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Don't believe everything you hear

Rumors persist about implementing electronic health records

If you believe the rumors, every dentist in the country will have to go paperless by this time next year.

But what have you been taught about believing rumors? The truth is, no dentist is required by the federal government to use electronic health records or implement digital radiography systems by 2014.


"Although some state Medicaid programs may require doctors to submit claims electronically, there is no looming requirement that we all must go paperless in the near future," said Dr. Jonathan Knapp, chair of the ADA Council on Dental Practice, who also serves on the ADA's Standards Committee for Dental Informatics, which is developing standards for dental EHR systems.

But the federal government is sweetening the deal for some Medicare providers who go paperless. Dentists who are Medicare providers may be eligible to participate in a program that provides incentive payments for demonstrating meaningful use of certified Electronic Health Records technology.

Medicare payment reductions will begin in 2015 for most providers who are eligible but choose not to participate. The reductions will be enforced at the rate of 1 percent beginning in 2015 and will increase by 1 percent per year to a maximum of 5 percent. A similar Medicare program encourages electronic prescribing by eligible professionals through a combination of incentive payments and payment adjustments.  

Dentists who are eligible Medicare providers aren't required by federal law to use EHRs but the loss in revenue may impact the finances of their practice. Most dentists do not participate in Medicare and are not eligible to participate in the incentive program, according to the ADA.

Some dentists are able to participate in a similar program through Medicaid but they have to have an unusually high volume of Medicaid patients to be eligible; at least 30 percent of their services must be provided to Medicaid patients. Some pediatric dentists may be eligible at a lower percentage of their patient base.

Dentists also need to pay attention to their state laws regarding the use of electronic transactions and electronic health records, as well as their contractual obligations as participating providers in dental plans. Minnesota is requiring most health care providers in its jurisdiction to implement interoperable EHRs.

"Given the variances in the laws state to state, the language from the federal government and the additional requirements from various insurance companies, I can understand why dentists are confused," Dr. Knapp said. "Electronic claims are a small piece of the broader topic of electronic record-keeping and although electronic health records can make filing electronic claims easier, they are generally not mandatory."

Participating in Medicare and Medicaid EHR programs is not without risk. Interested dentists should contact the Centers for Medicare and Medicaid Services and their state Medicaid authorities for more information.

EHRs include integrating digital imaging and archiving, treatment planning, ordering medications and tests, medication management and other related systems that can work together as an integrated seamless whole regardless of the vendor or platform. Eventually, a dental EHR should be able to import health information from another dentist or health care provider with minimal, if any, data entry.

It should also be able to share information with another health care provider. This interoperability across settings, specialties and technological platforms is a key goal of EHR implementation.

The ADA is attempting to clear up any confusion for dentists. For more information on the Association's activities or to learn more about electronic health records, visit www.ada.org/paperless