Functioning Dental EHR Workflow for Patient Visits

Dentist Dr. Guichet implemented a full electronic oral health record, and in this article he discusses the key preparation steps as well as the workflow his practice developed to fully utilize the dental EHR.

First, your hardware needs to be ready–before any software can be installed or implemented, the hardware must be present and up to date:

“You have to install an adequate and secure network infrastructure. This includes hard drive backups, an uninterrupted power source, and a stable, hardwired network based upon a high-speed gigabyte switch. All of this requires an investment in some expert advice. Those experts may charge between $70 and $135 per hour to set up the security and backbone of your digital office, but once it is built you can usually go as many as 3 years per server with only periodic updates.”

To provide the best cost-effective solution, Dr. Guichet advises that “a linked practice management-digital radiographic-photographic suite offers a practice the most stable and serviceable platform” due to the “irrefutable benefits.” This change, which may seem like a straightforward change of one process for another, actually dramatically altered the way in which Dr. Guichet’s practice collected information and provided clinical decision making. In particular, digital radiography allowed Dr. Guichet to spend less or no time on X-rays. Instead:

“Doctors make a mistake in performing all digital photography themselves. I delegate nearly 95% of all the digital photography done in my practice.”

However, the most exciting part of this article is the embedded video. Go to the site and view the demonstration of an electronic imaging system for demonstrating, evaluating and designing prosthetic care. The imaging system provides the ability to rotate, view and alter prosthetics virtually, providing real-time visualizations of different kinds of care plans. The geometry of existing bone as well as the potential implants and surgical treatments are combined with tooth impressions and digital scans to test out different implants virtually. This 3D software has transformed Dr. Guichet’s practice, and a variety of care plans are discussed in the short video (visit to view). One sample image is below.

Dr. Guichet

Lessons Learned:

  • Hardware must be in place before software can be implemented, so prepare for your EHR by assessing the readiness of hardware.
  • Radiography and digital photography can save dentists time, provide better information in the EHR and alter workflow.
  • 3D visualization in an EHR provides dramatic increases in ability to visualize and verify care plans.

Guichet, David (2008) “Moving Your Practice Into the Digital Age” National Dental Network, Sept 1.