Using Dental Systems for Quality Assessment

Titus Schleyer poses a question that few dental practitioners can accurately answer:

“Are my patients getting better?”

Currently 95%-100% of dental offices use computers, with 50-60% having chairside capability for charting. Yet only 14% of dental practices are paperless. Reasons that practices have not gone paperless vary, with the main one being unreliable access to computerized files, either due to downed servers or inability to login. Add to this the lag time for software companies incorporating ways to enter data from newly developed technologies and it becomes challenging to understand how to negotiate with vendors for improvements. For instance, diagonal measurements have become commonplace, utilizing laser technology sold by Patterson and Henry Schein, yet Dentrix (Henry Schein), Eaglesoft (Patterson Dental) and AxiUm software packages are slow to incorporate a place for these in their charting.

A greater question than why practices are not going paperless is, are dentists using software to improve the quality of patient care? Even those practices that are heavily dependent on computerized records are often not using their systems to full capacity. They may generate administrative reports for cash flow, insurance billing, and production, but fail to utilize the clinical reports that can improve the quality of care and health of their patients.

One way to become comfortable with clinical reports is to join one of the three Practice Based Research Networks (PBRN) in the United States. These networks incorporate practicing dentists in clinical studies. For example, a current study by Schleyer through the National Institute of Dental and Craniofacial Research (NIDCR) is looking at ten years plus of dental record data from one dentist to determine how long patient crowns are lasting. By using deidentified data, researchers hope to determine what patient, material, or provider factors impact tooth restoration survival times in this practice.

Utilizing dental systems to their full capacity requires an ongoing commitment to making them more usable by 1) improving the speed of data entry, and 2) improving the speed of data extraction. Current data entry often incorporates either dental assistant entry or voice recognition software (similar to the iPhone 4 Siri application). Rapid data extraction is the driving force behind evidence based practice (EVP). Currently dental EVP tends to rely on educating clients on the standard of care, or reviewing data retrospectively with providers. In reality the ideal dental system will allow real-time assessment of patient needs and application of clinical evidence.

The NIDCR provides online dental informatics certificates and funds dental informatics graduate programs.

Lessons Learned:

  • Dental software lags behind new technological devices in incorporating discrete fields for new data types.
  • Dental EHR software can facilitate evidence based practice by allowing dentists to generate reports that verify improving quality of care.
  • Participating in Practice Based Research Networks encourages lifelong learning and is one way of getting comfortable with generating clinical reports.
  • The National Institute of Dental and Craniofacial Research provides dental informatics training through online certification programs and funding for advanced degrees.

Schleyer, Titus. (2012, January 4). Dental Informatics: Time to Join the Revolution? . University of Pittsburgh School of Dental Medicine