Moore J., Goodwin N. Expanding Access to Care with Scope of Practice. Dimensions of Dental Hygiene. 2019; 17 (3):12-14
Online version available soon
There has been longstanding concern about uneven access to oral health services, particularly for some groups, including children, the elderly, racial/ethnic minorities, and the economically disadvantaged. Stakeholders with an interest in expanding access to care and improving the oral health status of the underserved are driving efforts to identify and adopt innovative strategies to improve population oral health. Dental hygienists (DHs), who are considered experts in prevention education and services, often play important roles in programs that improve access to needed oral health services
State-based laws and regulations define legal scopes of practice (SOP) for health professionals within a state. This contributes to variation in what DHs in different states are legally allowed to do. It is challenging to systematically describe these SOP differences, assess their impacts on population oral health and translate this into policy-relevant information. With support from HRSA’s National Center for Health Workforce Analysis, researchers at the Oral Health Workforce Research Center (OHWRC), Center for Health Workforce Studies (CHWS), developed a professional practice index to describe DH SOP across states and studied impacts of this variation on state oral health outcomes. Subsequently, researchers developed an infographic based on this work to depict state-level variation in DH SOP to help oral health advocacy groups, policy makers and other stakeholders better understand these issues.
Moore J. Health Professions Regulation in the United States. J Health Law (Revista de Direito Sanitario). October 2018;19(2):131-155.
Available at: http://www.revistas.usp.br/rdisan/article/view/152581/149071
In the US, states are primarily responsible for the regulation of health professions. The structure and content of state-specific health professions regulation has significant impacts on the delivery of health care services. This is particularly important given that health reform initiatives are designed to improve population health through the provision of accessible, high quality, and affordable basic health services. There is concern that existing state-based, profession-specific regulatory structures cannot easily support the workforce innovations necessary for health reform. Aspects of the current system that constrain the effective and efficient use of the health workforce include mismatches between professional competence and legal scopes of practice, lack of consistency in legal scopes of practice across states, limited flexibility to support overlap in scopes of practice across professions, and the slow and adversarial process for changing scope of practice rules.
Langelier M, Surdu S. Dental hygiene scope of practice regulation significantly impacts oral health outcomes in state populations. Perspectives on the Midlevel Practitioner (Dimens Dent Hyg suppl). October 2017;4(10):18-21. Available at: http://www.dimensionsofdentalhygiene.com/2017/perspectives_2017/Scope_of_Practice/Top-of-License_Dental_Hygiene_Practice.aspx
Rapid changes in health care systems during the first decades of the 21st century have significantly affected the delivery of oral health care services. In the policy arena, the new emphasis on high-quality, value-based services;1 improvements in diagnostic and treatment technologies and materials; proliferation of information systems and health information exchanges; team-based service delivery models; and integration of primary care and oral health care2 has influenced the deployment of health and oral health workforces. The move toward prevention and management of oral disease and away from the historical treatment paradigm requires the engagement of a comprehensive professional team.3 Dental hygienists are well positioned to contribute to improvements in access to preventive oral health services and, ultimately, to oral health outcomes.3
Mertz E, Spetz J, Moore J. Pediatric Workforce Issues. Dent Clin N Am. 2017;61(3):577-588.
Langelier M, Continelli T, Moore J, Baker B, Surdu S. Expanded Scopes of Practice for Dental Hygienists Associated With Improved Oral Health Outcomes for Adults. Health Affairs. 2016;35(12):2207-2215.
Mertz EA, Wides CD, Kottek AM, Calvo JM, Gates PE. Underrepresented Minority Dentists: Quantifying Their Numbers and Characterizing the Communities They Serve. Health Affairs. 2016;35(12):2190-2199.
Moore J, Continelli T. Racial/Ethnic Pay Disparities among Registered Nurses (RNs) in US Hospitals: An Econometric Regression Decomposition. Health Services Research. 2016;51(2):511-529.
Langelier MH, Glicken AD, Surdu S. Adoption of Oral Health Curriculum by Physician Assistant Education Programs in 2014. J Physician Assist Educ. 2015;26(2):60-69.
This study was undertaken to ascertain the number of PA programs teaching oral health topics and to evaluate the content of instruction and implementation strategies. A previous study in 2008 found that PA education program directors generally understood the importance of teaching about the linkage of oral health with systemic health; yet, few programs had actually integrated oral health instruction into the PA curriculum. The purpose of the study was to describe inclusion of didactic and clinical instruction in oral health in physician assistant (PA) education programs in 2014.
Boulton ML, Beck AJ, Coronado F, et al. Public health workforce taxonomy. American Journal of Preventive Medicine, 2014; 47(5):S314-S323. http://dx.doi.org/10.1016/j.amepre.2014.07.015
Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012–2014 to develop a public health workforce taxonomy.
Abramson EL, McGinnis S, Moore J, Kaushal R. A statewide assessment of electronic health record adoption and health information exchange among nursing homes. Health Services Research. 2014;49(1pt2): 361-372. http://dx.doi.org/10.1111/1475-6773.12137
A cross-sectional study was designed to assess level of EHR implementation, automation of key functionalities, participation in HIE, and barriers to adoption in New York State nursing homes.