Running head: DENTAL INFORMATION SYSTEMS 1
Dental Healthcare and Information Systems
Siena Height University
Information Systems Management
November 1, 2014
Dental Information Systems
My name is Crystal Davis I have been employed in the dental healthcare industry as a Dental Hygienist for over nineteen years. I remember many years back when many dental practices did not have any type of Information Technology (IT) computer software systems. Every dental practice operated using a paper system for their records and filing system, and to collect their fee for services. In the world today it seems almost impossible not to have modern technology available. There are still many dental practices that rely on paper forms to run their daily operations, just this year I worked in such an office. However, based upon my past years’ of experience, having an (IT) computer system helps the practice to be more productive, effective, and efficient. The (IT) systems help to prevent medical health errors, store information in the data base for easy access when needed, eliminates misplaced charts, makes insurance claims easier to process, reduces HIPPA violations, and makes sharing data easier. One of the main differences between Dentistry and Medicine is that Medicine has thousands of different codes in its former standard ICD-9, and tens of thousands that will be added in ICD-10(ICD-10-cms.gov>Medicare).
Dentistry uses a different coding system called SNODENT (Systemized Nomenclature of Dentistry). SNODENT is a set of diagnostic codes that was specifically designed to serve the field of dentistry. It is “a comprehensive taxonomy that contains codes for identifying not only diseases and diagnoses but also anatomy, conditions, morphology, and social factors that may affect health or treatment. An examination of a partial listing of the codes provided by the ADA shows that dentists can code not only the dental conditions but also concurrent medical conditions and risk behaviors (e.g., diabetes, smoking behavior) which might be expected to affect patients’ oral health and to influence treatment decisions. SNODENT has become an effective tool in enhancing the clinical practice of dentistry. It is also hoped that SNODENT will become a resource for both basic and clinical research into issues that involve oral health and the interaction of; Or-facial Systems with other systems in the body. Just as ICD is not a static code set, I am sure the same will apply to SNODENT. “(Systematized Nomenclature of Dentistry SNODENT, www.ada.org),” n.d.).
Many sources have indicated that there are deficiencies in SNODENT at present that will require time to fix. I am sure that revisions will be necessary until any potential problems are resolved and, as conditions, diagnoses, and treatments change, so will SNODENT. SNOMED CT is a vocabulary designed for use in the electronic environment, for electronic health and dental records. The intended purpose is to provide standardized terms for describing dental disease, capture clinical detail and patient characteristics, permit analysis of patient care services and outcomes, and to be interoperable with Electronic Health Records (EHR) and Electronic Dental Records (EDR). Its initial development began more than ten years ago. In 2007, the ADA began the process of updating SNODENT for use in the current environment to develop it for inclusion as a subset of SNOMED CT. The new version now has over 6,000 concepts. SNODENT is mapped to ICD-9 CM and currently, the ADA is developing a cross-walk from SNODENT to ICD-10 C. Obviously, ICD-9- has been very beneficial to the medical community and provides much data through the use of its codes. Does it seem strange that dentistry has not been requiring similar information? After all, with the growing research into the oral systemic link, dentistry is experiencing a paradigm shift and becoming, more accurately, the field of dental medicine. This shift comes with the need for dental practices to code medical claims for those procedures that are medically necessary now and, in the not too distant future, the need to report diagnosis codes for all procedures (Systematized Nomenclature of Dentistry SNODEN, www.ada.org).
This change in dentistry is that our Codes Dental Terminology evaluation states that the evaluations must include diagnosis and treatment planning, and these are the responsibility of the dentist. It is mandatory that a diagnosis be determined and, at least, documented for now. First of all, diagnosis codes provide an easy way to accurately communicate your diagnoses with patients. Patients can be provided with a list of their diagnosis codes that will give them accurate detail. Diagnosis codes prevent miscommunication on diagnoses. Treatment plan acceptance can only increase when patients have an understanding of why they need to have recommended procedures performed. Secondly, once diagnosis codes have been used consistently in a practice over the course of time, dentists will be able to compare the outcomes of treatment to patients with similar diagnoses; and for dentistry in general, diagnosis codes can provide a means of accumulating data for studies that can lead to improvements in our patients’ dental health care.
