There are some issues that need to be considered in purchasing an dental EMR program. The major issues are objectives and cost for the software. If these issues are not satisfied, users probably could not purchase it. Defining what is needed first, then deciding on the parts that are wanted helps determine purchasing options. Users always should reserve the right to tell the vendor what they need, not the other way around. The cost of the software varies greatly between companies. Total costs include the software, hardware requirements, recurring maintenance agreements, upgrade fees, training costs and routine operational expenses. The key is finding the right balance for a specific dental office. The minor issues to be considered are data standards, graphics, reporting and outcome analysis, data format and associated medical information. Standards provide the bridges to the many islands of electronic patient data so that the data can inexpensively be combined into an EMR. Several different types of data standards are needed, including message standards, code standards, person and place identification standards, and security standards. Message standards apply to the structure and delivery of clinical data. Health Level 7 is the message standard of choice for communicating clinical information such as diagnostic results, notes, referrals, scheduling information, treatment notes, complications, clinical trials data, master file records, and more. Many aspects of the dental examination could be recorded with graphics. The simplest approach is to start with a picture and annotate text with an arrow or number pointing to the location the text refers to. Reporting and outcome analysis may be one of the most useful areas in the future of dental software. All of the information that is entered as discrete data is available to generate detailed reports. Clinicians could use the information to find patients eligible for certain studies (eg, all patients aged 30∼70 years with mandibular asymmetry who have a internal derangement of TMJ) or even conduct retrospective dental record reviews and put together case series for publication. Data format can be entered into EMR either free text or structured data. Text fields allow entry of sentences and paragraphs of information. Structured data fields usually allow entry of a number, a word, or short sentence. There is no perfect way to enter data. The needs of an individual practice should dictate which method is most desirable. Most EMR programs are either bundled together with other associated medical information, such as laboratory information system, electronic data interface and hospital information system that can be purchased separately. If there is a problem with communication between programs, the potential exists that neither company would claim responsibility for fixing the error, blaming the problem on the other company's software. To improve care, increase efficiency, and reduce time, current paper recording systems should be changed. A universal electronic EMR program could be the solution. The future of dental EMR will depend on new technologies, such as cordless notebook-size charts, exploring credit card type, "smart card." The continued refinement of the dental EMR program over the future years will eventually present limitations and become an essential part of the dental practice.
Bibliographical noteFunding Information:
This work was financially supported in part by Yonsei University Research (Yonsei University College of Dentistry, Oral Science Research Center)Fund of 2002.
All Science Journal Classification (ASJC) codes
- Dentistry (miscellaneous)
- Radiology Nuclear Medicine and imaging