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Clinical Decision Support to Reduce Opioid Prescriptions for Dental Extractions using SMART on FHIR: Implementation
D Brad Rindal1, Dhavan Prasad Pasumarthi1, Vijayakumar Thirumalai1
1HealthPartners Institute, Minneapolis, MN, United States.
JMIR Medical Informatics
|November 7, 2023
Summary
This study developed a clinical decision support (CDS) tool for dentists to personalize pain management and reduce opioid prescriptions after extractions. The EHR-integrated system provides evidence-based recommendations at the point of care.
Area of Science:
- Health Informatics
- Dental Surgery
- Clinical Decision Support Systems
Background:
- Clinical decision support (CDS) enhances evidence-based care and can optimize analgesic prescribing.
- Personalized CDS tools can improve efficiency and safety for healthcare providers.
Purpose of the Study:
- To describe the development of a CDS system for dentists to personalize pain management post-extraction.
- To evaluate the utilization of this CDS system in reducing opioid prescribing.
Main Methods:
- Developed a CDS application using SMART on FHIR, integrating EHR data (medical, dental, patient history).
- The system includes a drug interaction algorithm and access to state Prescription Monitoring Program data.
- Implemented the CDS within an EHR system for dental extraction procedures.
Main Results:
- Provider usage of the CDS varied, with some opening it for up to 87% of encounters.
- The study examined opioid prescribing patterns during the implementation period (Feb 2020 - May 2021).
Conclusions:
- The developed CDS is an EHR-embedded tool aiding dentists in personalized pain management recommendations.
- The SMART on FHIR-based CDS is adaptable, scalable, and EHR vendor-agnostic for dental settings.
Keywords:
EHRFHIRFast Healthcare Interoperability ResourcesSMARTSubstitutable Medical Applications and Reusable Technologiesalgorithmanalgesicsapplicationclinical decision support systemsdecision supportdentistrydentistsdesigndevelopmentelectronic health recordsimplementationpain managementpatient caretool
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