Dental EHRs and Quality Assurance

Nova Southeastern University College of Dental Medicine (NSU-CDM) switched to the use of electronic dental and health records. Filker et al. chronicle the quality assurance aspects of this transition. One major benefit immediately apparent was that chart audits were conducted on similar documents–apple to apple comparison. Because dentists had to fill in the same information for each patient, quality assurance information like follow-up care, appropriate signatures and full treatment notes were easily detectable and traceable to the originating author.

During an interview with researchers, Judith Sands, a risk management specialist, stated,

“The EHR has provided us with a mechanism to track unusual or problematic events, address continuity of care concerns and alert providers that a case needs to be handled cautiously. The notes are now more legible and organized, and forms are no longer missing from the chart.” (p. 1097, Filker et al. 2009)

Using the data available in the EHR, NSU-CDM was able to identify the number of patients who returned for quality-of-care reasons due to treatment, and take steps to assess whether those treatment processes, dental materials, dental students or patients needed attention.

At this particular institution, the improvement in quality assurance and quality of care was dramatic and much lauded. However, Filker et al. also bring up the need for standardized terminology for health information exchange. With increasingly mobile populations, being able to do data mining to detect trends in treatment compliance, disease prevalence and adverse drug reactions could transform dentistry. Yet even when dentists use the same software, terminology differences can prevent direct use of data. Electronic health records provide new insights into quality of care data, and in upcoming years, the data will tell many stories.

Lessons Learned:

  • Electronic records allow for standardized information entry and output, enabling analysis of care.
  • Data quality tracking can lead to reminders and improvements in the EHR to improve data quality.

Filker, P.J.; Muckey, E.J.; Kelner, S.M. & Kodish-Stav, J. (2009) “Taking a Quality Assurance Program From Paper to Electronic Health Records: One Dental School’s Experience.” Journal of Dental Education, September, 73(9).