Tip of the Month: How to Run the Caries Prevalence and Periodontal Index Report

Dentrix Enterprise offers many useful reports that can help improve  patient outcomes. One example is the data captured in the "Caries Prevalence and Periodontal Index Report". 

HINT: This report can be found from DXOne Reporting module | List | Caries Prevalence and Periodontal Index Report |

The report displays statistics for five age groups including:

• Age group 2-5 years is on the first page
• Age groups 6-14 years and 15-19 years are on the second page
• Age groups 35-44 years and 55 years and older are on the third page

DMFT, Dmft, DMFS & Dmfs describe the amount - the prevalence - of dental caries in an individual. DMFT, Dmft, DMFS & Dmfs are means to numerically express the caries prevalence and are obtained by calculating the number of

• Decayed (D)
• Missing (M) (m)
• Filled (F) (f)
• teeth (T) (t)
• surfaces (S) (s)

**The difference between a M | m or F | f is a permanent vs primary tooth**

The report displays an estimation illustrating how much the dentition until the day of examination has become affected by dental caries. It is either calculated for 28 (permanent) teeth, excluding 18, 28, 38 and 48 (the "wisdom" teeth) or for 32 teeth (The Third edition of "Oral Health Surveys - Basic methods", Geneva 1987, recommends 32 teeth). Thus:

• How many teeth have caries lesions (incipient caries not included)?
• How many teeth have been extracted?
• How many teeth have fillings or crowns?

The sum of the three figures forms the DMFT-value. For example: DMFT of 4-3-9=16 means that 4 teeth are decayed, 3 teeth are missing and 9 teeth have fillings. It also means that 12 teeth are intact.

**TIP**

The Dentrix Enterprise Caries Prevalence Report also provides the following useful measures:

• Caries Free
• Untreated Decay
• Using Tobacco
• Dental Fluorosis
• Sealants
• Mean # of Sealed Teeth
• Mean DMFT
• Perio Pockets
• Loss of Attachment
• Diabetes (Must have the condition code "15202" posted in the chart

NOTE: This particular report utilizes very specific ADA Codes for each age group: The below chart indicates which procedure codes are used to capture data on this particular report.

Age Group 2-5 - dmfs and dmft	D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250
Caries Condition All ages	15104, 15105, 15106, or 15107
Missing Teeth Condition All ages	15100 or 15101
Using Tobacco	15203
Dental Fluorosis	15200

Refer to the Dentrix Enterprise Reports Reference Guide for additional information.

Stay tuned to next month's blog post for additional Dentrix Enterprise Tips & Tricks!

Multi-Code Tip of the Month

One of the most significant benefits to utilizing Dentrix Enterprise in our FQHC’s is how easily the system allows our users to consolidate the number of <Clicks> it takes to perform point of care documentation. Allowing the users to select the treatment to post with the 24 procedure buttons will save time, reduce the number of clicks, and help with standardization. These procedure buttons collectively represent the most common procedures performed in the operatory or clinic.

Tip of the Month

Utilize the Procedure Code Buttons by incorporating "Multi-Codes"

To use your top 24 Procedure Code Buttons or "Hot Keys" as I refer to them, follow the below simple steps:

Setup

Create and decide which multi-codes will be used in the procedure code button.

1. Starting from the Office Manager




2. <Click> Maintenance | Practice Setup | Multi-Code Setup

Using the Procedure Code Buttons in Dentrix Enterprise

Link the Multi-Codes to the Procedure Code buttons

1. Starting from the tooth chart


2. <Click> File | Setup Procedure Code Buttons

*** Keep in mind when setting up these procedure code buttons, the user-definable buttons can represent a single procedure code, dental diagnostic code, condition, or "Multi-code" ***

ASAP List- Tip of the Month

As Winter comes to an end, and Spring draws near, we should all welcome the opportunity to revise our organization’s best practices and policies. To assist in our Spring cleaning, Dentrix Enterprise offers many tools to help an organization reach their potential, including the ASAP List.

Tip of the Month

Utilize the ASAP List to fill open times:

In the FQHC world the name of the game is “Billable Encounters” and keeping our operatories full is critical and essential in our overall organizations success. Implementing the ASAP List functionality will ensure your operatories remain occupied and in use on a daily basis.

