Do We Really Need Electronic Dental Records [EDRs]?

BY DARRELL K. PRUITT DDS

Do you really need digital records, Doc?

Why?

The Important Role of Dental Records - Fiorillo Dental


“Ransomware criminals’ demands rise as aggressive tactics pay off – Average ransomware demands and payments are up as criminal enterprises pour money into the profitable operations.”

By Brooke Crothers for FOXBusiness, August 14, 2021.
https://www.foxbusiness.com/technology/ransomware-criminals-demands-rise-aggressive-tactics-pay-off

Crothers: “The ransomware crisis just keeps getting worse as criminal enterprises pour money into highly profitable ransomware operations, according to a report from Palo Alto Networks’ Unit 42 security consulting group. The average ransomware payment climbed 82% to a record $570,000 in the first half of 2021 from $312,000 in 2020.”

I am asking Dr. Roger P. Levin, DDS, founder and CEO of Levin Group, why he and his international consultant group still promote electronic dental records.

How about it, Dr. Levin? Can you describe how practice management software benefits dental patients? The software doesn’t make dentistry safer or less expensive than paper records – even if digital is more convenient for dentists and staff (most of the time).

YOUR THOUGHTS ARE APPRECIATED

Thank You

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Dodging an Embarrassing Question about Electronic Dental Records

MORE ON EDR SECURITY

The Secrets of AmeriPlan® Corporation's Discount Dentistry ...

By Darrell K. Pruitt, DDS

Dental Care Alliance Data Breach Impacts More Than 1 Million Patients

NEWS FLASH!

Sarasota, FL-based Dental Care Alliance, LLC, a dental support organization with more than 320 affiliated dental practices across 20 states, has been hacked and the protected health information of more than a million individuals has potentially been compromised. The breach occurred on September 18, 2020, was detected on October 11, and was contained on October 13.”

Steve Alder

[HIPAA Journal – December 10, 2020]

LINK: https://www.hipaajournal.com/dental-care-alliance-data-breach-impacts-more-than-1-million-patients/

Currently I am in conversation on LinkedIn with a Chief Information Officer for an IT firm. He assures me that the cloud is more secure than paper dental records stored in heavy and loud metal filing cabinets, but cannot say why.

Meanwhile, I have never heard of a million paper dental records being stolen in one heist. Wouldn’t that require a truck or two? What’s more, once the thieves escape to their hideout, someone will have to enter the data onto computers – while struggling to interpret bad handwriting.

ASSESSMENT: Your thoughts are appreciated …. More later.

THANK YOU

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Medical “Chartless future for everyone closer than you think”

2015 … Really?

 

 

 

 

 

 

By Darrell K. Pruitt DDS

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“By 2015, health care is scheduled to be chartless. The federal National Health Information Infrastructure (NHII) is already formulating the parameters for this future. Chartless records are not a choice. The year 2015 is less than seven years away. We have seen hospitals, physicians’ offices, and other health-care providers moving in this direction.

In dentistry, only about 25% of practices are using computers chairside and only 1% is chartless. The American Dental Association is taking a proactive role in NHII. Individual dentists must also take part in the coming changes or once again be victims to others’ choices.”

-Patti DiGangi, RDH, BS

[Dental Economics, 2009]

***

http://www.dentaleconomics.com/articles/print/volume-99/issue-3/features/chartless-future-for-everyone-closer-than-you-think.html

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Conclusion

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Can Politically-Correct Names Save Obamacare?

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Saving Electronic Health Record Interoperability?

1-darrellpruittBy D. Kellus Pruitt DDS

If HHS successfully persuades Americans to use happy names for its bad ideas, will the cheap trick save electronic health record interoperability which is critical to the success of Obamacare?

Healthcare Lexicon 

According to the government’s modernized healthcare lexicon, doctors have been demoted to “providers,” insurance companies, including Medicare/Medicaid, have been promoted to “payers,” and patients’ position in the hierarchy has diminished from “principals” to “stakeholders” – a rank on par with 3rd parties such as insurers, HHS and other unaccountable parasites.

