Agreement in Medications Reported in Medical and Dental Electronic Health Records

Abstract

Introduction: The historical separation between medicine and dentistry has resulted in the creation of separate health records, which have the potential to negatively impact patient care and safety. Of particular importance, errors or omissions in medication lists in separate electronic health records (EHRs) may lead to medical errors and serious adverse outcomes. Objective: This study aimed to compare medication lists reported in the EHRs of active patients treated by both the University of Michigan School of Dentistry and Michigan Medicine to determine if differences exist. Methods: In this cohort study, EHRs of a population of 159,733 patients that the University of Michigan medical and dental clinics share in common were investigated for agreement in the reporting of 16 medications. After exclusion of minors and patients not seen in the last 5 y, records of 27,277 patients were examined. Results: The maximum percentage of agreement in medications reported in both records was 52% for levothyroxine, and the minimum was 7% for sildenafil. The medical record had a significantly higher number of unique medications than the dental record, suggesting higher underreporting in the dental setting. Conclusion: The lack of agreement in the report of medications with serious dental and medical implications argues in favor of unification of records and use of available technology to increase accurate medication reporting. Knowledge Transfer Statement: The results demonstrate a lack of agreement between medications reported in medical and dental records, which can have serious implications to patients’ health. A unified health record, employing available technology to increase accurate medication reporting, would mitigate this problem.

The Forefront of Dentistry—Promising Tech-Innovations and New Treatments

“…However, challenges in health information technology still exist. A study comparing medication reporting in dental and medical records highlights the disconnect between medical and dental records (Tenuta et al 2021). There is a great need to better integrate dental and medical EHRs, develop a consistent way to enter information that patients bring (e.g., genetics), improve natural language processing (“talk into the record”), and train more data scientists in dentistry.…”

Going electronic: an Epic move

“…Medicine and dentistry have historically existed as separate entities, resulting in the creation of separate patient health records, which may limit patient care and safety. 13 The General Dental Council emphasises the need to 'make and keep contemporaneous, complete and accurate patient records' as part of the expected standards of the dental team, with no suggested preference on paper or electronic notes. 14 Despite offering clear advantages in primary care dental practice for efficiency, patient accessibility and financial benefit, the comparatively limited uptake of electronic records in dentistry in the secondary care setting has created barriers for patients and clinicians in delivery of evidence-based oral care.…”

A Perspective: Integrating Dental and Medical Research Improves Overall Health

“…The goal of this innovative Precision Medicine initiative, launched by the NIH in 2015, named All of Us, is to build one of the most diverse health databases in history by inviting one million Americans, 18 and older, of all backgrounds, to voluntarily submit biologic samples and personal information to enable investigators to learn how biology, lifestyle and environment affect health (28). Participants are asked to answer surveys; they can submit data from wearable measuring devices and allow researchers access to their electronic health records (29). Early on, to get the program going, they were not able to include dental questions in the survey.…”

“…Exclusion of oral health data can delay diagnoses and treatment by missing characteristic oral signs of particular conditions, syndromes and diseases, with repercussions on overall health over the lifetime. Establishing a fully integrated dental-medical electronic health record must be a priority to ensure research advances provide optimal clinical care and guidance (28,29). We recognize the current siloed approaches are on both the medical and dental side.…”