Assessing Use of a Standardized Dental Diagnostic Terminology in an Electronic Health Record

Abstract

Although standardized terminologies such as the International Classiication of Diseases have been in use in medicine for over a century, efforts in the dental profession to standardize dental diagnostic terms have not achieved widespread acceptance. To address this gap, a standardized dental diagnostic terminology, the EZCodes, was developed in 2009. Fifteen dental education instutions in the United States and Europe have implemented the EZCodes dental diagnostic terminology. This article reports on the utilization and valid entry of the EZCodes at three of the dental schools that have adopted this standardized dental diagnostic terminology. Electronic data on the use of procedure codes with diagnostic terms from the three schools over a period from July 2010 to June 2011 were aggregated. The diagnostic term and procedure code pairs were adjudicated by three calibrated dentists. Analyses were conducted to gain insight into the utilization and valid entry of the EZCodes diagnostic terminology in the one-year period. Error proportions in the entry of diagnostic term (and by diagnostic category) were also computed. In the twelve-month period, 29,965 diagnostic terms and 249,411 procedure codes were entered at the three institutions resulting in a utilization proportion of 12 percent. Caries and periodontics were the most frequently used categories. More than 1,000 of the available 1,321 diagnostic terms were never used. Overall, 60.5 percent of the EZCodes entries were found to be valid. The results demonstrate low utilization of EZCodes in an electronic health record and raise the need for speciic training of dental providers on the importance of using dental diagnostic terminology and speciically how to use the terms in the electronic record. These indings will serve to increase the use/correct use of the EZCodes dental diagnostic terminology and ultimately create a reliable platform for undertaking clinical, outcomes, and quality improvement-related research.

A Competition between Care Teams Improved Recording of Diagnoses in Primary Dental Care: A Longitudinal Follow-Up Study

“…There are former studies suggesting that factors related to use of the applied diagnostic terminology itself, use of the electronic patient chart interface, or use of the terminology as part of clinic workflow may modify the frequency to record diagnoses and the quality of these recordings in dental care [ 12 , 13 ]. There may also be aspects such as cultural traditions (instead of recording diagnoses, dentists are used to record treatments and procedures), extra work required to learn to use novel, possibly changing terminology, financial incentives, and fear of loss of autonomy which may decrease enthusiasm to record diagnoses [ 9 , 14 ]. There is variance in how diagnostic terms are set up for use in electronic patent chart systems, and if the terms are not easy to be navigated in the category/subcategory, they may end up in the wrong place in the ICD-10 system [ 14 ].…”

Improving Oral–Systemic Healthcare through the Interoperability of Electronic Medical and Dental Records: An Exploratory Study

“…17 Another hurdle is the development of documentation standards for electronic dental records, which have not been satisfactorily nor frequently used. 18,19 As a result, information exchange between medical and dental EHRs is essentially nonexistent, with only rare examples in the literature. 20 While there are myriad dental and medical EHR software packages on the market, most medical EHRs do not include a dental module, or at best include a "stand alone" dental module, and most dental EHRs are not interoperable with medical EHRs.…”

Recording of diagnoses in public primary oral health care in a retrospective longitudinal observational study in a Finnish town: Underrepresentation of periodontitis diagnoses

“…There are former studies suggesting that factors related to the use of the applied diagnostic terminology itself, or to the use of the terminology as part of clinic workflow and the related use of the electronic patient chart interface may influence the frequency of recording diagnoses and the quality of these recordings in oral health care (Obadan-Udoh et al, 2017). There may also be aspects, such as extra work required to learn to use novel, possibly changing terminology, financial incentives, and fear of loss of autonomy which may decrease enthusiasm to record diagnoses (Ramoni et al, 2017;Tokede et al, 2013;Walji et al, 2013). In addition, cultural traditions (e.g., instead of recording diagnoses dentists are used to recording treatments and procedures) may have an influence on these factors (Ramoni et al, 2017;Walji et al, 2013).…”