Wall of Shame

Ominously, HHS recently changed the contentious name “Wall of Shame” to a more innocuous“ breach reporting tool,” to describe the public list of data breaches involving the medical records of more than 500 patients. It turns out that the growing list of major data breaches is unexpectedly shaming  far too many providers and payers – including Medicare/Medicaid. Imagine that!

In fact, since Americans’ growing disgust with privacy breaches threatens the very success of Obamacare, there is evidence that HHS has turned to betraying its lawful obligation to the nation by hiding breaches from those who are most vulnerable – Americans.

HIPAA Failure

The half-baked plan to shame providers who experience data breaches – perhaps through no fault of their own – is not working out like HHS had hoped. Due to HIPAA’s abysmal failure to halt data breaches, the Wall of Shame has become a national embarrassment and an obstacle to EHR adoption. I expect the public listing of major breaches to be quietly scrapped soon in favor of keeping patients in the dark concerning their risks of identity theft.

Dentistry 

In dentistry, on the other hand, common sense as well as market resistance evidently caused HHS and other stakeholders to give up trying to prohibit use of the 8 syllable “electronic dental records” in favor of the 14 syllable “electronic health records for dental practices.”

Nevertheless, holdouts (including Dissent Doe) still occasionally feel it is important to correct this dentists when I use “EDR” instead of “EHR.” You got to love ‘em.

Obama Care 

Assessment 

Transparent silliness suggests that HHS is failing in its duties. Due to lack of accountability, we can expect EHRs and EDRs to become even more expensive and more dangerous, possibly bringing an end to Obamacare.

Conclusion

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Pennsylvania dental patients’ stolen social security numbers posted online

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EDR Data breach in Williamsport, Pennsylvania

By D. Kellus Pruitt DDS

1-darrellpruittOver the last 7 years, I have absorbed a surprising amount of criticism for warning my community that electronic dental records continue to grow both more expensive and more dangerous than paper dental records. That chunk of bad news which not one dental leader is ready to acknowledge is becoming increasingly difficult for even the most popular practice management consultants and other 3rd parties to hide. Unresponsiveness from those who profit from EDR sales is unethical and has already harmed dental patients.

Vulnerability Notes

In the Vulnerability Notes that have been issued by the US Department of Homeland Security to dental software giant Dentrix in the last year, security expert Justin Shafer was thanked in both for alerting authorities to Dentrix’s weaknesses.

Though evasive EDR stakeholders were able to fend off transparency far too long, it is fast becoming obvious to the world that their free ride with no accountability has always been destined to end ugly, and greed is to blame. Unforgiving media coverage of the nation’s loss of confidence in EDRs just might start in day or so in the parking lot of dentist’s office near Williamsport, Pennsylvania. Take cover, Dentrix

Eyeing Dentrix 

In the last two years, Justin Shafer’s uninvited watchful eye over Dentrix’s vulnerabilities may have already helped protect millions of dental patients from identity theft. Nevertheless, Dentrix’s security problems which company officials apparently hide, continue to endanger the welfare of uninformed Americans. I have learned that Shafer doesn’t give up easily. He’s in HIT for the long haul.

Yesterday morning, he posted a heads-up on the City of Williamsport’s Facebook, as well four other local Facebooks, warning of the results of a dental office data breach of Dentrix software: Dental patients’ social security numbers have become available on a zip file from Piratebay.

Shafer: “I am willing to bet there are a lot of your citizens SSN’s in this database. Look at rsc_dat.dat and patient.dat… Seems a dental database ended up on piratebay. You may already know.. you may not.”

He explained it to me this way: “the practice info is in rsc_dat.dat, patient info is in pat_dat.dat. It’s a nightmare, and I told dentrix and the doctor a full year ago.”

Insightful or clueless dentist?

Assessment 

Did your opinion of censorship in dental care recently undergo change?

Conclusion

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The Flaws of Electronic Records

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Reporting on an Op-Ed by Drexel University’s Scot Silverstein

By Darrell K. Pruitt DDS

pruittRecently, on Philly.com, I read the following interesting essay and counter-opinion.

