Before beginning a discussion of certified dental EHR software, it is important to realize exactly what the terms EHR and/or EMR mean. EHR stands for “Electronic Health Record” and EMR represents “Electronic Medical Record.” Are these two acronyms different designations for the same thing, or are they actually two different items?
Although many people use the two terms interchangeably, it seems to me that there is a difference between an EMR and an EHR. As I understand it, an Electronic Medical Record, or EMR, is a complete record of a particular medical exam or event. That would then be a record for a specific office visit, encounter, examination or treatment that included all the medical clinical information to completely describe the event or exam. It would not be just the accounting information necessary for charging the patient and billing the insurance carrier for work done at that event or exam.
An Electronic Health Record, or EHR, on the other hand, is more an aggregation of multiple EMR records along with other health related information such as medical histories and historical records over time of medications prescribed and taken, vital signs, immunizations, and health problems or complaints. In other words, an EHR would be a complete history of many aspects of a patient’s overall health rather than just a small subset of those items restricted to just one phase, event or type of health status such as dental, mental, visual, or specific internal medical category.
Software has been designed for many areas of healthcare to electronically record the information making up your medical or health issues and status over time, and that’s where the terms EHR and EMR come from. In the past, as we all know, physicians and dentists have traditionally kept these health records in paper based charts which are hard to keep updated and especially hard to share with other health care providers and facilities like hospitals.
It is the great need for sharing and portability of a patient’s medical and health records that has prompted the push for all Electronic Health Records. Government mandates that all healthcare providers and facilities move to electronic records that can be shared among disparate providers and facilities to improve the quality of care delivered to the patients have resulted in the creation of an independent, non-profit certification body, CCHIT (Certification Commission for Health Information Technology), to define the criteria as well as to test software products for compliance with those criteria in order to “certify” them as capable of producing and sharing such electronic records.
So, a “Certified” EHR software product is simply a software product that has been designed to record medical, including dental and other health related information, electronically, and has been examined by CCHIT, the Certification Commission for Health Information Technology, for compliance with all the criteria that have been set out by the U.S. Department of Health and Human Services and found to be capable of meeting those criteria.
Unfortunately, when developing the criteria for certification, hospitals and other large medical clinical facilities were the main targets, and all the criteria are based on the perceived needs of those facilities. Dentists and other specialized healthcare providers working from small offices were not considered. This has resulted in all specialty software products, like dental software, optician’s software, etc., having to meet the medical recording and reporting requirements that were designed for the hospitals and large medical facilities.
That is why dental software must meet all those criteria for hospital grade medical software, at least at the current time, in order to be designated as a Certified Dental EHR software product. That is also why none of the mainstream dental software products is currently certified. They would have to program in all the medical functionality required for the certification status, even though it is of no real importance to a dentist for his patient records. In fact, if they did write all those additional medical tracking functions into their dental software, the dentists would not use most of it. All that extra functionality would accomplish would be to complicate the dentist’s record keeping and add significant extra work to every patient visit. Even though one dental program, The Complete Exam®, was developed around the year 2000 specifically to create electronic health records for dentists before the terms EHR and EMR became popular, it is not certified at this time since it was not designed to record and track the medical information required for certification. It was, and still is, the first dental EHR system and still has the most advanced clinical charting capabilities in the industry.
Fortunately, Health and Human Services has recognized the problems with requiring all programs, regardless of specialty or area of healthcare, to be certified to large medical facility criteria. They are currently working with the American Dental Association to try and develop separate criteria for dental applications, and they are also working on criteria for some other specialized areas of healthcare such as ophthalmology and mental health.
There currently are a very few “dental” software products that are certified, and they are predominantly medical software that has been adapted to handle the different coding and procedural aspects of dentistry. These applications are seriously deficient in the charting capabilities needed by dentists, and are really not much more than accounting and billing systems with the medical tracking capabilities necessary to achieve certification.