Developing and Defining the GAPA Digital Infrastructure for Coordinated Oral Health Planning Across Home Care Organizations

By
Sara Björns
Jessica Persson Kylén
October 9, 2026

Digital Health

Overview

The GAPA study describes development of a cross-organisational digital platform intended to support shared oral health planning between Swedish municipal home care and public dental services. Its rationale is that digital documentation alone is insufficient: assessments, older adults’ preferences, responsibilities, recommendations, and follow-up need to be visible across organisational boundaries.

Background

Older adults receiving home care commonly have complex care needs, including multimorbidity and functional limitations, while interacting with multiple health and social care providers. Oral health is often poor in this population but is not adequately incorporated into routine workflows or interprofessional care planning, despite its connections with nutrition, comfort, communication, systemic health, and quality of life. In Sweden, public dental outreach assessments generate recommendations, but integration of paper-based recommendations into electronic records remains inadequate. The WHO Global Strategy and Action Plan on Oral Health 2023–2030 calls for stronger integration of oral health into health systems.

Data Highlights

Measure or feature	Source detail
People reached by the nationally funded public dental support programme	Approximately 151,000 people in 2022
Study period	January 2022 to February 2026
Development process	Five cycles, from needs assessment and paper-based workflow modelling to specification of a high-fidelity platform
Study design and framework	Multimethod intervention development study structured by the updated Medical Research Council framework

Key Findings

The study aimed to develop and specify a digital platform for shared oral health care planning between municipal home care services and public dental services.
In the Swedish context described, dental hygienists generally conduct outreach oral health assessments in collaboration with municipal care personnel and produce recommendations for daily oral care and dental treatment when indicated.
Paper-based recommendations are inadequately integrated into electronic record systems, limiting continuity, accountability, and follow-up.
The development premise was that digital documentation alone would not resolve fragmentation; shared infrastructure should make assessments, preferences, responsibilities, and follow-up actions visible across organisational boundaries.
Development followed five iterative cycles and used end-user, professional, organisational stakeholder, and researcher participation, guided by co-design and integrated knowledge translation principles.
The related ADA news article reports advocacy for dental-sector needs to be considered in the U.S. Federal Health IT Strategic Plan; the supplied context does not provide further details of the ADA’s proposed criteria.

Clinical Implications

The source identifies a need for oral health assessments and recommendations to be incorporated into shared care planning and communicated across home care and dental service boundaries. It also emphasises including older adults’ preferences and participation in oral-care planning; the supplied material does not report clinical outcomes from implementation of the GAPA platform.

Conclusion

GAPA’s development work specifies a cross-organisational digital infrastructure intended to support person-centred oral health planning in home care. The source frames shared visibility of assessments, responsibilities, preferences, and follow-up as central to addressing fragmented workflows.