“The flaws of electronic records – Drexel University’s Scot Silverstein is a leading critic of the rapid switch to computerized medical charts, saying the notion that they prevent more mistakes than they cause is not proven.”

by Jay Hancock, writing in:

KAISER HEALTH NEWS.

http://www.philly.com/philly/entertainment/20130218_The_flaws_of_electronic_records.html

Do you recall that I advised dentists to wait a year or so before purchasing electronic dental records?

Dr. Silverstein warns Hancock that we’re in the midst of “a mania” as traditional patient charts are switched to computers. “We know it causes harm, and we don’t even know the level of magnitude. That statement alone should be the basis for the greatest of caution and slowing down.”

Silverstein Speaks

Silverstein tells Hancock that he doesn’t discount the potential of digital records to eliminate duplicate scans and alert doctors to drug interactions and unsuspected dangers.

“But, the rush to implementation has produced badly designed products that may be more likely to confound doctors than enlighten them, he says. Electronic health records, Silverstein believes, should be rigorously tested under government supervision before being used in life-and-death situations, much like medical hardware or airplanes.”

Physician George Lundberg, editor at large for MedPage Today, says Silverstein “is an essential critic of the field,” and that “It’s too easy for those of us in medicine to get excessively enthusiastic about things that look like they’re going to work out really well. Sometimes we go too far and don’t see the downside of things.”

Hancock Writes

Hancock writes. “Many say he comes on too strong.” Remind you of anyone? It’s easy to fall into a habit of “coming on too strong” once politeness proves ineffective and not nearly as much fun.

Silverstein points out that since the government doesn’t require caregivers to report problems, “many computer-induced mistakes may never surface.”

In dentistry, EHR stakeholders bury computer-induced mistakes even deeper by ignoring and even censoring dentists’ concerns about cost and safety.

Shah Opines

Furthermore, ME-P thought-leader Shahid N. Shah MS opines in Chapter 4 of the book: www.BusinessofMedicalPractice.com

Chapter 13: IT, eMRs & GroupWare

And … Pruitt Wonders?

I sincerely wonder how many dentists have been kicked off of DrBicuspid, DentalTown, Dental Economics and LinkedIn for pointing out dangerous flaws in advertisers’ dental products. I offered to start a listing of the censored, but got no response. Nevertheless, I bet I’m not the only one.

Assessment

More opinions from ME-P contributors and essayists:

Conclusion

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How I Lost my Battle Against the NPI

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Refusing a National Provider Identifier Number

By Darrell K. Pruitt DDS

pruittI can no longer refuse to apply for a National Provider Identifier (NPI). I lost that long battle. Anyone rejoicing?

I’m spent. My leverage has vanished. Telling insurers “I have no NPI” held much more inherent power than “I have an NPI but I won’t share it with you on principle.” Far too many words. My profession has become dominated by unresponsive, unaccountable 3rd parties that dental leaders in the ADA welcome as policy. Working together, they promote and commandeer the technology dentists purchase and clueless patients pay for in increased fees. I have painfully learned that principles are only for dentists who can still afford them, and it’s a bad economy for luxuries.

Non-HIPAA Entity

Since I am not a HIPAA-covered entity and therefore not required by law to adopt an NPI, my capitulation to extortion disappoints me as an American citizen. I still find it hard to believe that an anti-consumer HIPAA rule enthusiastically enforced by the dental benefits industry could force me to “volunteer” for a PERMANENT identifier. As I and 96% of dentists become jerked around by our NPIs, I hope dental historians note that I am the ONLY dentist who publicly asked “Why?” instead of “Why not?” After 6 years, I’m still awaiting an answer to that question from leaders who continue to promote the NPI to dentists while ignoring their questions.

Dental Benefits Providers

I was able to hold out up until Aetna, Delta Dental and other dental benefits providers deprived my office of access to details of patients’ dental benefits unless I have an NPI. I’m waiting for someone – anyone – to tell me how the identifier can possibly improve the dental care of those who pay Aetna and Delta Dental premiums, especially if their benefits are intentionally kept secret from their dentists. I am certain that if the nation’s employers who purchase dental benefits were aware of the transparent nonsense, they would never purchase such products. Where’s the US Chamber of Commerce? Where’s the FTC? How about the US Constitution?

