CDM Professor Develops Clinical Decision Tool for HIV Testing in Dental Settings
The Columbia University College of Dental Medicine has been at the forefront of medical dental integration in electronic health records since 2020, when the College began using the Epic Electronic Health Record in concert with Columbia University Irving Medical Center. A single EHR for each patient means that patients and providers have a comprehensive view of patient health in a record that treats oral health as an element of systemic health. CDM is one of a very few dental schools that employs this tool in partnership with a medical center
CDM also leads in the exploration of ways in which this integration can positively impact both patient and public health.
According to the Center for Disease Control and Prevention, HIV testing is recommended for all individuals between the ages of 13 and 64. Despite the recommendation, fewer than 50 percent of adults in the U.S. have been tested for HIV. In response, the U.S. Department of Health and Human Services has announced an initiative the goal of which is to eradicate HIV. To support this initiative, Dr. Sharon Perelman, CDM’s chief medical informatics officer, in collaboration with the infectious disease specialists at CUIMC, has created a clinical decision support tool, known as a BestPractice Advisory (BPA), in Epic to identify patients who could benefit from HIV testing.
Because HIV testing is the gateway to offering effective HIV care, treatment, and prevention, and, in order to diagnose patients as early as possible, Perelman and the development team identified specific criteria, which were integrated into the BPA, and that trigger alerts to dental providers, ensuring a focused approach to HIV testing. The testing is done using a rapid antibody test, which means that patients receive results before the end of their appointments. In order to prepare dental residents for implementation of the tool, they were given instruction in the proper method of administering the test, interpreting the results, and documenting them in the EHR. As a result, once a patient has agreed to be screened, a process for friction-free, point-of-care screening is in place.
“For this initiative in particular, it’s an opportunity further incorporate dentistry as a part of the healthcare ecosystem,” said Perelman. “We are able to leverage our location in the medical center to establish interprofessional collaborations.”
Perelman was in private dental practice for 20 years, holds a master’s degree in medical informatics and is one of the few dentists who is a fellow of the American Medical Informatics Association. She has played an integral role in the development and implementation of Epic at CUIMC, helping to optimize workflows and incorporating caries management by risk assessment into the EHR.