The Future of the Texas Dental Workforce to Improve Access to Care Robert Wood, MPH Biostatistician, Department of Family and Community Medicine and Regional Center for Health Workforce Studies, University of Texas Health Science Center at San

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The Future of the Texas Dental Workforce to
Improve Access to CareRobert Wood,
MPHBiostatistician, Department of Family and
Community Medicine and Regional Center for Health
Workforce Studies, University of Texas Health
Science Center at San AntonioTexas Oral Health
Summit Advocacy, Equity and Access Austin,
TexasSeptember 9-10, 2004
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Texas Oral Health Summit Advocacy, Equity
Access
Workforce Surveillance The Border Health
Workforce Informatics Initiative
Robert Wood MPH Jane E. M. Steffensen MPH,
CHES UTHSCSA
Austin, Texas September 2004
RCHWS at CHEP - 2002
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Mission of RCHWS at CHEP
Address U.S.-Mexico Border Health Workforce
issues through research and data development
projects and serve the workforce information
needs of Arkansas, Louisiana, New Mexico,
Oklahoma, and Texas.
RCHWS at CHEP - 2002
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Informatics

• Health workforce informatics, defined as the
  systematic application of information and
  computer science and technology to health
  practice, research, and learning.

Premise ..that health outcomes will be improved
and health costs lowered by the provision of
accurate and timely individual and aggregated
information that supports health decision makers
at the consumer, provider, community, and
national levels.
Adapted from A National Agenda for Public Health
Informatics Summarized Recommendations from the
2001 AMIA Spring Congress WILLIAM A. YASNOFF,
MD, PHD, J. MARC OVERHAGE, MD, PHD, BETSY L.
HUMPHREYS, MLS, MARTIN LAVENTURE, MPH J Am Med
Inform Assoc. 20018535545.
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From Data to Knowledge
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County and/or State or even National boundaries
arent always barriers to those who seek health
care
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Addressing the Information Needs

• Information Issues
• Dental Health Workforce Demographics
• Age, sex, age, Ethnicity?, FTE in multiple
  practice sites?
• Tracking individuals in the workforce across time
• Retention of legacy data in standard format in
  necessary for true tracking
• Rational Service areas defined using Multiple
  Practice site locations?
• (real addresses for geo-coding)
• Service area definitions less constrained by
  County or State (or National) boundaries?

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Addressing the Information Needs

• Information Issues
• Dental Health Workforce Demographics
• Age, sex, age, Ethnicity?, FTEs in multiple
  practice sites?

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Percentage of Dentists by Age in Texas, 1999
gt60 Dentists lt50 yrs. Average Age
48 yrs.
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Percentage of Dentists Population by Race /
Ethnicity, USA, 1999
Bureau of Labor Statistics, Bureau of the
Census PI Pacific Islander AIAN
American Indian Alaska Native
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Addressing the Information Needs

• Needs/Recommendations Partnerships and ongoing
  communication with professional associations to
  collect ethnicity and other health workforce data
  not always available.

• Action Second Border Health Workforce Roundtable
  in El Paso (July 30, 2003) with Border workforce
  information stakeholders. Discussed were
• Data exchange and data standardization (within
  and across states).
• Adoption of Geo-coding procedures

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Addressing the Information Needs

• Information Issues
• Tracking individuals in the workforce across time
• Retention of legacy data in standard format is
  necessary for tracking

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Dentists in 43 Border Counties
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Addressing the Needs

• Need Development of a centralized information
  system and a comprehensive mechanism for data
  collection. Also, defining the border in terms of
  geography, migration, culture, demographics, and
  rural versus urban areas.

Actions GIS studies are being conducted
Dental Workforce migration data between Texas
border and non-border regions are available
(1995-2000) and will be updated and extended to
urban vs. rural areas
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Addressing the Information Needs

• Information Issues
• Rational Service areas defined using Multiple
  Practice site locations?
• (real addresses for geo-coding)
• Service area definitions less constrained by
  County or State (or National) boundaries?

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Dental Health Professional Shortage Areas
(Dental-HPSAs), Texas 1999
Dental HPSAs 71 Whole Counties 15 Partial
Counties Prepared by Health Professions Resource
Center Office of Policy and Planning Texas
Department of Health Data Source Division of
Shortage Designation USDHHS April 20, 1999
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Addressing the Information Needs

• Need Data on FTEs and direct care for all health
  professionals including Dentists. Also, better
  information on practice location addresses, FTE
  at each location and service range (Medicaid,
  CHIP).

• Action
• Discussions with the agencies collecting
  workforce data in Texas and the Border states
  toward standardization and inclusion of direct
  care and FTE data in progress.
• (Texas agencies collect and disseminate more
  information than is done by some other Border
  states)

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Addressing the Information Needs

• Need Partnerships and ongoing communication with
  professional associations to collect ethnicity
  and other workforce data not available throughout
  the Border

• Action Second Border Health Workforce Roundtable
  in El Paso (July 30, 2003) with Border workforce
  information stakeholders. Initiatives discussed
• Data exchange and data standardization
• Geocoding
• Proposal for cooperative projects

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Health Workforce Informatics Policy Goals
Long-term Goals Improving health workforce
capacity and quality
Strategic Goals Provide
reliable, valid and timely information
for internal and external decision making
Informatics integrated into Major Outcomes
1. Beginning the development of an Border
region-wide decision
support system 2. Beginning the development of
an automated statistical
surveillance system for core health
workforce data 3. Developing and
maintaining a web-based,
interactive, user-friendly data system for
workforce tracking and
assessment
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What now? Can we help each other?
Data sharing can we actually exchange data?
Defining the minimal data set is small beautiful?
Data standards the impossible dream?
Geo-coding can we get the point?
Longitudinal and tracking capability can we
ever remember?
How to sustain the effort can we survive aging?
What else?