This is exactly why there needs to be more openness in our profession, Doc. The cockroaches who were invited to quietly overrun dentistry cannot withstand transparency, yet I don’t know how much longer I can fight for it without further risking the health of my practice.

As anyone can understand – and as anticipated by corporate executives in the insurance industry as well as by those with vested interests in the ADA Department of Dental Informatics – to have to explain to new patients why I cannot estimate how much they will owe for treatment would destroy my practice. Outside the US, other societies deem it unethical to deny patients informed consent to treatment for any reason. The NPI is such an egregious blunder that I never expect those who promoted to accept ownership.

###

NPI

Assessment

If I lost the battle, who won? Do EDR enthusiasts in the ADA call this a glorious victory and a likely source of ADA pride for decades to come? Or is it much more shameful? Since I lost freedom, I want to know who won?

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On Practice-Based Research Networks

In Dentistry – if only it were that easy

By D. Kellus Pruitt DDS

I like the concept of a Practice-Based Research Network for teasing out latent miracles from dentalcare data, but I’m afraid any hope of networking success is limited by insurmountable cost and safety concerns of EDRs that few in the dental industry are yet willing to recognize.

Dr. Schleyer 

Titus Schleyer, DMD, PhD, Associate Professor and Director, Center for Dental Informatics, University of Pittsburgh published “The feasibility of an electronic dental practice-based research network” a few days ago.

“The long-term goal of our research is to use data from EDRs to improve patient care and its outcomes. The objective of this project is to develop a generalizable method for extracting EDR data for practice-based clinical research, using Dentrix as the test system.

In our first specific aim, we will determine the utilization of clinical data elements useful for research by practitioners by mining the electronic dental records of 100 Dentrix users and generating summary statistics about patient documentation patterns by data field.

The second specific aim will develop a technical Infrastructure for extracting data from Dentrix and integrating them with manually collected research data. The main outcome of this project will be the electronic Dental Practice-Based Research Network (ePBRN), a generalizable method for extracting clinical data from EDRs and reusing them for practice-based research. This project is a first step in making the increasing amount of electronic clinical data available for improving research, clinical care and patient outcomes.”

-Abstract: September 30, 2011

http://halley.exp.sis.pitt.edu/comet/presentColloquium.do?col_id=2348

I agree with Dr. Schleyer. However, until dentists perceive value in EDRs instead of liabilities, the dreams that he and I share about real-time, evidence-based research on an internet platform will be nothing more than just a cool-sounding fantasy of a handful of geeky dentists hoping to get a better peek at an obscure healthcare niche.

On Transparency 

Transparency in dentistry, rather than NPI numbers, has a better chance of revealing cost-effective solutions for painful and even life-threatening health problems. In addition, nothing is holding down the cost of HIPAA compliance, and data breaches from healthcare facilities – including dental offices – are only becoming more common.

Assessment 

Sidestep liability. De-identify now. If a dentist’s EDR system is breached, yet it contains no Protected Health Information [PHI], who cares?

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The Absurdity of “Meaningful Use” Requirements in Dentistry

Let’s End the Silence

By D. Kellus Pruitt DDS

Hey, Doc. How can your silence possibly serve your patients’ best interests?

For my colleagues in the audience who have quietly examined the critical and timely issues I’ve repeatedly offered for discussion – adults with post-graduate degrees who might have briefly considered publicly responding  to what I write, but who still cannot take ownership of an opinion – what on Earth is holding you back? Whatever it is, I say there are only lame, self-serving excuses for dentists to continue to betray patients’ trust. So how does that make you feel, Doc? A little angry maybe? Indignant? Let’s work on that professional nerve a little more. Maybe I’ll get a rise out of you yet.

Where Have You Been? 

