Electronic dental records in research: from the National Dental PBRN [presentation]
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Objective: National Dental Practice-Based Research Network (network; NationalDentalPBRN.org) practitioners treat patients in a variety of practice settings. Two large, multi-site group practices employ an electronic dental record (EDR), making them well suited to use their EDR to conduct research. We evaluated using EDRs for practice-based research in these two settings and discuss considerations for using EDRs for research. Method: HealthPartners (HP) Dental Group implemented its comprehensive EDR in 2003. Its EDR supports clinical and business functions while capturing all encounter, procedure, diagnosis and charge data. Permanente Dental Associates (PDA) began using an EDR in 1982. Its EDR contains scheduling, benefits, treatment history and procedure codes. Practitioners use it in conjunction with paper clinical records. Result: Of the 22 studies the network has conducted, 9 were appropriate for EDR use. HP used the EDR for research in 6 of these. HP dentists used customized data collection screens and entered data chairside. PDA used its EDR in 8 of these 9 for practitioner selection, monitoring, and longitudinal follow up. We identified three categories to consider regarding EDR use in practice-based research. First, if desired research data are the same as data already in the EDR, the EDR can greatly facilitate the research. Second, if desired research data are similar, but not the same as what is in the EDR, using the EDR can be a disadvantage because it may require additional programming or meet resistance from practitioners asked to enter data similar to actual practice data. Third, for studies outside of normal care, practitioners may be more open to using the EDR because no ‘double’ recording of data is required. Conclusion: EDRs can be a powerful research tool. They should be designed, implemented and supported with research as well as quality and business purposes in mind.
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