PennWell Dental Community
EHR / PACS - The Great Debate ... please share your input
In 2006, U.S. Health and Human Services Sec. Michael O. Leavitt, in an address to the ADA House of Delegates said, "There is understandable anxiety about this — it's a big change." He also emphasized that a medical record void of dental records is incomplete, paying notice to the oral/systemic link of which we so desperately need to convince our patients. Thus, it is important, as EDS systems evolve, that dentists help insure the transparency, AND the interoperability with other systems, medical and dental. With this, should we decide to jump on the pioneer wagon of EHR and possibly PACS, we can make sure the investment will ultimately lead to a double return, with value not only to patients, but to providers as well.
With all the debate among us, fueled by the ADA's position on the "inevitability" of going EHR in our practices, and possibly PACS (image sharing), upon which many dental specialists rely daily, let us compile a detailed LIST of the particular issues/questions you (dental team members) have.
With that, working with an accomplished writer, and nationally recognized, independent consultant, specializing in the evaluation, implementation and oversight of EHR and PACS systems, we will provide you with articles that address your questions and concerns, as well as tips on the "tricks and traps" to know and avoid as you consider long-term relationships with vendors.
Please post your questions/concerns here. Please note, 'discussion/response' is not a feature, as this is intended only to gather the list. Thank you!
With all the debate among us, fueled by the ADA's position on the "inevitability" of going EHR in our practices, and possibly PACS (image sharing), upon which many dental specialists rely daily, let us compile a detailed LIST of the particular issues/questions you (dental team members) have.
With that, working with an accomplished writer, and nationally recognized, independent consultant, specializing in the evaluation, implementation and oversight of EHR and PACS systems, we will provide you with articles that address your questions and concerns, as well as tips on the "tricks and traps" to know and avoid as you consider long-term relationships with vendors.
Please post your questions/concerns here. Please note, 'discussion/response' is not a feature, as this is intended only to gather the list. Thank you!
Replies to This Discussion
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Permalink Reply by Darrell Pruitt on -
Are we at last approaching a meaningful debate on the future of eDRs in the nation between the US Air Force and Darrell? Or will one of the two parties suddenly feel outflanked and beat a retreat?
Long ago, I posted somewhere that HIPAA will first be recognized as an undeniable national failure in dentistry. I bet $5 against the kitty that the shock of transparency to HHS will occur before July 4th.
I posted this on Medical Executive-Post in response to someone who signed her (?) comment “A Civilian.”
By now, you have to agree that I am showing you the event horizon of dental history.
Darrell
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Thanks, Civi.
I think your point concerning the level of respect patients and providers can anticipate from socialized medicine is astute and timely, unfortunately. I would like to add that eDRs, aided by HIPAA, is the tool that can make your fears a reality in a dental chair if monsters like Delta Dental and BCBSTX have their way with HIPAA’s national NPI requirements - which legally provide for pay-for-performance based on FOIA-discloseable claims records. (That was probably far too much information stuffed into one paragraph. Sorry).
Interoperable digital records as mandated by the 1996 HIPAA Rule are clearly not being demanded by the principals in dental care - dental patients and dentists - for the same reason that CCHIT hasn’t a clue that dentists are also licensed healthcare providers: There is no money to be made in digital dental records because they are simply of no benefit to the principals. Duh.
Worthlessness has everything to do with why eDRs are being attempted in the military. Civilian dentists just don’t want them. And that is a shameful loss for the nation’s future health care. Imagine the Evidence-Based discoveries that might have already been uncovered if control of clinical data had not been granted to stakeholders over a decade ago in exchange for political contributions. There are so many common sense ways to introduce eDRs to dentistry, but unfortunately they aren’t CCHIT-certified because applications like computer interfaces with fax machines are not at all what insurance companies demand. Forget about dentists’ and patients’ concerns about privacy.
If the natural, consumer-friendly and traditional business model of dentistry is driven further from unimpeded fair competition that exists only in a free market - patients’ rights to free choices in providers will be eliminated according to cost-effectiveness as determined by adjustable algorithms in stakeholders’ computers. Like casino odds, fuzzy actuary science creates complicated insurance rules that always favor managed care - including universal care or any other single-payer type plan yet to be rolled out.