As a healthcare provider whose trusting patients depend on you to protect their interests from stakeholders who cannot be held accountable – where have you been? Do you really believe dentists’ stoicism upholds and promotes the ideals of the healing profession? What about the Hippocratic Oath? How?

Or, is your shyness perhaps the manifestation of a character weakness revealing little confidence in your own personal ethics? You can’t blame me if that pisses you off. As long as you are silent, it’s impossible for me to tell a thing about you. So please, feel free to describe how my observations make you feel. You could easily change my opinion by merely speaking up to defend your silence … which promises to be an interesting argument.

ADA Members 

Or, maybe, as an ADA member, or more so a vetted official, professional silliness isn’t your choice at all. Perhaps you are torn between supporting common sense and honesty in your community and a professional dedication to the ADA’s committee-approved slogan “Speaking with one voice.” What looks to me like a cheap PR hack’s piece of art – purchased by either a clueless or nasty-cynical ADA official – is intended to not only keep members in their place as policy, but to also give state and national politicians the impression that all dentists unquestioningly unite behind any and all ADA ideas – sight unseen. (Public discussion of policy with membership is never permitted, even though it’s just dentistry). Elsewhere in the world, that would be called tyranny. It’s also easy to see that “one voice” is a generous exaggeration of our current dental leaders’ influence in Washington.

Stage 2 Meaningful Use

If anonymous leaders who secretly manage a silent profession insulated from the community were the least bit effective at protecting dental patients’ welfare, dentists who actually provide dentistry for the poor wouldn’t be faced with absurd and overwhelming Stage 2 Meaningful Use documentation requirements that will be enforced by CMS in 2012:

  • Record Smoking Status for Patients 13 Years Old or Older
  • Generate Lists of Patients by Specific Condition
  • Check Insurance Eligibility Electronically from Public and Private Payers
  • Submit Claims Electronically to Public and Private Payers
  • Provide Patients with Timely Electronic Access to their Patient Information
  • Computerized provider order entry (CPOE)
  • eRX
  • Record Demographics
  • Record and Chart Vital Sign
  • Patient Reminder
  • Electronic Copies
  • Clinical Summaries
  • Advising Smokers to Quit

Rising Above Politics

As healthcare professionals, our patients depend on us to rise above political correctness and petty, cheap slogans. Indeed, how good is it for healthcare when doctors evade unpopular issues? Can anyone in the audience explain how our patients are better served by PR hacks than dialogue? Anyone?

Assessment

Face it. The absurdity of Meaningful Use [MU] requirements in dentistry proves that our non-responsive leadership is incapable of protecting our dental patients. From now on, only you and I can do that on our own as individuals. But to make a difference, you must be heard.

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Challenging a Naive eDR Advocate

An Open Letter to Dr. Margaret Scarlett

By D. Kellus Pruitt; DDS

For the last few weeks, I’ve been challenging a naive EDR advocate. They are becoming increasingly hard to find. Here is what I posted today on her blog.

Dear Dr. Margaret Scarlett

This open conversation on your Medscape Connect blog not only alerts the nation to the possibility of imminent failure of interoperability in post-computerized dentistry, but it also features dialogue introducing potential solutions around otherwise insurmountable problems the industry is encountering.

http://boards.medscape.com/forums?128@884.9VVBadZEUsj@.2a077212!comment=1

Courageous 

A forum such as yours that invites frank discussion about the faults of EDRs is almost unprecedented and entirely politically-incorrect. But then, that is why it is incredibly meaningful. Thank you for your courage, Dr. Scarlett.

Collegial

Let’s keep it collegial but challenging.

First of all, in your April 21st response, you justifiably expressed concern that EHR/fax hybrids might increase danger of data breaches over the incredible risk that already exists in digitalized healthcare. I assume that now that you know more about cloud-based companies such as Sfax, you agree that your security concern is unfounded. Fax, telephone and the US Mail will always be more secure than the internet – an often-forgotten fact. Any arguments?

