title: Toward Implementing Primary Care at Chairside: Developing a Clinical Decision Support System for Dental Hygienists.
abstract: BACKGROUND
  The goal of this project was to use the Consolidated Framework for Implementation Research (CFIR) as the theoretical foundation for developing a web-based clinical decision support system (CDSS) for primary care screening and care coordination by dental hygienists at chairside.
  
  
  METHODS
  First, we appraised New York State education and scope of practice requirements for dental hygienists with input from health experts who constituted a Senior Advisory Board for the project, and reviewed current professional guidelines and best practices for tobacco use, hypertension and diabetes screening, and nutrition counseling at chairside. Second, we created algorithms for these four health issues (tobacco, hypertension, diabetes, and nutrition) using evidence-based guidelines endorsed by authoritative professional bodies. Third, an information technology specialist incorporated the algorithms into a tool using an iterative process to refine the CDSS, with input from dental hygienists, dentists, Senior Advisory Board members and research staff.
  
  
  RESULTS
  An evidence-based CDSS for use by dental hygienists at chairside for tobacco use, hypertension and diabetes screening, and nutrition counseling was developed with the active participation of the individuals involved in the implementation process.
  
  
  CONCLUSIONS
  CDSS technology may potentially be leveraged to enhance primary care screening and coordination by dental hygienists at chairside, leading to improved patient care. Using the CFIR as a pragmatic structure for implementing this intervention across multiple settings, the developed CDSS is available for downloading and adaptation to diverse dental settings and other primary care sensitive conditions.
authors.affiliation: Department of Epidemiology & Health Promotion, New York University College of Dentistry, 433 First Avenue, 7th Floor, New York, NY 10010, USA.
authors.forename: Stefanie L
authors.initials: SL
authors.lastname: Russell
authors.affiliation: Department of Epidemiology & Health Promotion, New York University College of Dentistry, 433 First Avenue, 7th Floor, New York, NY 10010, USA. Electronic address: ap140@nyu.edu.
authors.forename: Ariel Port
authors.initials: AP
authors.lastname: Greenblatt
authors.affiliation: Dental Hygiene Program, New York University College of Dentistry, 421 First Avenue, New York, NY 10010, USA.
authors.forename: Danni
authors.initials: D
authors.lastname: Gomes
authors.affiliation: Department of Epidemiology & Health Promotion, New York University College of Dentistry, 433 First Avenue, 7th Floor, New York, NY 10010, USA; Dental Hygiene Program, New York University College of Dentistry, 421 First Avenue, New York, NY 10010, USA.
authors.forename: Shirley
authors.initials: S
authors.lastname: Birenz
authors.affiliation: Department of Epidemiology & Health Promotion, New York University College of Dentistry, 433 First Avenue, 7th Floor, New York, NY 10010, USA.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Golembeski
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Shelley
authors.affiliation: Technology and Informatics Services, New York University College of Dentistry, 421 First Avenue, New York, NY 10010, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: McGuirk
authors.affiliation: Technology and Informatics Services, New York University College of Dentistry, 421 First Avenue, New York, NY 10010, USA.
authors.forename: Elise
authors.initials: E
authors.lastname: Eisenberg
authors.affiliation: Department of Epidemiology & Health Promotion, New York University College of Dentistry, 433 First Avenue, 7th Floor, New York, NY 10010, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Northridge
mesh_terms: D020000:Decision Support Systems, Clinical; D003756:Dental Hygienists; D006801:Humans; D020407:Internet; D009518:New York; D011320:Primary Health Care
keywords: Care coordination; Clinical decision support system; Dental hygienist; Health screening; Implementation science; Primary care