EHRs in Dental Schools: Changing Practices and Ethics

As electronic health records permeate healthcare, behavioral changes have begun to affect clinician-patient interactions and care. For instance, as one scholarly article points out:

“Patient interaction with the EHR continues to increase as patients may digitally enter health information; view radiographs, intraoral photos, and patient care information; or search for dental information away from the dental office or dental clinic… Entry, storage, and retrieval in an electronic form also allow patients more control over their health information and may empower them to take a more active role in their treatment. “

However, the widespread use of electronic records also offers challenges. Particularly because of the transferability of information and the sharing of patient data across individuals, the potential for information breaches is often higher with electronic records. In dental schools, that possibility is increased because student misconduct is an admitted problem. In addition, Cederberg & Valenza point out that interacting with a computer can lead to “depersonalization” of the patient, which can reduce conscious and implicit understanding of patient rights. When the computer is introduced as a third party during treatment, a requisite participant in the process, the process of dental care changes. One of the key ways to combat these ethical concerns is to emphasize the long-standing, upstanding nature of dentistry. As healthcare professionals who treat entire human beings, dentists–particularly those who are teaching–can emphasize and model the best behavior. For instance:

“Making professionalism part of a student’s grade for clinical procedures is already a key grading component for many dental schools. It clearly demonstrates to the student the importance of professionalism and that proper clinical behavior is not only supported but rewarded.”

This attitude and culture of professionalism, respect and integrity is necessary for all users of electronic health records, to protect patient rights, reduce liability and yet benefit from the increased access and quality of care that EHRs make possible. Lessons Learned:

  • EHRs change clinical practice and clinical interactions and can lead to depersonalization of the patient if care is not taken.
  • Increased access is one of the benefits of EHRs, but also provides increased opportunities for breaches.
  • Upholding the culture of respect and professionalism in dental schools and dental practice can reduce ethical breaches.

Cederberg, Robert; Valenza, John. (2012) Ethics and the Electronic Health Record in Dental School Clinics. Journal of Dental Education May 1: 76(): 584-589