A large part of your response concerned interoperability and aggregation problems that will be easily solved by the Health Information Exchanges (HIE) and EHR/fax companies. Why would their product not be seamless like any other digital transmission? From our perspective as dentists, your concern is a non-issue. Anything that can be printed on paper can come up on a computer screen and vice versa. Fortunately for our patients, you and I don’t have to worry ourselves about the technological magic of common office equipment.

I just have to say that when I read about your concern for “dependence on ink supplies, phone connections, or the availability of personnel to handle pieces of papers without any mistakes,” I noticed you didn’t say anything about saving the forests and paper cuts. Quite frankly, I think even you recognize that these lame arguments against a new idea are disingenuous stretches. Who’s to say there will be fewer keystroke errors on digital records than paper? See what I mean?

Lastly, in your April 21st response, you seem to suggest that unless the vast majority of dentists spend tens of thousands of dollars to purchase EDRs which will raise the cost of the care they provide, huge pools of data stored in HIEs that you claim somehow “assure patient-centered care,” will not be available to dentistry. You’ve got to be kidding. How many years away is that science? Let me repeat: Dental patients are fortunate that EDRs are going nowhere because of dentists’ solid business reasons in the land of the free. Until EDR advocates base sales claims on evidence rather than hearsay, they are only entertaining themselves with the fantasy.

Assessment 

I only wish the anonymous EHR experts in the ADA who are quietly influencing lawmakers would step out and introduce themselves to the community they serve. Can you think of any possible reason that the ADA can’t answer a few questions about what they have been doing on our behalf. Or should that not concern dentists?

Conclusion

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Electronic Medical Records and Dentistry

A Note to Diane Rehm

[By Darrell K. Pruitt; DDS]

Dear Diane Rehm,

I always enjoy your show.

You add value to my drive to work.

As a dentist, I was especially interested in your March 10 show “Electronic Medical Records.”

http://wamu.org/programs/dr/10/03/10.php?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+WAMU885DianeRehm+%28WAMU%3A+The+Diane+Rehm+Show%29&utm_content=FaceBook#30598

In all the excitement that surrounds the 19 billion dollars our grandchildren have unwittingly granted to physicians and hospitals for “meaningful” adoption of certified eMRs, you probably haven’t noticed that nobody is talking about including dentistry in the conversion from paper to digital. Do you find that odd?

Small and Mid Sized Practices

Like small and mid sized physicians’ practices, small dental practices are intended to be part of the federal mandate for interoperable eMR adoption – even without the help from stimulus money that physicians receive. You probably weren’t aware that the stimulus money will run out before HHS gets around to defining “meaningful use” of eMRs in dental office. That would be impossible, but nevertheless, I anticipate that the attempts will be entertaining. Physicians in small practices typically have tens of thousands of paper charts as thick as phone books. On the other hand, a busy solo dental practice, like the majority of practices in the US, might have 5,000 files that are very thin in comparison to files that involve the whole body instead of just the bottom third of the face. That makes sense, doesn’t it?

Marginal Benefits May Not Exceed Marginal Costs 

I listened to your guest Dr. Carol Horn, who practices internal medicine in private practice, as well as others involved in the actual delivery of healthcare. They list not only the benefits of eMR adoption, but in fairness, they also described the expense and liability of digital records that continue long after the tedious and dangerous conversion from paper to digital. In other words, it appears that the benefits for physicians barely make the effort worth the price, even with 19 billion dollars in help.

Editor’s Note: In economics, we say that the marginal benefits may not exceed the marginal costs; all things being equal.

Assessment 

And so, it occurs to me that if dentists are to be included in the plans for digital interoperability, we will be very, very slow adopters for natural reasons: like eMRs in physicians’ offices, eMRs in dentists’ offices are more expense and trouble than they are worth – even before considering the bankruptcy-level liability of a data breach.

Most of those who champion eMRs for the entire healthcare system in the nation don’t realize that the bottleneck in dental offices isn’t the front desk. It’s the dentist who is hopefully taking his or her time providing care with those hands instead of working a keyboard.

