What is this toolkit?
Levels of integration
CO MDI overview
The Need for CO MDI
CO MDI Model
CO MDI implementation approach
Building MDI Models
Readiness & Budgeting
Building a CO MDI Team
Building CO MDI Space
Building CO MDI Models of Care Delivery
CO MDI Model Readiness Assessment
These 12 questions, arranged by topic, will help you determine your practice’s readiness to integrate a dental hygienist into your medical care team, particularly for the CO MDI model. The person completing this assessment should be very familiar with your practice and on the team that will be implementing the MDI work.
Once you complete the entire assessment you will receive an overall response of
as well as a response to your answer for each individual question. Your answers to the individual questions are weighted to come up with the overall response. Each colored response contains an explanation as to why you received that score and tips to learn more about the topic. You can save your responses/results as a PDF file or print them.
What do the red, orange, and green responses mean?
If you received a red response, the key factor/s needed for success are not present. Work on strengthening these factors and re-visit medical-dental integration in the future.
If you received an orange response you may want to pause before moving forward. At least be aware that a weakness may be present and consider what you could improve now to bring you success in the future.
If you received a green response, your practice has the factors needed for a high likelihood of success! Congratulations and let us know how it goes!
This assessment was developed by Delta Dental of Colorado Foundation, and was inspired by the Primary Care Team Guide Assessment at
This refers to your Chief Executive Officer, Executive Director, Chief Operating Officer, etc. If you are in a very large organization, perhaps this refers to another leader who will not implement the work but has an overarching director role.
Is genuinely interested in oral health integration. Has a history of consistently inspiring the team to adopt new visions. Expects engaged teams that are improving patient care and providing high-quality care. Provides time, training, and resources to the team to accomplish the work. Will break down barriers when needed.
Is genuinely interested in oral health integration and may have time to stay aware of project progress and provide support. Checks in on quality of the work when possible.
Is moderately interested in medical-dental integration.
This refers to whether or not the target population in your medical practice needs oral health services. The target population could be your entire practice but could also be groups such as children, pregnant women, or diabetic patients.
The majority of the target population have public insurance such as Medicaid or CHP+, which currently include dental coverage; however, the patients have difficulty accessing dental services due to time, transportation issues, or few providers who take their insurance.
The target population has a balanced mix of public and private dental insurance.
The target population has private dental insurance coverage and regularly attends their dental visits.
This refers to the physical space in your medical practice where the hygienist will work. Most often this is a medical exam room that is turned into a dental exam room. It could also be another space in the clinic that is used or that is shared with medical providers. It should be large enough to hold all equipment necessary for full-scope dental hygiene (the largest pieces are the chair, light, and mobile delivery unit).
The practice has space available which could be made into a dedicated dental exam room. Or, the practice has multiple spaces available in which mobile equipment could be used.
The practice really wants to do this work but will need to build out the space.
The practice cannot identify a space/s (for permanent or mobile equipment) that could be used as a dental space.
This refers to the person leading the day-to-day implementation of the project. This is someone in addition to the integrated hygienist, perhaps the practice manager or another administrative role.
Is genuinely interested in oral health integration and will take actionable steps to consistently champion it daily. Will provide constant direction, clarity, lead problem solving activities, and break down barriers when needed.
Is genuinely interested in oral health integration and will sometimes take actionable steps to champion the work and support the team.
Is moderately interested in oral health integration and will do the minimal work necessary to implement the project. Has many commitments to other projects.
This refers to the medical providers in the practice.
The providers understand the value of offering oral health services in a medical practice and may be concerned it will negatively affect their patient flow. However, they are looking forward to providing more comprehensive services to their patients.
A minority of providers have reservations about the rationale for oral health services being provided in a medical setting.
The majority of providers have reservations about the rationale for oral health services being provided in a medical setting.
This refers to the clinical (such as medical assistants) and administrative (such as front desk) staff.
The clinical and administrative staff understand the importance of integrating oral health services into the practice, have a history of willingly taking on new activities for new initiatives, and have the time for these activities.
The clinical and administrative staff understand the value of integrating oral health services into the practice but have some history of reluctantly taking on new activities in their job or may not have the time to.
The clinical and administrative support staff are neutral on if oral health services should be added to the practice and don’t like to take on new activities.
Building a team
The team refers to one representative from each department in the practice that will collectively work on implementing the project.
Leadership will be able to include a representative from each department to serve on the medical-dental integration development team. These staff will have the time to devote monthly.
Leadership wants to include one person from each department on a medical-dental integration team, and those people will be intermittently available to serve and contribute to the work.
It is unlikely there will be many department representatives participating in integration other than the hygienist.
This refers to how much time the daily project staff (hygienist and supervisor) have available to work on medical-dental integration.
The staff working on the project daily will frequently meet (for example, weekly) to work on the development and implementation. In between meetings, each member has time to work on their assigned responsibilities.
The staff working on the project daily will have some time to invest in the project and will meet at least monthly. Sometimes there is time to work on the project between meetings.
The staff working on the project daily will meet as needed to respond to urgent needs.
Quality improvement experience
This refers to how much training and experience the practice already has with quality improvement activities.
Practice has experience with quality improvement activities, staff/ providers participate regularly in such activities, and appreciate the value they bring to their work.
Practice isn’t aware of or doesn’t have experience with quality improvement activities.
Staff/providers have expressed clear dislike or avoidance of quality improvement activities.
This refers to a visual or narrative representation of the flow (you might say “steps”) of work through the office related to patients receiving services. It could also refer to a visual or narrative representation specific to one activity within the office that has multiple steps and people involved.
Many workflows throughout the clinic have been documented, are referenced, evaluated, and modified on a regular basis.
Workflows are documented in some departments, but the concept is not regularly used.
There is an aversion to documenting and/or using workflows.
Relationships with dentists
This refers to the relationships with dentists to provide exams and restorative care.
Our practice has a staff dentist with capacity for additional patients, or our practice already has one or more dentists in the community who have committed to work with us to provide exams and restorative care for our patients.
We have talked with our community dentists to see if there is willingness to collaborate with us to provide exams and restorative care, but we don’t have any commitments yet. Or, our practice has a staff dentist, but there is little or no capacity for additional patients at this time.
Our community (within a reasonable drive) does not have any dentists to provide exams and restorative care, or the dentists that are here do not accept Medicaid or uninsured patients.
Practice capacity for change at this moment
The practice has a stable electronic medical record, built environment, and leadership. The practice strategically manages priorities by thoughtful consideration of what funding and improvement activities they participate in.
The practice is considering multiple changes and/or grants in the next two years and could foresee limitations to manage them all.
The practice is planning for any of the following types of changes in the next two years: leadership, building, electronic records. Or, the practice is participating in many other projects and quality improvement activities right now limiting staff ability to participate.
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