Bowen Health Workforce Newsletter

News

Oral Health Disparities: An Important Health Issue

Oral health is integral to overall health and quality of life. The human mouth is the portal for life- sustaining air, water and food. It is also a primary mechanism for human communication, contributing to psychological, social and emotional health.

Access to care is among the factors contributing to oral health disparities. Health care services focused on promoting, maintaining, attaining and restoring oral health may be grouped into two types: oral healthcare and dental care. Oral health is an aspect of overall health and may be broadly defined as a state of being free from pain, diseases and disorders affecting the oral cavity. Oral healthcare (or the “care” of oral health) is a part of the overall patient care and includes activities such as risk assessment, health promotion and education and referral for dental care services. Dental care is a critical component of oral health care which includes health services specifically focused on maintaining, attaining or restoring oral health. Whereas oral health care is broadly focused on identifying need and activating and engaging patients, dental care is specifically focused on the delivery of intervention and restoration. Oral healthcare is within the domain of all healthcare team members. Dental care, on the other hand, requires specific knowledge, training and, in some instances, licensure or certification. Dental care services are provided by health care team members who have completed the appropriate training and possess the required skills. The bottom-line: oral health care is everybody’s business, whereas dental care is the responsibility of specific team members.

In 2011, the Institute of Medicine (IOM) published a report, Improving Access to Oral Health Care for Vulnerable and Underserved Populations, which suggested that collaborative and multidisciplinary healthcare teams working across the health care system in various settings were needed to effectively address oral health in America. Today, health care organizations are turning to innovative health care delivery models to improve access to oral health care and reduce these oral health disparities.

Join Drs. Hannah Maxey, PhD, and Connor Norwood, PhD, MHA, this fall as they present a broad overview of the various strategies health care organizations have employed for oral health integration. This webinar will specifically focus on recently published research that examines how Federally Qualified Health Centers (FQHCs) and primary care physicians have played a central role in oral health integration efforts throughout the country. This webinar will be delivered in collaboration with the Center for Interdisciplinary Health Workforce Studies at Montana State University. Stay tuned for more details regarding this event.

Research: Exploring the Roles of Primary Care Physicians in Oral Health

Health care providers know oral health is an aspect of overall health. Regardless of this fact, very few medical practices have oral health care (including risk assessment, health promotion and education and dental referral) incorporated into their primary care services. Historically there has been a separation of medical and dental care delivery systems which has not valued oral health as part of overall health. The national movement to strengthen comprehensive primary care services for the population includes integration of oral health and primary care.

Although primary care physicians recognize the need for oral health care among their patients, many believe there is a lack of requisite training for integration. Bowen’s recent article ‘Primary Care Physician Roles in Health Centers with Oral Health Care Units’ published in the July/August 2017 issue of Journal of the American Board of Family Medicine (doi:10.3122/jabfm.2017.04.170106) explores roles of primary care physicians in integrating oral health care into their practice. These critical roles are champion, collaborator and interprofessional team member. While focused on health center practices, the findings are relevant for primary care physicians practicing in settings across health systems.

Resources

The Bowen Health Workforce Information Portal (HWIP) was developed to allow stakeholders the ability to readily discover, use and share health workforce information. Additionally, HWIP provides reliable and timely data on Indiana’s health workforce in order to support data-driven policy development and to inform decisions at both the state and local levels. The HWIP is maintained by the Bowen Center for Health Workforce Research & Policy at the Indiana University School of Medicine in collaboration with the state of Indiana.

Between May 2016 and July 2016, the Bowen Center conducted an assessment of stakeholders’ data access and health workforce mapping needs. Based on needs identified by stakeholders, a data portal from which customized health workforce information would be accessed was prioritized. Technical and functional requirements for the HWIP were established with the assistance of an advisory committee. These executive decision makers from key state agencies provided ongoing input on technical and functional requirements, wireframes and graphic design specifications. Three major functions were defined during this process: an Interactive Workforce Mapper, a Map Gallery and a Data Download application. These functional components will provide a solid foundation from which future expansion may occur in order to provide Indiana with timely and relevant data to inform health workforce policy and planning. Start discovering, using and sharing health workforce data now at bowenportal.org.

Evaluation: Moving the Needle - Strides in Health Workforce Policy

The Bowen Center is honored to provide support and technical expertise to the Governor’s Health Workforce Council (Council), whose mission is to support and advance health workforce-related policies. The Council created two task forces to target key workforce issues in Indiana: 1) Mental and Behavioral Health Workforce and 2) Health Workforce Education/Pipeline. Each task force resulted in a number of recommendations which were adopted by the Council and recommended to the Governor. Many of these directly resulted in policy change:

  • A burdensome licensure process may hinder qualified behavioral health professionals from obtaining a license to deliver mental health services. The enactment of Senate Enrolled Act 59 allows for mental health practitioners with a license in another state to more easily obtain an Indiana license.
  • Telemedicine allows electronic health care delivery, particularly for individuals who may experience barriers to accessing care. House Enrolled Act 1337 removed restrictions which previously limited the delivery of mental health and addiction services.
  • The lack of bridge programs for certified nurse aides (CNAs) hindered educational advancement of CNAs to higher nursing education. Ivy Tech Community College created a bridge program to provide college credit to CNAs pursuing additional education.

