Understanding Government Mandates and Industry Trend

Government Mandates

1) HIPAA

Mandated and signed by Pres. Clinton in 1996 with complete compliance by 4/13/2003. This was mandated to all health profession and included the dental industry (though health plans might be separate from dental and vision coverage). Though exemptions existed like long-term health plans and limited-scope plans, most dental office were required to comply. Also, the development NPI were created

2) Red Flag

Mandated by Federal Trade Commission (FTC), businesses were to safeguard against identity fraud and theft. All business had to comply by Nov 1, 2008 but did not clearly define dental industry as one of the industry for compliance. With the work of ADA, the dental industry was given an extension to 5/1/2009 for compliance.

Emergence of Practice Management Software

Practice Management Software (PMS) started in the Medical Industry in Late 70s to early 80s (with the advent of computers and software development). With medical and dental field going hand in hand, dental industry developed PMS. With the progression and computing power of the PC, PMS expanded its roles from scheduling in the front side to the “chairside” and clinical part of the practice. Since data are entered into the PMS, it laid the backbone to the emergence of eDRs by being the central depository of data of patient from insurance info, finances, treatment plan, clinical notes, and family history.

Emergence of Digital Radiography

Like PMS, digital radiography focuses on the procedure and diagnosis of patients’ x-rays and “cosmetic” images (from digital camera and intraoral cameras). The physical equipment of digital radiography are reusable (compare to film being an one-time usage item) and require a means to store data in a central depository (imaging software). This provides the same foundation for the emergence of eDRs.

Conclusions:

With my deduction from Pres. Bush integrating oral health as part of the overall health (and CPRs/eHRs) and 10 year mandate of Executive Order 13335, I believe the expectation of eDRs will be mandated with the compliance date of 2014 (unless the ADA steps in to delay the implementation). Added with the increasing usage of PMS and digital radiography (with imaging software), as the means of communicating electronically, eDRs are the de facto vehicle for patient information (in particular HIPAA compliance when a patient goes to another practice as well as e-claim services by insurance).

Also, PMS and Imaging software vendors are implementing eDRs directly into the software (and it’s a logical implementation) without any concerns for most practices who are already utilizing the one or both software. That is an intrinsic cost and value already covered by your support/upgrade package you pay to the software vendor (usually annually).

At the end of the conversation, it is not a question of if but when?