Dental E-Prescribing Standards

The lack of an international terminology for dental diagnostics hinders coding efforts and information exchange. SNODENT is gaining in popularity, but the new ICD-10 overshadows some of those advances. Electronic prescriptions are a key terminology need, particularly as “current prescribing practices are a weakness in the delivery of high quality medical care” (ADA white paper, referenced below, page 1). Prescription errors can be deadly, and yet prescriptions are often prone to a variety of errors, ranging from ambiguous orders to difficulty with fax or handwriting legibility.

The ADA has put together a white paper to document the current state of electronic prescriptions for dentistry, and they call out the need for a standard, which they have created and call the NCPDP/SCRIPT standard. Rather than using technology because it’s available, the ADA recommends establishing an industry-wide standard that pharmacies will be able to reliably process. In addition, it would facilitate data exchange between practices and with physicians.

In addition, the ADA specifically mentions the “cost efficiency of the practice” as a reason to implement e-prescribing, using the voluntary standard. Interoperability, decreased legal problems, improved quality of care and reduced dental errors are seen as motivations for adopting electronic prescriptions.

The core capabilities the ADA recommends in the standard include searchable medication lists (by a variety of features), medication lists, directions to patients, prescriber signature, refill quantity, dispense-as-written or substitution allowable, comments to pharmacists, drug-drug interactions,  and name and address of both patient and prescriber. Other core data points are also included (see white paper).

One of the major challenges to adoption of e-prescribing is that few software systems support it for dentists. This is a major failing that vendors need to remedy. The benefits of electronic prescriptions are numerous, and yet there are few to no examples of them in practice. Dentists need to advocate for and negotiate with vendors to make this happen.

 

Lessons Learned:

  • The ADA endorses the benefits and potential savings of electronic prescriptions, but software is currently lacking.
  • The proposed data standard for e-prescribing includes many fields that assist in patient care, legal protection and billing.
  • Reducing medication errors and delays is possible through e-prescribing, but software has not yet caught up.

Electronic Prescription Standard for Dentistry.” (2012) American Dental Association White Paper.