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What certified products are available for dentistry?

• How do you find a certified EHR that meets the Meaningful Use requirement?
• What are the barriers to dentists adopting health IT?
• Can oral health providers meet Meaningful Use criteria with the current available products?

To determine whether an EHR, specifically a dental EHR, is certified to meet Meaningful Use requirements, individuals may search the Certified Health IT Product List available on the ONC website. Additionally, there are several other ONC-Authorized Testing and Certification Bodies which are available to assist with certifying complete EHR and EHR modules as detailed by the EHR Standards and Certification Final Rule. These additional certification and testing groups, such as the Certification Commission for Health Information Technology , also generate searchable lists of products that are ONC-ACTB certified.

Finding a certified dental EHR is particularly challenging for dentists. There is a limited number of either certified dental EHRs or certified EHRs which offer dental modules. Currently, there are two modules available for dentistry that are certified by the Office of the National Coordinator for Health Information Technology (ONC): the Indian Health Services’ Resource and Patient Management System (RPMS) and Electronic Dental Record (which is a Dentrix product) and the Veterans Administration’s VistA Dental Record Manager Plus. The VistA system is certified as a module, while the IHS product is certified as a full EHR. Further, per the Dentrix website, “the Dentrix dental practice management software can receive modular certification” to help oral health providers as they demonstrate Meaningful Use. However, as noted earlier, many of the core objectives for Meaningful Use do not apply to oral health providers which can make participation in Meaningful Use particularly challenging.

Other challenges and barriers to the adoption of health IT and/or Meaningful Use that are particularly relevant to oral health providers include:

• The absence of EHRs with diagnostic, therapeutic, or decision support applications appropriate for dentists, such as the functionality to capture, store, display, and analyze digital images;
• Difficulty in meeting the eligibility thresholds for Medicaid or needy patient population;
• Lack of proven interoperability between medical and dental EHRs;
• Lack of training on oral health IT at the pre-doctoral and residency program level;
• Lack of software for oral health that meets the certification criteria of the ONC-Authorized Testing and Certification Bodies (ONC-ATCB) ;
• Inability to meet criteria surrounding quality reporting;
• Willingness of oral health providers to adopt EHRs;
• Interoperability with EHRs;
• Cost to implement EHRs, with particular respect to those individual oral health providers who, even if they meet Medicaid Meaningful Use requirements, the cost to implement the EHR may prove to be more than the incentive received; and
• Ensuring sufficient training on EHRs during dental school.

Although multiple challenges to dental EHR adoption continue to exist, there are emerging opportunities for advancing health IT in the delivery of oral health care.  Advances in health IT systems, and increased awareness about the needs of dental providers with respect to health IT, EHRs, and requirements of Meaningful Use are just a few potential avenues to help mitigate these barriers. Organizations, such as Regional Extension Centers (RECs), can be used to promote partnerships within the dental community to assist dentists with the adoption and implementation of health IT. Additionally, although quality measures specific to oral health were not included in stage 1 of Meaningful Use, they may be included in later stages.

Though there are numerous barriers to adoption, it is possible for an oral health provider to meet Meaningful Use criteria with the currently available products. To do so, a provider would have to be eligible for the incentive payments, based on the requirements detailed in the Final Rule and also use one of the two nationally certified products available (the Indian Health Services’ RPMS or the Veterans Administration’s VistA ). For specific information on eligibility, please refer back to the Meaningful Use Eligibility section of this module.

Related Resources

• Electronic Health Records (EHRs) and ARRA, HITECH, and EHRs Fact Sheet - American Dental Association (ADA). The ADA provides this fact sheet and this section of their website as a resource for providers who have questions about, among other things, how Meaningful Use is applicable to dentists.
• Challenges in Quality Assessment of Dental Care (2010) - Article by James D. Bader, DDS in the Journal of the American Dental Association. Discusses limitations of the quality assessment methods for dentistry, reasons quality assessment is limited in the field, and ways to address the limitations that exist.