Quality EHR System Necessary in Dental School

Arthur A. Dugoni School of Dentistry is a private dental school at the University of the Pacific located in San Francisco, California. It boasts 14 clinics with many staff members and faculty and treats about 12,000 patients yearly. It is a successful dental program with many graduates.

One problem existed that could lead potential applicants to seek other schools and that was an inefficient and aging electronic health records (EHRs) system.

At one time, it was 50% electronic and 50% paper. Many processes were completed either electronic or paper. Student educations suffered from confusing problems with inconsistencies of processes and procedures. Staff and faculty workflows varied at each clinic compounding the problems for them as well as students. Clinical research often took more time and effort or could not be completed at all with reduced collaboration processes. They needed one electronic records system that would satisfy all groups and promote education of future dental professionals.

“An immature, half-digital patient record created numerous problems for students, staff, and faculty members during patient care. Charts were often misplaced, signatures and entries were sometimes illegible, and there was a lot of going back and forth between the paper chart and the EHR. Frequently, two people needed the same chart simultaneously” (2010).

The conversion processes involved in transitioning to one effective fully integrated EHR was successful though challenging. Several specialized team groups were created to manage the implementation, training, and workflows by staff and faculty. Training and support was ongoing throughout the entire process from pre-implementation to post-implementation. Challenges included resource costs, staff and faculty buy-in and workflow behavior changes, and change management considerations. Cultural and traditional changes were especially challenging since staff tend to be attached to current tasks and the way things are done. Communication practices needed to incorporate all staff, faculty and students and utilized many sources including email, meetings and conferences.

Lessons learned:

• Effective communication throughout the entire process promotes an organizational culture of teamwork and cohesion.
• Establish clear goals prior to, during, and post implementation.
• Invite staff and faculty early and encourage participation and feedback to gain buy-in.
• Expect, anticipate if possible, and manage problems and delays promptly.
• Be cost effective, applying monies where necessary to achieve best results.
• Seek experienced external assistance.

Fredekind, R. DMD, MA. (2010). Electronic health record conversion in a private dental school. Journal of the American College of Dentists, 77 (1); 16-20.