Personalized EHR-Integrated CDS for Dental Extraction Analgesia

Providers in the CDS arm were given access to the CDS at the point-of-care through the EHR, which was accessible to providers who were seeing patients for a dental extraction, with a highlighted link in the EHR when a patient had a treatment plan involving an extraction. The CDS content was developed by the research team and content experts to provide guidance on pain management recommendations for dental extractions. Prior to deploying the CDS, the study team conducted observations of 15 dental extractions at HealthPartners to determine provider workflow related to analgesic decision-making, including review of the EHR and discussions with the patient, in order to optimize the placement and timing of the CDS within the EHR. The CDS was personalized for the patient to display potential medication interactions with commonly recommended analgesics as identified in Micromedex [20 ], flagged relevant health conditions that may have a bearing on pain management decisions and risk for opioid misuse (including history of substance use disorders, history of overdose, current naloxone prescription), and provided automated access to the state’s prescription drug monitoring program (PDMP). The CDS then provided guidance regarding analgesia options to consider recommending based on the available evidence with the overarching goal of providing personalized healthcare. The CDS was designed to simplify decision-making by synthesizing this relevant information in a single interface within the EHR.