In the December JADA cover story, "Should Dentistry Be Part of the National Health Information Infrastructure?" Titus Schleyer, D.M.D., Ph.D., wrote that dentistry indeed should be included in a national health record, but on its own terms.1
Whether a patient’s health information is entered into his or her electronic record via speech recognition or keystrokes, somebody has to lead the electronic health record design to avoid medical errors caused by mistakes in communication. Your ADA was among the first health professions to create policies and standards to guide the architecture of computer-based patient records. As a result, one day dentists may be able to access health data from all providers of all patients electronically, and to have that infrastructure designed to best serve the needs of their patients and themselves.
In the 1970s, most dental software was created by individual dentists working on their home computers to design homegrown patient charting and record-keeping software systems. Soon, many were surprised to find a lot of software incompatibilities.
A groundswell of frustration prompted the ADA House of Delegates to pass a resolution in 1992 on the issue: "Resolved, that the American Dental Association facilitate the development of electronic dental patient records through the involvement with appropriate organizations and efforts to resolve legal, legislative and regulatory barriers to the evolution of this application of electronic technology."2
In response, the ADA formed a Department on Dental Informatics, and a Standards Committee on Dental Informatics (SCDI) soon followed. That committee published a document entitled "The Computer-Based Oral Health Record Concept Model: A Framework for the Electronic Dental Health Record" in 1996.3 Also that year, the Association noticed that a national health record was being debated, with or without its input. The ADA House of Delegates passed resolution 92H-1996,4 which directed its vision of an overall patient health record (which was the focus of the nation’s health care leaders), not simply a dental health record. The resolution described how the patient’s electronic health record should be "seamless"—that is, it should have confidentiality safeguards while being accessible at the time and place of care to practitioners authorized by the patient. The resolution also called for the architecture of the computer-based health record to be "open and compatible with all segments of the health care system, with no barriers based upon profession, specialty or discipline."4
The ADA has continued to lead the development of the nation’s electronic health record architecture. It provides dental nomenclature, as well as specifications for systems. Here are just a few of the ADA’s health record initiatives:
- – The ADA leads in the design of systems so that significant benefits will be accrued to dental patients, dentists, third-party payers, vendors and all other users.
- – In 2001, the SCDI developed American National Standards Institute/ADA Specification 1000: Standard Clinical Data Architecture for the Structure and Content of an Electronic Health Record.5 This is a blueprint from which commercial vendors are encouraged to build uniform health records in interoperable practice management systems to prevent incompatibility problems between vendor systems.
- – The SCDI is preparing an informational report called "Practitioner’s Guide to Electronic Dental Records" to specify the capabilities of computer-based dental record systems.
While a few pioneering practices are completely automated, the paperless dental office still is years away. Before it arrives at your practice, the ADA will be working with groups inside and outside dentistry’s ranks to ensure that any computer-based health record system that emerges will meet future needs of your practice and your patients.
TOP
REFERENCES
