California Community Hospital Dental Practices: The Argument for Dental EHRs

In an overview of community hospital strategy for the state of California (cited below), many issues are covered, including payer mix, billing, expansion, patient flow and other topics. However, the role of technology has a few pages in the overall report. The authors state that dental electronic health records and practice management systems are good investments:

“Investing in digital radiography and EDR/PMS has the dual benefit of both making the practice look and feel like a private dentists’ office and ensuring that the safety-net standard of care measures up to the community standard of care.”

In addition to providing clinical improvements, the authors highlight that recruitment and retention of new, particularly younger, dentists is much easier with electronic rather than paper records and technology.

However, the authors warn that implementation of a new electronic records system should not be taken lightly. They provide a case study of a dental office expanding from 6 to 12 chairs, moving to a new facility and implementing a new dental EHR system on the same day. This unnamed practice had months of lowered productivity … but this could have been caused from trying to implement too many changes concurrently and not just from a move to new software .

“For about the first three months, the practice experienced a downturn in productivity as staff struggled to master the new software. The practice manager continuously monitored the information being entered into the system and met every two weeks with providers and administrative staff to discuss problems and re-educate everyone on proper use of the software.”

This quote demonstrates the key role of project management and continual information analysis and training. The practice manager becomes key personnel in any software transition, but particularly when clinical care is affected. The practice manager in this case had particular advice for anyone considering implementing a dental EHR:

“When you are configuring the software to fit your practice, the people who need the data should be involved in making the decisions about how the fields and tables are constructed. Otherwise…they do not give you the information you need.”

Lessons Learned:

  • To meet standards of clinical care, community dental practices can invest in dental EHRs.
  • Recruitment and retention of new dentists is easier in practices with dental EHRs.
  • Implementing a dental EHR needs focus so try to avoid too many additional changes during this time.
  • Practice managers are key project managers for software transitions, especially dental EHRs.
  • Data users need to participate in design and definition of software tables, fields and reports.

Scott, Mary Kate, Bingham, Dori & Doherty, Mark (2008) The Good Practice: Treating Underserved Dental Patients While Staying Afloat. By California HealthCare Foundation. p. 20-23.