Multnomah County Health Department (MCHD) implemented an Epic EHR in their 8 clinic systems around Portland in 2005. Now, they are seeking to do the same thing for their mobile dental clinics. Slides detailing the plan are available to download as a PDF. Their mobile dental clinics are safety net providers for the region, and visit schools and other locations to provide on-site treatment.
Because of the lessons learned from implementing at ambulatory clinics, MCHD dental clinics are aware of the fact that an EHR needs to be properly structured and designed in order to properly extract useful information to improve quality of care and track ongoing changes.
One of the major arguments for adopting digital systems is the reduction in photo processing chemicals, reducing exposure, storage and handling concerns. The sustainability of reducing use of paper is another argument. However, their primary argument is around the ability to extract and use population-based data. With paper records, analyzing population and environmental data is very difficult. If research questions are defined during design and training, EHRs can be massively helpful for analysis and understanding of variables.
If MCHD applies the lessons learned during ambulatory clinic EHR implementation, they will create a core dental EHR that will be adaptable to different environments throughout their mobile network.
- Extraction of useful quality of care and outcome information requires careful attention during design and training, and cannot be expected as a default.
- An EHR can reduce costs, dangers and hazards of hard copy photo-based dentistry.
- Paper records make population-based analysis difficult or impossible, but EHRs can be designed or users can be trained to track, assess and provide high-quality data for outcome analysis.