Very often patients call wanting an appointment sooner than your next available time. In these situations, it can be useful to offer to call the patient if an appointment time becomes available. In Dentrix Enterprise you can flag scheduled appointments as ASAP (As Soon As Possible). Once an appointment has been flagged as ASAP, it appears on the ASAP List. This ASAP list provides a list of patients who can fill holes in the event an appointment is cancelled.

To assign an appointment to the ASAP List

1.    In the Appointment Book, double <click> on the appointment

2.    Toggle on the down arrow in the Schedule field

3.    Choose ASAP

4.    <Click> ok



Screen Shot A



To use the ASAP List

1. In the Appointment Book, from the Appt Lists menu, point to ASAP List, and then click Current Clinic to view appointments for the clinic currently being viewed or All Clinics to view appointments for all clinics. The ASAP List View dialog box appears so that you can filter the appointments in the list. (Screen Shot A)

2. Make your selections, click ASAP, and then click OK. The ASAP List window appears, displaying all appointments scheduled in the next seven days (unless another number was specified) that have been flagged as ASAP. (Screen Shot B)



Screen Shot B



3. Contact the patient and schedule the patient; Once confirmed, <Double Click> on the patient.

 

Screen Shot C

4. Dentrix Enterprise will allow you to modify the appointment directly from the ASAP List (Screen Shot C)

Dentrix Enterprise Tips & Tricks

As many of us dig out from a cold mega snow storm in the northeast, our thoughts are with the states impacted. This past week, I had ample time to reflect on what makes our Community Health Centers so successful. When our CHC’s began using Dentrix Enterprise over 10 years ago we were torn between using certain key functionality in fear of duplicating our user’s efforts. However, we quickly realized that certain core functionality is not only required but crucial to running an efficient dental practice. This month’s posts will focus on various Dentrix Enterprise tips and tricks that every Enterprise user should utilize and take advantage of.

Tip #1

Utilize your procedure code buttons

I refer to these as your top 24 "Hot Keys". These hot keys are user defined and can house a specific procedure or a multi-codes. We recommend having a mix of procedures, multi-codes, and conditions. These hot-keys allow for quick, efficient, one-click documentation

Tip #2

Utilize color in the Progress Note panel of the tooth chart

Treatment is color-coded so that with a single glance at the patient's graphic chart, you can tell whether a procedure is a condition, existing, treatment-planned, or completed.

Next month’s blog post we will review various tips and tricks for clinical charting and treatment plan presentation. Additional information can be found on the Dentrix Enterprise website’s on-demand training sessions. (Customer ID & Zip Code of Practice required to access)

http://www.dentrixenterprise.com/resource-center/index.aspx

 





 

Integration...... The Final Frontier!

I am often approached with the question what best practices work well in the FQHC market? I always tell folks that if you have seen one community health center….. you’ve seen one community health center. Each organization is as unique as the next. However, some standard best practices and key concepts can be followed to ensure you get the most out of Dentrix Enterprise.

1.    Integration is key:

a.    Communicating a shared vision – Integration is paramount and organizations leadership need to empower this vision. Working in silos is no longer an option.

b.    Understanding both languages – Primary Care and Dental providers speak different languages. Team members will need to develop a new language, and it will be important to learn and begin to incorporate the ideals of working together to improve patient care. And most importantly, Medical Directors and Dental Directors need to listen to one another and work towards a single, unified front.

c.    Providing integrated solutions – Organizations must work to develop innovative solutions that work in both primary and dental care settings to maximize returns and minimize duplicative functions. Be sure to budget for and invest in integration tools.

d.    Mitigating conflict – Conflicts between dental providers, CEO’s, and Organizational Leadership must be avoided and dental leadership should be able to moderate open discussions between stakeholders.

e.    Building Trust – Understanding the “Big Picture” while the Meaningful Use incentives are certainly important, let’s not forget the other core reasons for implementing an EDR which include patient safety and improving the oral health care of the underserved communities we serve.

