General Questions about EHR
1. What is a basic Electronic Health Record (EHR) and Electronic Medical Record (EMR) System?
An EHR/EMR system has all of the following functionalities: patient history and demographics, patient problem lists, clinical notes, comprehensive list of patients' medications and allergies, computerized orders for prescriptions, and ability to view laboratory and imaging results electronically.
2. What is an Electronic Dental Record System (EDR)?
An EDR is an electronic health record. It is a combination of processes and data structures, used by dentists, for purposes of documenting or conveying clinical facts, diagnoses, treatment plans, and services provided.
For our purposes, EDR will be used interchangeably with EHR.
3. When will EHRs adoption be required for dental practices?
For the majority of dental practices, there is no deadline to switch to EHRs. Beginning in 2015, Medicare eligible dentist who do not successfully demonstrate meaningful use will be subject to a payment adjustment. The payment reduction starts at 1% and increases each year that a Medicare eligible professional does not demonstrate meaningful use, to a maximum of 5%.
Dentists should check with their State Medicaid Agency for applicable state law requirements.
4. I have heard that dentists are required to have digital dental imaging implemented in their offices by 2014 even if they don’t adopt an EHR system.
Although an increasing number of dentists are using digital dental imaging for radiography, photography, and, as an adjunct to Computer Aided Design/Computer Aided manufacture (CAD/CAM) fabrication devices, there is no federal law that requires every dentist to implement digital dental imaging.
However, if a dentist meets the definition of a “Medicare eligible professional” under the Medicare EHR Incentive Program, Medicare will apply payment adjustments beginning on January 1, 2015 unless the dentist qualifies as a “meaningful user” of certified electronic health record (“EHR”) technology, which may require the adoption of digital imaging technology. For more information about the payment adjustments, visit the Centers for Medicare & Medicaid Services (“CMS”) webpage, Payment Adjustments & Hardship Exceptions Tipsheet for Eligible Professionals. For more information about the Medicare EHR Incentive Program, visit the CMS EHR Incentive Program website.
State law and state implementations of the Medicaid EHR Incentive Program vary from state to state, so check with a qualified professional for information about your state’s requirements for the adoption of EHRs and digital imaging. Your state dental association may also have information about the requirements in your state.
5. What are the secured methods for the transmission of dental digital images?
Exchanging identifiable patient information via unsecured e-mail can pose a risk of unauthorized access and may lead to data breaches requiring notification under HIPAA and/or applicable state law. Clinical photographs and full 3D (three dimensional) X-ray volumes can be considered to contain protected health information (“PHI”) as defined by HIPAA if they identify the patient or if they could be used to identify the patient.
Guidance to safeguard the transmission of protected health information (PHI) and how to render it unusable, unreadable, or indecipherable to unauthorized individuals can be found on the Health Information Privacy section of the HHS website.
6. My dental office is virtually paperless now. Would I qualify for the Medicaid EHR incentive program?
The keys to qualifying for the incentive program is that you have adopted a certified EHR and you have the necessary Medicaid patient volume threshold. Eligible professionals must demonstrate adoption, implementation, upgrading, or meaningful use of certified EHR technology, as appropriate.
7. How can I check to see if my EHR is certified for the Medicare and Medicaid EHR Incentive Programs?
A certified product list is maintained by the ONC. The most up to date information can be found on their website.
American Dental Association
Department of Dental Informatics
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