Objectives: Use of electronic medical records for quality improvement and research has been reported. However, the literature is scant regarding use of electronic dental records (EDR) for these purposes. Studies have tended to use the EDR to identify subjects or to analyze claims data rather than to collect data at the point of care. Our objective is to communicate “real world” lessons learned while we adapted the EDR for research data collection in a large dental group practice in Minnesota (HealthPartners; HP).
Methods: HP is part of the Dental Practice-Based Research Network (DPBRN; www.DPBRN.org). One of DPBRN's five regions, the HP/MN region comprises dentists employed by HealthPartners Dental Group and private practitioners in Minnesota. We adapted the HP version of an EDR system to collect data for DPBRN Study 2 ("Reasons for placement of restorations on previously unrestored surfaces"). Among other items, this study collected data on the reason the restoration was placed, preoperative and postoperative caries lesion depths, and type of restorative material used.
Results: Inputting data (using existing codes) by HP practitioner-investigators themselves into modified EDR screens during actual delivery of usual care was judged to be very feasible by the 29 HP DPBRN practitioners who did the Study 2 protocol. However, using the EDR for study monitoring, correcting errors and obtaining a final study dataset provided challenges. Because study data were derived from diagnosis and treatment codes, errors in coding required voiding and replacing claims information. Ability to enter information through several different pathways allowed variation in application of the protocol among practitioner-investigators.
Conclusion: Despite encountering several challenges, we found significant advantages when adapting the EDR for data collection at the point of care in a dental PBRN. EDR adaptation has the potential to speed translation of research into daily clinical practice. Support: U01-DE-16746, U01-DE-16747.