Team Member Spotlight

The Bowen Center congratulates Dr. Connor W. Norwood, on the successful completion of his PhD and dissertation defense. His dissertation titled, “Nurse Practitioner Patient Care Patterns & Practice Characteristics: Understanding the Role of State Scope-of-Practice Policies” examined the impact of changes to state scope-of-practice policies on various measure of access to primary care. Dr. Norwood has served as the assistant director of the Bowen Center and research associate in the Indiana University School of Medicine, Department of Family Medicine since July of 2015.

“Research is to see what everybody else has seen, and to think what nobody else has thought.”  – Albert Szent-Gyorgyi

The Results Are In! Impacting Access to Care

Having comprehensive health workforce data is crucial for identifying communities in Indiana with limited access to health care. The Bowen Center is currently working on the Indiana Primary Care Needs Assessment (PCNA), an ongoing geographic evaluation of Indiana’s health workforce which informs Indiana State Office of Primary Care activities.

First, all primary care physicians, psychiatrists and general dentists actively practicing in Indiana are identified and their practice characteristics are verified. The verified provider data are then uploaded to an online data management system which is used to prepare federal health professional shortage area (HPSA) designation applications. Using this information, the Bowen Center identifies areas in Indiana having the greatest shortage of health professionals.

During the 2016-2017 fiscal year, 5,007 primary care physicians, 408 psychiatrists and 3,097 dentists were identified as actively practicing in Indiana. Using the verified provider data, 25 HPSA applications have been prepared and submitted. Thirteen (13) applications have been approved and 12 are under review. To date, nearly one-quarter (24.8%) of Hoosiers reside in a HPSA. Compared to previous years, Indiana has acquired a greater number of designations during this fiscal year. Thus, the efforts of the PCNA project has led to more communities receiving the resources needed to improve access to health care.

A Word From Our Partners

The Bowen Center for Health Workforce Research & Policy, in collaboration with the Indiana Area Health Education Centers Network, recently hosted its second annual conference: the 2017 Indiana Health Workforce Collaborative. This year’s event brought together more than 160 highly-engaged stakeholders representing various sectors and perspectives. The Collaborative provided attendees with the latest updates on key health workforce issues at the national- and state-level and served as a platform for united health workforce policy discussions.

The Collaborative was honored to have Indiana’s Lieutenant Governor Suzanne Crouch provide opening remarks to commence the day’s events. A distinguished plenary panel, which included recently nominated for U.S. Surgeon General Dr. Jerome M. Adams, began the morning session by discussing the Quadruple Aim which integrates workforce issues into the traditional triple aim. The Bowen Center also provided a demonstration of the new online Bowen Health Workforce Information Portal (HWIP) data dashboard.

Events throughout the day included interactive roundtable lunch discussions focused on education, practice and policy. These roundtable sessions provided attendees an opportunity to network and engage in cross-sector discussions. The keynote address, was given by Dr. Barbara Brandt, director of the National Center for Interprofessional Practice and Education. The afternoon breakout sessions explored the implications Governor Eric Holcomb’s pillars (Cultivate a strong and diverse economy; Create a 20-year plan to fund roads and bridges; Develop a 21st Century skilled and ready workforce; Attack the drug epidemic; Deliver great government service) might have for the health workforce.

Evaluation results proved the event to be extremely well received, with highlights including outstanding speakers, informative sessions, ample networking opportunities and the HWIP demonstration. Slides from the event can be found at: scholarworks.iupui.edu/handle/1805/5420.

How Can We Assist You

Looking for data or technical assistance? The Bowen Center for Health Workforce Research & Policy provides stakeholders with critical information on Indiana’s health workforce that can be used for evaluation, original research and reporting. Contact us today to discuss how we may assist you!

Give Now

Philanthropic support helps to advance research in the Bowen Center for Health Workforce Research & Policy and the Department of Family Medicine that will benefit Hoosiers throughout Indiana. Your gift also supports the training of the next generation of physicians who benefit from the expertise of our dedicated faculty. For additional information about the various ways to give, please contact Joshua Lee at 317.278.2124. Gifts to the Bowen Center for Health Workforce Research & Policy and the Department of Family Medicine can be made online by clicking the “Gift Giving” tab on the top of the page at family.medicine.iu.edu/hws. Thank you for making a difference!