Today, the military’s AHLTA software is the most widely implemented eDR system in the nation. If civilian dentists don’t wake up soon, they could be forced to purchase eDRs similar to the ones Air Force colonels like. (I think I smell Delta Dental). That is why I think my challenge to Col. Page McNall is very important, regardless of what a committee tells her to say.
I bet five dollars against the kitty that Col. McNall can’t fly anything over my head that I have not already shot down at least a half a dozen times and in as many ways. I hope she knows that she should leave talking points in the hangar. They’ll boomerang.
From years of experience at this, I can tell you that most command-and-control entities outside the military refuse to publicly engage me because it is so easy to see that my barbaric approach is blatantly unprofessional. I want the Air Force brass to know that I conveniently provide this excuse for anyone who needs it. I offer that because I am aware that some feel very strongly that image is everything.
D. Kellus Pruitt DDS
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Permalink Reply by Christine Taxin on -
Hello to all,
I have my pro's and con's about the electronic downloads to be seen by other then the patinet and his or her doctors both dnetal and medical. If we ever truly want the respect we deserve in the medical field we need to referr to ourselfs as providers of health. Today I recieved an email that they now have a genetic link connecting perio disease and heart desease. Is that not medical? Of course we need to be able to communicate and work with all providers for the benefit of the patient. The only thing we need to make sure of is to protect our abilites to have the patients relay on their medical providers to make informed descisions, not insurnace or a federal health plan. We need to gather all the doctors, and dentists to start to become more vocol on the important issues............Thanks for allowing me to voice my opionion.
Christine Taxin
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Permalink Reply by Darrell Pruitt on
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Thanks, Christine.
My point is, there are many other safer ways to move information than over the Internet. Dentists rarely need intricate and private medical information, and they almost never need it in real-time. Phone calls and faxes are adequate for the vast majority of dentists in the nation.
Your reference to allowing DNA information on eDRs is actually pretty scary.
Darrell
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Permalink Reply by Darrell Pruitt on
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I want to take this opportunity to congratulate Dr. Paul Feuerstein, D.M.D. for being featured in the November 2009 edition of the Texas Dental Journal.
In the Texas Meeting Preview on page 1118, Dr. Feuerstein writes: "Technology has invaded our dental practices in many areas. Computer software and networks manage offices, while equipment now has sophisticated electronics to help us treat our patients more effectively. The internet and cell phones have changed the way we communicate with each other, manufacturers, our patients and even how we obtain some continuing education."
Dr. Feuerstein, who has discussed eHRs on this DentistryiQ thread, adds:
"Hiding up in Massachusetts is a GP who has decided to make [the study of cutting-edge technology] his life’s work. Paul Feuerstein, DMD, does not play golf - this is his passion and how he spends his “spare” time. His undergraduate training in physics, math, chemistry and computer science gave him the foundation to observe and understand the products and processes that have been presented to dentistry. He has gone to over 100 dental meetings, helped new products come into development, and has spent the rest of his time teaching all of these findings to his dental colleagues. Somewhere in that schedule he has a full-time dental practice, which actually allows him to use these products and report on his findings. The office is just like everyone else’s - there are no fancy labs or test equipment. Just someone in the “real world” giving his clinical opinion. He will be sharing this knowledge at the next TDA Annual Session with a number of products and processes including these and many more. Since he has used many of these products, practical examples from his own patient base will be explored and shown. The return on investment, a frequent question will also be discussed. In addition, there will be workshops where many of the products and processes will be demonstrated and available for hands on inspection without pressure of a salesperson standing by.”
Dr. Feuerstein and I both encourage you to “Save up your questions, and your money, for the upcoming Texas Dental Association Annual Session.”
D. Kellus Pruitt DDS
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General dentist in Fort Worth, Texas. I surround myself with the most wonderful staff and the kindest patients in the nation. It is our mutual confidence and respect that grants me the freedom to stand nose-to-nose with anyone in the marketplace. I’m blessed. And I like to write.
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