MORE Care Process
Using a Breakthrough Series Collaborative model, MORE Care works in selected rural communities to establish inter-professional oral health networks (IPOHNs) to integrate and coordinate person-centered oral health care in rural communities.

The MORE Care project team focuses first on assisting the rural medical practices in developing the skills and adopting the processes necessary to integrate oral health services into their patient well visits. Medical practices then work with an identified dental practice to develop a reliable and efficient referral and communication process.

What is MORE Care?
MORE Care (Medical Oral Expanded Care) is an initiative of the DentaQuest Institute (DQI) with an aim of providing primary and secondary preventive oral health services in primary care medical offices to underserved populations, as well as testing optimal patient-centered referral systems between primary care and dental care teams.

In the MORE Care model at the medical level there is operational integration of oral health care: Oral health evaluation includes heads, ears, eyes, nose, oral cavity and throat. From the dental side of this model is the operational integration of primary care referral characteristics includes referral acceptance verified, clinical summaries completed for referral communication, referral dental care completion verified. Cooperative tasks shared by both the medical and dental arenas are to : 1) implement a bi-directional referral system (medical-dental referral coordination); 2) initiate, develop and improve inter-professional communication protocols and processes; 3) identify areas of clinical and professional overlap to optimize time and care delivery.

Addressing Rural Disparities through MORE Care
Millions of Americans lack access to basic oral health care. Children and adults living in rural communities, however, face additional challenges including higher rates of poverty, dental provider shortages, and a lack of dependable transportation.

Although rural primary care providers have the potential to play a pivotal role in the oral health of their patients, several key elements needed for successful integration of oral health into primary care are currently lacking, including:
*Medical education training on oral health competencies needed for primary care providers to provide primary and secondary oral health prevention
*A sustainable, systemic model for collaborative practice with dental providers
*Practice systems that support oral health care delivery and coordination with dental providers

DQI is partnering with state offices of rural health to begin testing strategies to overcome these barriers and develop the systems in the primary care practices to support the delivery of oral health care as well as develop infrastructure to create a dental delivery system for patients who need dental treatment of disease.