Conclusion

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Kelly Mclendon RHIA censors D. Kellus Pruitt DDS

By Darrell K. Pruitt; DDS

Dateline: 8.15.09

pruitt

Dear Kelly Mclendon, Registered Health Information Administrator

You are beginning to make me feel insulted, and I will not have that. I just noticed that the last two comments I submitted to your Website, www.spacecoastmedicine.com, on August 9 and 10, are still “awaiting moderation.”

http://www.spacecoastmedicine.com/2009/08/electronic-records-for-all-patients-mandated-by-2014.html#comment-89 

(For clarity, the comments which scared Mr. Mclendon are copied below) 

Over five days have passed, and I want you, your readers and my readers to know that I spent a lot of time preparing those two pieces exclusively for you at your invitation for comments. You are as sincere as I am, aren’t you? 

When I’ve caught others in the squeeze you might be experiencing, several have pleaded that the censorship was an innocent oversight, and did the right thing immediately by posting everything I send them (include this comment, please). And then again, there are a few slow-learning, command-and-control types who think they cam still somehow control the content of their Websites. Like you, Kelly, an anonymous dentalblogs.com editor whom I call “Nancy” by default, also informed me that my comments were awaiting indefinite moderation. What a foolish, rookie mistake that proved to be. For example, if you google “dentalblogs.com,” my article “Dentalblogs.com hates D. Kellus Pruitt DDS” is their 4th hit. It seems to be very popular. 

How’s this for the title of a comment that should make it to your first page by Monday: “Kelly Mclendon RHIA censors D. Kellus Pruitt DDS”? Please, no phone calls. 

D. Kellus Pruitt; DDS 

Dateline 8.9.09 

I’m sure physicians’ businesses are no different than dentists’ when it comes to the liability of data breaches – especially considering the giddy, mindless momentum of HITECH-empowered HIPAA. If a computer is stolen in a burglary, compromised by a dishonest employee who sells IDs on the side, or otherwise hacked, and the dentist reports the tragedy according to the letter of the law, it inevitably means bankruptcy even before the feel-good fines are levied by HHS (HIPAA) and the FTC (Red Flags Rule) for not having required irrelevant documentation of administrative trivia in order. What were our lawmakers thinking? 

I guess the HIPAA blunder proves that when politicians, insurers and healthcare IT entrepreneurs get together in vendor clubs like CCHIT, the only government-approved eHR certification authority, they can mandate damn well any law that suits their needs. 

Allscripts CEO Glen Tullman, who is an influential friend of Barack Obama as well as a Trustee of CCHIT told Bloomberg.com reporter Alex Nussbaum in an interview almost a year ago that providers should make the financial commitment “to ensure that doctors have some skin in the game.” 

Glen Tullman is only one reason our nation’s healthcare IT industry stinks from the top down. 

D. Kellus Pruitt; DDS

Dateline: 8.10.09 

Thank you, Kelly Mclendon, for providing a rare venue to possibly clear up a few items of uncertainty about eHRs in dentistry. First of all, if a technological advancement such as eDRs does not pay for itself, even with government subsidies, who pays for it? That seems like a quick way to increase the costs of dental care – and for what? How do dental patients benefit from expensive HIT solutions when the telephone, fax machine and US Mail serve us fine? 

Digitalization of records offers no benefits to dental patients. Only stakeholders who would grab our patients’ money benefit from HIT. Everyone else loses. Trusting, naive dental patients lose the most. 

Electronic dental records are expensive hazards. If you can think of a lame reason for them, please let me hear it. You can bet I’ve crushed it before. I’ve been down this road with others many, many times. 

Within a week, the government will price computerization smooth out of dentistry. Over 90% of dentists have patient identities on their computers today. If HIPAA is enforced, with or without the Red Flags Rule, I predict that less than half of the nation’s dentists will be computerized a year from now. 

As for your argument that eHRs somehow provide up-to-date and otherwise superior medical histories for dental patients, think about this: If someone changes a paper medical history, it leaves a paper trail. If an insurance thief alters allergies on a digital record to suit his or her own needs, nobody in the emergency room can tell. Whoever said “Paper kills,” lied. It is a catchy PR pitch, though.

Conclusion

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