Since our coding system is so much smaller, most dentist offices will continue to use the “Dentrix Dental System. It was the first practice management system for Windows back in 1989, and was the first to be approved for Windows 98. This deep, rich experience with the Windows operating system has aided us in our efforts to make sure our software is the most compatible in the industry”.(Dentrix,2003). Dentrix's early vision of a completely paperless, front office is coupled today with a strong commitment to developing the tools necessary to boost productivity and improve efficiency. As the world’s leading practice management software provider, Dentrix is striving to develop products that meet the evolving needs of every dental office” (About Dentrix section, paras. 2 & 3). Our dental practice uses this system to send electronic claims to their insurances companies. The software systems contains a password administration screen which contains the information for making patient appointments, continuing care, treatment plans, insurance, billing and collections, prescriptions, and a number of other shared resources.
Dentrix continues to update their systems with new software to meet the challenges of the new Healthcare Information Technology era with a strong commitment to developing the tools necessary to boost productivity and improve efficiency in the dental practice. (About, Dentrix, 2003, para.4) Practice management software has been around for quite some time and Dentrix was one of the first systems. For that reason they are one of the leaders of this field. As a testimonial I’ve been using the system for over 8 years. They currently they are on version 11.0 and continue to update and improve their program. It seems to be updated on a yearly basis. Writing in testimonial of the Dentrix system Dr. Andrew W. Chin (a prominent dental surgeon in California writes “As with most practice management software there is more than enough programs to use to keep you busy. The entire system can run all departments and system operations for the entire dental office. Almost every imaginable protocol or function needed to operate an office is within the Dentrix system. The program will run your office from basic scheduling, accounting, to tracking your lab cases. These important aspects of practice management are only about 30% of all the different systems this program can do for you. The company has incorporated several accessory packages to make it all encompassing. The biggest fault the Dentrix system has is that it has too much” ("(www.dentalcompare.com/Reviews/2279 -Dentrix-Dental)," n.d.)
One more fact to take in consideration when looking at Healthcare Information Technology and using it in the practice of dentistry is that the dentists are, in most cases a solo practitioner, they are primary owners, and the only dentist in the practice treating patients. Dentists that are in ownership positions represent about 91 percent of all practicing dentists, and solo practitioners account for about two-thirds (67 percent) of all dentists, based on data from the American Dental Association (ADA) 2010 Survey of Dental Practice.
Due to the small nature of some dental practices in some areas, some dentist will not buy any kind of Healthcare Information Technology System for their practice and pay the penalty. As stated to me by one of my professors, “No law will get all doctors to purchase an Electronic Medical Records System. As I have mentioned, some physicians are willing to take the penalty for not having an Electronic Medical Records. For them, it will be less expensive to take a 1% Medicare cut than to purchase an (EMR) that does not fit their practice. This is especially true of solo practices and small primary care practices” (Dr. Barry Schoenbart MD in October, 2014 week seven class discussion). Nowhere else in the healthcare field are more doctor’s still solo practices and members of small primary care clinics then in the dental field (“American Dental Association. (ADA, 2010 Survey of Dental Practice,” n.d.) .
It seems to me that many dentists will either forego using a Healthcare Information Technology System at all, or continue to use the Dentrix system to satisfy their Healthcare Information Technology needs. There is a couple of more system that is similar to Dentrix and used by some dentist, but Dentrix is used by the vast majorities that have Information Technology Systems at all. This makes Healthcare Information Technology a far less daunting prospect for dentistry then it does for the medical profession.
The trend in dentistry is utilizing technology to make dentistry more comfortable, durable, efficient and natural looking for the patient. Advancements in new dental technology offer better solutions for traditional oral health problems than ever before. Procedures that formerly took multiple trips to the dentist or required multiple health care providers can often be performed in the comfort of one office by one qualified provider. There are much new advancement in dentistry that your dentist may choose to offer for an enhanced state of comfort and improved oral health.
