The Next Generation of Dental EHRs

Dental electronic records are mainstream in dental training schools, but they often still replicate paper records. Yet these dental EHRs are also key to operations, training and evaluating the next generation of dentists. Schleyer et al. took the opportunity of the 75th anniversary of publication of the Journal of Dental Education to evaluate the state of dental EHRs, and what they should look like.

In particular, Schleyer et al. call out the odd disparity between utilization and features:

“As of 2011, electronic dental records (EDRs) are quickly becoming the “Swiss Army knife” of dental education: they are the central nexus for connecting data among educational, clinical care, research, and administrative activities. Yet, in light of their potential, EDRs are still primitive tools, despite a period of lengthy development.”

The authors point out that most dental schools in the US use axiUm EHR software, and that the key tooth records in that electronic record simply replicate paper forms. Information linkage, care guidelines and other information just isn’t available.

Furthermore, the authors highlight that research has shown that systemic care and dental care are heavily related. Yet even with dental care that takes place inside a health system network, usually completely separate records are used. Information isn’t exchanged between systems, and patients are treated as either health patients or dental patients, without crossover of data, recommendations or care guidelines. Yet it is well known that:

“Many interventions—for instance, for chronic diseases such as diabetes and heart disease, tobacco cessation, and obesity management—work best when supported by coordinated and collaborative care among several types of providers.”

Without complete health records, including dental prevention and intervention treatment, physicians and dentists lack key information. Quality of care may be compromised.

Furthermore, the authors discuss that although evidence-based treatment is becoming more and more accepted in dental care, data mining and use of existing electronic data is still “only in its infancy.” Individual dental schools are developing proprietary data mining systems, but that will not be able to integrate and use data from other dental EHRs, and the data won’t map for comparison.

The authors focus on dental informatics as an emerging field that will assist in articulating, exploring and solving these problems. Dental practitioners need to be aware of the state of the field, and when negotiating and discussing dental EHRs with vendors, bring up and demand solutions to these problems. Expecting more from dental EHRs is the first step towards change.

Lessons Learned:

  • Most dental EHRs replicate paper records, rather than using the platform to improve record keeping.
  • Even in large health networks with dental practices, dental data is often silo-ed–despite the fact that evidence shows systemic health results from dental care.
  • Data mining and evidence-based approaches should go hand in hand, but most dental EHRs do not support pooling of data, mapping of data or aggregate analysis.
  • Practitioners need to be able to articulate and demand the tools they need in the next generation of dental EHRs.

Schleyer, Titus K., Thyvalikakath, Thankam P., Spallek, Heiko, Dziabiak, Michael P. and Johnson, Lynn A. (2012) From Information Technology to Informatics: The Information Revolution in Dental Education. J Dent Educ 2012 76:142-153