Dental EHR Conversion Case Study

Stephen Hudis, DDS, converted slowly to electronic dental records–in his own words, it was an “evolutionary process over more than a dozen years.” He told the tale of his gradual conversion in an article, summarized here (reference below).

For his practice, one key tip for success was to ensure that the protocols and steps for capturing, storing and using information were well in place before the electronic system. Since an electronic dental record cannot directly change workflow, he ensured that workflow was in place that the electronic system could fit into. This allowed his staff to adapt to the new system without struggling with the what or where of key information.

A second key tip he shared was to take small steps. He and his staff chose one system or task at a time to switch to electronic capture and use. Each step of the process was evaluated before proceeding to the next, which allowed the team to understand and handle problems at their root cause, rather than wondering which part of the system or workflow was responsible for a data lapse. How did he create that list of tasks and steps? Thorough preparation:

“You have to have a clear assessment of your starting point, and a clear vision of what the final product will look like. A list should be made of all of the systems in the office. They would include financial and billing, scheduling, charting and treatment planning, radiography and photography, progress notes, correspondence, and, finally, consent forms, medical/dental questioners and HIPPA release forms. As you can see, this is quite a long list. There is an immense amount of information here. Attempting to change all this at once is practice suicide.”

Instead, Dr. Hudis recommends breaking the information into separate workflow components and automating one at a time. His practice started many years ago with putting consent and HIPPA forms online, for patients to fill out at home. They discovered that patients were more likely to read thoroughly and complete the entire form, and that it reduced time spent waiting in the office–for both staff and patients.

Digital imagery has also provided great time savings and increases in patient care. Patients can see the problems the dentists see, as well as being able to print out and send diagnostic images to insurance. Dr. Hudis also is able to immediately email a diagnostic image to another dentist and talk on the phone to figure out a treatment plan–sometimes while the patient is still in the chair! This reduces the number of phone calls, appointment setting and time to treatment.

Overall, Dr. Hudis acknowledges the time and financial commitment. Still, in his opinion, “I personally find computer technology to be a wonderful tool in my day-to-day practice.”

Lessons Learned:

  • Approach transitioning to electronic records as a process, not a recipe to be completed.
  • Check for workflow problems after each stage.

Hudis, Stephen I (2010). “Converting to electronic dental records” The Journal of the American College of Dentists, 77 (1), p. 13.