Some of the technological advances that you may see on your next trip to the dentist include; Computer Assisted Design, computer assisted manufacturing technologies are used in various industries to provide highly accurate design of items or materials to be constructed. In the dental world this advanced technology allows for the design and fabrication of dental restorations that resemble the look and feel of natural teeth. This type of new dental technology can be used for dental bridges, inlays, on lays, porcelain veneers, and crowns.
Laser Dentistry; laser dentistry offers a less invasive alternative to many procedures. The light energy that is emitted from lasers results in a shortened and almost painless healing period. This option is commonly available for the treatment of benign tumors, cold sores, crown lengthening, decay removal, gummy smile changes, dental fillings, tongue tie and speech impediment improvements, nerve regeneration for damaged nerves and blood vessels and scars, certain conditions related to sleep apnea, temporomandibular joint (TMJ) conditions and tooth sensitivity.
Oral sedation dentistry is being utilized by more and more dentists because it is both safe and effective. Compared to more traditional IV sedation, oral sedation requires no needles and the patient experiences a conscious state of mind and can respond to the dentist. This is helpful for patients, who fear the dentist or avoid trips because of anxiety of sitting in a dental chair,
Dental implants are perhaps the leading dental technology advancement because of their fit and function as replacements of a tooth root. The implants integrate with the jaw bone and the procedure can be done in almost any adult who needs missing teeth replaced. The treatment time of this type of procedure has also been shortened as some patients can receive the crown that attaches to the implant immediately after tooth extraction as opposed to waiting six months after.
Air-abrasion is a great dental advancement over the dental drill as it allows precise removal of decayed teeth without the use of a local anesthetic. The air-abrasion system uses blasts of pellets, of air, and aluminum oxide to treat tooth problems such as cavities.
CAT scans- for dentists performing specialized procedures such as implants; 3-D imaging helps them to view and work on the jawbone or surrounding bone structure to produce more accurate results. Placing dental implants requires a precision touch and the CAT Scans provide dentists or implant specialist accurate imaging of where to place the restorative devices.
Digital x-rays have the benefit of reducing exposure to radiation, and allow images to be projected on a computer screen. This modern dental technique is also more comfortable and allows dentists to find problems with the teeth, mouth, and jaw.
Intraoral cameras provide dentists with quality imaging equipment that can be used for patient education, higher case acceptance, and improved patient communication. The small lightweight cameras are used in the patient's mouth to provide clear images of the mouth, and can help in the detection and prevention of oral health problems.
Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-tss) is a device used for patients who suffer from Temporomandibular Disorder and migraine headaches. The device eliminates the need for more invasive surgery and can help with problems associated with Temporomandibular Joint (TMJ) discomforts. (“Nissani, M. Bruxism: Advice, Links, Resources, October, 2008”) The device can be molded to fit teeth and is effective at reducing the pains associated with Temporomandibular Disorder.
Composite resins are used to adhere filling material to tooth structures. Composite resins are used in many restorations such as bonding and veneers. They offer the advantage over older technologies such as gold or amalgam because they are better refined to replicate tooth colors and tooth function. Additionally they are easier to apply and more durable than ever before. Dental professionals can apply the material directly to the tooth and mold it to the shape and color that resembles natural teeth.
Dentists utilizing digital photography can adapt a photograph for a patient so that they can provide them with an idea of what they will look like after a complex dental procedure such as a smile makeover or full mouth reconstruction. This is appealing to patients because they can work with their cosmetic dentist to inform them of what they want to look like and what their expectations are (www.acedentalresource.com/.../dental-technology)," n.d.).
In conclusion, these are the ways that I have seen the revolution in Healthcare Information Technology Systems, and advancements in technology effect the practice of dentistry, and these advancements have helped dentistry achieve new heights in the services that they have to offer patients, and make a larger contribution to the field of medicine overall.
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Systematized Nomenclature of Dentistry SNODENT, www.ada.org)," n.d [Systematized Nomenclature of Dentistry SNODENT, www.ada.org)," n.d.]. (n.d.).
www.dentalcompare.com/ Reviews/2279- Dentrix-Dental, n.d.
www.dentix. com/ promotions/ E Services/ Index. html.