Outcomes Data Registry for Dentistry

Using large amounts of data from many different dentists or surgeons is a way to improve the quality of healthcare. From such clinical data registries in healthcare
many things can be gleaned regarding information about individual surgeries or medical devices. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has recently launched OMS Quality Outcomes Registry or OMSQOR for short which is discussed on pages 7-12 of the March/April 2019 issue of AAOMS Today. The groundwork for OMSQOR actually began in 2014 and OMSQOR officially launched in January 2019. The way OMSQOR works is that treatment data from all members who participate will be collected in a national registry that will be used to help improve the quality of care and patient outcomes. Such quality data will allow for tracking surgical outcomes, complications, and possible gaps in treatment. OMSQOR will even allow an individual surgeon to compare their patients to all patients in the database to identify areas in their practice they may be lacking and improvement is needed. AAOMS is encouraging all of their members to sign up and participate.

The data registry will be used to help AAOMS be able to better advocate on behalf of oral and maxillofacial surgeons along with conduct additional research to improve outcomes. Practice patterns across the entire specialty can be tracked. This can allow for better reimbursement for services that is fair where insurance companies may be challenging them. This can also allow for better data showing how often an anesthesia death occurs by oral and maxillofacial surgeons. This is important to them because many have challenged their delivery model of having the surgeon both perform surgery and deliver anesthesia which is not how surgeries are conducted in other specialties. The data registry can allow for the frequency of particular complications after particular surgeries to be identified. Of particular interest is identifying the frequency of nerve injuries after wisdom teeth surgery. The data registry can also be used to explore medical prescription prescribing habits which is of particular interest with recent studies demonstrating possible over prescribing of opioids which are then diverted to non medical use. According to the AAOMS Today article:

“Often, anesthesia advocacy stalls because AAOMS does not know how many anesthetics OMSs safely and routinely use. With OMSQOR, relevant aggregate data can be collected and safety statistics shared with federal and state agencies as well as insurance companies.”

Currently the safety of oral and maxillofacial surgeons delivery anesthesia is measured by several morbidity and mortality studies that have been conducted over time see for exaxmple http://www.teethremoval.com/mortality_rates_in_dentistry.html along with anecdotal reports and hearing about patient death or serious injury from media reports. Included with OMSQOR, is a Dental Anesthesia Incident Reporting System (DAIRS) which is an anonymous self-reporting system used to gather and analyze
information about dental anesthesia incidents. For example if an equipment fails or a cardiac event occurs in a patient a surgeon could report this anonymously using DAIRS. All dental dental anesthesia providers are being encouraged to report to DAIRS in order to help improve patient outcomes.

Even with the advantages of OMSQOR it is true that some members may be hesitant to want to use the system. This is because it can potentially be a significant time burden involved with the initial set-up to import all the data and surgeons may frankly just not like everyone else knowing intimate details about their practice. In addition their may be concerns with patient privacy. Both patient information and surgeon information will however be de-identified in the data registry so these concerns should not be subdued. Even so it may be possible to re-identify de-identified data. For example if there is a rare complication or death that occurs and is then picked up by the news media it may be possible to piece together who the patient and doctor is. Even with the limitations it seems that if many oral and maxillofacial surgeons and dental anesthesia providers use both OMSQOR and DAIRS then patient outcomes for dental procedures including wisdom teeth surgery may improve in the future.