Dental Therapists and Electronic Health Records

Led by Minnesota’s 2009 decision to license dental therapists, a new breed of providers has been entering the marketplace: mid-level dental therapist providers are stepping into the care gap. Dental therapists are a new role in most of the US, and two dozen other states are considering following Minnesota’s lead. In Alaska, a tribal consortium has used mid-level dental therapists since 2005. Dental therapists are certified to do a variety of procedures, including fillings, crowns, local anesthetic, and sometimes removing teeth (a further certificate).  After certification, dental therapists can work under “indirect supervision.”

One of the key supports that dental therapists need to successfully perform their work is electronic health records software. Dental therapists also tend to see much lower income patients, with a higher proportion of Medicaid patients. In Minnesota, one half of a dental therapists’ patients must be low income or on medical assistance. This means that often many dental therapists are mobile, treating patients in several locations, and that multiple providers may be involved—at the least, the supervising dentist and the dental hygienist.

Meeting the dental care needs of a growing population with fewer dentists, particularly for Medicaid patients, demands efficiency and use of technology. Dental software that supports treatment plan approval, mobile EHR for mobile populations, and multiple care providers is crucial to successfully treating patients.

In medicine, mid-level providers like nurse practitioners who see at least 30% Medicaid patients are reimbursed for electronic health record adoption through meaningful use. They are eligible for the federal incentive. It’s not an insignificant amount–$63,750 over 6 years. However, dental therapists are not yet included in the list of eligible providers for meaningful use incentives (CMS Flow Chart, see link below).

Lessons Learned:

  • Dental therapists have been providing crucial treatment in Alaska since 2005 and Minnesota since 2009, particularly for low income and Medicaid patients.
  • Half of US states are considering licensing dental therapists to meet dental care needs.
  • Software that supports multiple care providers, treatment plan approval and mobile dental hygienists will be necessary to expand this model.
  • Dental therapists are not currently eligible for meaningful use, though other mid-level health care providers (like nurse practitioners) are.

 

Healy, Michelle. (2013) Dental therapists aim to fill dental-care gap. USA Today, Jan 2. Last Accessed 4/1/2013: http://www.usatoday.com/story/news/nation/2012/12/21/dental-therapists-minnesota/1731979/

Rosenblum, Gail. (2013) Minnesota dental therapy model goes nationwide. Star Tribune, March 31. Last Accessed 4/1/2013: http://www.startribune.com/local/200743261.html?refer=y

CMS Flow Chart (2010) Flow Chart to Help Eligible Professionals (EP) Determine Eligibility for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Last Accessed 4/5/2013: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/eligibility_flow_chart.pdf