February 8, 2013
The Institute of Medicine first issued a call for improved quality in American healthcare in November 1999 with its To Err is Human report. Two years later, the IOM followed up with Crossing the Quality Chasm. Washington’s policy experts, yellow highlighters in hand, pored over each report and parsed the growing public awareness that the healthcare system needed to be modernized. Among the highly recommended fixes was to computerize health records to help centralize information, prevent medical mistakes, reduce costs, and improve health care. By 2004, federal efforts were launched to create secure personal electronic health records for most Americans over the next 10 years.
As medical groups prepared to make the transition, dentistry gathered needed baseline data. In 2006, the Center for Dental Informatics published survey results showing that a quarter of all general dentists in America use a chair-side computer, and 1.8 percent had made the transition to a completely paperless office. Two years later, the American Dental Association Survey Center found that 43.7 percent of general dentists now were working with electronic patient records.
In the January issue of the Journal of the American Dental Association, NIDCR grantees and colleagues provide the latest snapshot in time based on a survey of 649 American dental professionals. They found that 73.8 percent of solo practitioners used a computer to manage some patient information, with 14.3 percent indicating they have gone completely paperless. For group practitioners, the numbers are 78.7 percent and 15.9 percent. The information that was most likely to be stored electronically is appointments, treatment plans, completed treatments, and images.
The survey was conducted among members of the NIDCR-supported National Dental Practice-Based Research Network, or National Dental PBRN. The network is an investigative union of practicing dentists, hygienists, and academic scientists. It provides practitioners with an opportunity to propose or participate in research studies that address day-to-day issues in oral healthcare. Because network members resemble the general demographics of dental practitioners around the country, the results likely can be generalized in the same way as the previous surveys.
One of the survey’s major aims was to determine whether electronic recordkeeping was now the rule in enough PBRN-affiliated dental offices to merit some future network studies possibly to reuse existing data. The idea being, generating new data can be expensive and sometimes duplicative. Mining existing data is often cost effective and can be highly informative. The researchers concluded that electronic recordkeeping was indeed widespread enough and almost certainly will continue to increase in the coming years.
“Reusing data for secondary purposes must recognize the role of confidentiality and security and occur within the strict framework of the Health Insurance Portability and Accountability Act, as well as related regulations,” they concluded. “However, EDRs [electronic dental records] may be an important resource not just for supporting clinical care, but also for supporting quality improvement and research to improve oral health.”
- Schleyer T, Song T, Gilbert GH, et al. “Electronic dental record use and clinical information management patterns among practitioner-investigators in The Dental Practice-Based Research Network,” JADA 2012 Jan;144(1):49-58.