Medical and Dental Electronic Health Record Reporting Discrepancies in Integrated Patient Care

Abstract

Introduction: Oral health mirrors systemic health; yet, few clinics worldwide provide dental care as part of primary medical care, nor are dental records commonly integrated with medical records. Objectives: To determine the degree to which misreporting of underlying health conditions poses problems for dental clinicians, we assessed misreporting of 2 common medical health conditions—hypertension and diabetes—at the time of dental examination and assessment. Methods: Using comparative chart analysis, we analyzed medical records of a diverse group of patients previously seen at the University of Texas Physician outpatient practice and then treated at the University of Texas Health Science Center at Houston School of Dentistry. Electronic health records of patients aged ≥18 y were extracted from 2 databases: Allscripts (University of Texas Physician) and axiUm (University of Texas Health Science Center at Houston). We identified 1,013 patients with the commonly occurring conditions of diabetes, hypertension, or both, with nonintegrated records contained in Allscripts and axiUm. We identified the percentage of those patients previously diagnosed with diabetes and/or hypertension by their physicians who failed to report these conditions to their dental clinicians. Results: Of those patients with diabetes, 15.1% misreported their diabetes condition to their dental clinicians, while 29.0% of patients with hypertension also misreported. There was no relationship between sex and misreporting of hypertension or diabetes, but age significantly affected reporting of hypertension, with misreporting decreasing with age. Conclusions: Because these conditions affect treatment planning in the dental clinic, misreporting of underlying medical conditions can have negative outcomes for dental patients. We conclude that policies that support the integration of medical and dental records would meaningfully increase the quality of health care delivered to patients, particularly those dental patients with underlying medical conditions. Knowledge Transfer Statement: Our study illustrates an urgent need for policy innovation within a currently fragmented health care delivery system. Dental clinicians rely on the accuracy of health information provided by patients, which we found was misreported in ~15% to 30% of dental patient records. An integrated health care system can close these misreporting gaps. Policies that support the integration of medical and dental records can improve the quality of health care delivered, particularly for dental patients with underlying medical conditions.

Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study

“…Other authors have evaluated the real effectiveness of medical records in diagnosing other pathologies. Adibi et al noticed that 15.1% of patients do not report diabetes and 29% do not report high blood pressure [ 30 ] when the question is not well addressed or is missing. According to the authors, this latter aspect has played a crucial role in this study’s results as well.…”

“…Furthermore, there is also inconsistency among professionals about how a patient’s medical history is recorded. Even the terms listed in the medical record can be a source of misunderstanding, such as hypertension or high blood pressure [ 30 ]. Therefore, there is often no specific question for sleep disorders in medical record questions, which leads both patients and clinicians to a lack of understanding of the actual state of health.…”

Aadhar Arogya: Integrated Electronic Health Record as an Aid in Bridging the Gap between Individual Health and Public Health in India – A Review

“…Secondly, the clinician could subject the patient to the required tests to ascertain the existing medical condition, which sometimes could be repetition as the patient could not produce the recent reports of the tests, he/she underwent. Moreover, most often these conditions are misreported and this significantly increases with an increase in age [1] and some individuals who don't deem their medical history important either due to a lack of awareness or just negligence might not report accurately.…”

“…[2] Integrated medical and dental records can help close these misreporting gaps and improve the quality of dental services rendered especially to individuals with underlying medical conditions minimize the duplication of resources. [1] The word 'Aadhar' means foundation or base while 'Arogya' means health. Why the concept of 'Aadhar Arogya' could be a one-stop solution to finally bridging the gap between public health and individual health is the objective of this review.…”

Resilience Will Sustain Us

“…Along with reports involving child oral health (Burgette and Rezaie 2020; Nair et al 2020; Wang et al 2020), we have 2 that focus on electronic health records. In their publication, Adibi et al (2002) demonstrate that patients do not always accurately share their medical conditions with their dentists, which can lead to tragic consequences. Thus, they urge the development of policies that integrate medical and dental records.…”