2.    Types of common Integration interface options:

One of the most common interface languages used today is Health Level 7 or HL-7.  Implementing an HL-7 interface between your Medical EHR and Dentrix Enterprise is a key feature that should be budgeted for and implemented prior to going live on Dentrix Enterprise. One of the true benefits of implementing Enterprise Dentrix vs. Core Dentrix is the ability for the software to have HL-7 messages flow between disparate systems. i.e. Medical EHR and Electronic Dental Record (EDR).  The following segments of HL-7 are intricate to minimize duplicative data entry and to stream line processes. Some of the more common segments of HL-7 are:

a.    ADT- (Admit Discharge Transfer) - Typically refers to patient demographics such as Name, Date of Birth, Social Security Number, Address, and Phone Number.

b.    DFT- (Detailed Financial Transaction) - Typically refers to a financial transaction that is sent to a billing system and is used for patient accounting purposes. This message might include things like ancillary charges or patient deposits.

c.    SIU- (Scheduling Information Unsolicited) - Typically refers to messages used to communicate information about a patient’s appointment from two disparate scheduling systems or clinic’s practice management system.

d.    ORU- (Observation Result) - Typically refers to messages such as clinical lab results, imaging study reports, EKG pulmonary function study results and patient condition i.e. diagnosis history, problem list, vital signs, allergies, clinical notes, etc.

These interface engines are typical between the various medical EHR systems and Dentrix Enterprise. Additional costs will be incurred to implement these segments of integration and most often are uni-directional. So budget for these features and consider them a “Must Have”.

Another, type of interface that many software vendors are exploring is called Application Programming Interface or (API) for short. This allows the communication between various software components within an application. For example, wouldn’t it be efficient if the Dentist or Dental Assistant can update the patient’s allegies and current medications from within Dentrix Enterprise.  With a simple click on the Dentrix Enterprise data entry screen the user is taken into the corresponding component of your medical EHR maintaining one point of prescription entry, one allergy list and one complete medication list.

Stay tuned for next month’s post where we will dive into best practices and standards utilizing Dentrix Enterprise.

New Year…. New Workflows

There is something about a new year that brings new beginnings and new hopes. A new year helps us reflect on our previous successes and failures and allows us to formulate a roadmap for future success. This is also an opportune time to evaluate your business and I.T. processes and determine what works and what does not. Conducting the following work flows will identify gaps in your workflows.

• Patient workflow- "Patient workflow" means many different things to different people. Certainly, patients are the main focal point. Understanding and truly assessing your current workflow on an annual basis from a subjective viewpoint is a critical piece of the pie that will help redesign and improve your electronic processes with minimal impact on "People Flow". Having someone objectively document the entire workflow from the time the patient walks in the front door all the way through the waiting room, triage, treatment and discharge is a required step in improving patient flow and overall patient satisfaction.


• Create visual landmarks within your office and within your health center so patients can reorient themselves.


• Don’t move the patients unnecessarily. It confuses the patient and wastes staff time.


• Avoid having a circular flow which can create bottlenecks. While the intent may be good idea, People typically try to exit the same way they came in.
 
• Provider workflow- Dentists and Hygienists contribute the most critical flow in the office. Why? Because all revenue is generated by providers. If their flow is inefficient the practice and health center can be impacted.
Breaks down the silos.


Understanding how your providers operate in the operatories is crucial in managing a successful EDR implementation and most importantly ensure utilization.


A key element of a successful implementation is the pre and post workflow assessments.


How do the provider’s communicate with their support team?


How do the provider’s communicate with each other?
Perceived/Expected workflow- Take the time to talk to the key individual stakeholders and listen. Listen to what they expect the EDR to do and not to do. Make a list of "Must Have" vs. "Nice to Have" items.


• Become one with the providers


• Listen! Listen! Listen! (Take notes)


• Implementing an EDR is not an IT project. Implementing an Electronic Dental Record (EDR) should be considered an organization wide project where IT will play a major role.
 

Having the key stakeholders take ownership of their own Enterprise Database with the support of I.T. will not only ensure success it will aid in adoption. Remember, the days of simply implementing an EHR are gone. FQHC’s and their affiliated providers now must adopt and utilize certified EHR technologies in a "Meaningful" way. They address specific key items to address health disparities and specific quality measures.

If you want more information on Meaningful Use in the Oral Health arena the Dentrix Enterprise website is a great place to look. There is great information at

http://www.dentrixenterprise.com/meaningful-use/ 

 

Also, take a look at "Facts & Myths on Meaningful Use" http://www.dentrixenterprise.com/pdf/C-ENTMUFAQ-Q312.pdf