The Information That Dentists Collect
Traditionally, dentists have collected information for two key purposes:
- As an aide memoire: to make a record of care for the next time that the patient visits.
- To obtain payment for services rendered from either the patient, an insurance company, dental plan provider or a public health care system.
However, even paper records have been used for other purposes. In addition to these two main purposes, dentists have used paper records to
3. carry out retrospective audit and research
4. justify and defend their actions in the event of complaints or problems
5. communicate the nature of, and reasons for, treatment to patients
The reality is that the modern environment in which dentistry is operating needs more and better information for a wider range of purposes, including:
- Matching supply and demand for dental services
- Increased emphasis on health promotion
- Clinical governance
- Greater emphasis on patient choice based on informed consent
- Cost control
Many of you will home in on the last purpose and say that this is the real reason. In many ways you would be right. In all aspects of health care, people are concerned about the rate at which costs are rising.
The Information That Dentists Need to Collect
The percentage of national wealth spent on health care by the US, Canada and the UK has increased by about half since 1983, as measured by the OECD. Whether you are an individual patient, insurance company, or Government, these are fairly scary figures if you are paying for care. Of course, those being paid may well not have seen the benefit as costs rise in terms of materials, indemnity insurance and other factors.
This has led to an environment characterised by the following characteristics:
- Constant health care reform in both the public and private sector. In dentistry in the UK, this has the added dimension of threatening to destroy the balance between public and private dentistry. If too much reform and cost control is introduced in the public sector, then dentists will simply withdraw into the private sector.
- Pressure for efficiency savings, and IT is heralded as a major source of such savings (see, for example, the Wanless Reports in the UK or the Romanow commission in Canada). Whilst they may appear to have little direct to say about dentistry, they say a great deal about the environment in which dentistry operates. Similarly, whilst they speak primarily of the public system , the same pressures apply in the private sector, and may bite even more rapidly there
- Emphasis upon health (not disease) and prevention rather than cure. Health and prevention are double winners: they can achieve better care whilst saving money. This is irresistible for any Government, insurance company, or even private individual. However, prevention and health promotion are expensive in terms of the demands that they place upon information and the associated technology.
At its simplest, we need to know about our patients and about the activities undertaken to keep their teeth healthy or restore them to health when they are diseased. This means we have to keep information about patients and about procedures.
Fortunately, we do not have to work out for ourselves, the information and functions that we need from our systems. Other clever people have done that for us. For example, in the USA, there are a range of standards and technical guides approved by the American National Standards Association and the American Dental Association to define what a dental information system should include. Visit the American Dental Association web site for more information.
1. Wanless, D Securing Our Future Health: Taking a Long-Term View, Report for HM Treasury, April 2002, HMSO, London.
2. Wanless D Securing Good Health for the Whole Population, Report for HM Treasury, February 2004, HMSO, London.
3. Romanow, R Building on Values: The Future of Health Care in Canada, Final report of the Commission on the future of health care in Canada, ISBN 0-662-330343-9
4. The American Dental Association https://www.ada.org