The Cures Act, The Information Blocking Rule and Interoperability in Dentistry—What Dentists Need to Know Right Now to Put Their Patients First

While most dentists in the United States are doing their very best to deliver exceptional clinical care, many don’t realize that their practices are failing patients in a critical area—the handling of their patients’ health data.?

Why is this happening?

There are two basic reasons:

1. Most professionals in our industry are simply unaware of how some fairly recent legislation affects our patients’ Electronic Dental Records (EDRs).
2. Practice Management Solutions (PMSs) that currently exist are not compliant with recent regulations.

To continue upholding the standard of care, dentists need to understand how three fundamental concepts impact dentistry: the 21st Century Cures Act, the Information Blocking Rule and interoperability.

If you’re a dentist and these terms are new to you, rest assured, you’re far from alone. I’m on a mission to help more dentists understand these topics because they play a significant role in the patient-first approach to care, so I’ll clarify these terms in this article.

Additionally, I’m going to explain why the current patient information management systems don’t work and what kind of solutions can help dentists put their patients first.

The 21st Century Cures Act

Signed into law on December 13, 2016, this act was intended to:

• accelerate healthcare innovation
• improve patient access to new treatments
• increase the use of health information technology

This piece of legislation also gives patients the right to access their electronic Personal Health Information (ePHI) when they need to.?

The Cures Act has direct implications for all medical practices and dentists are not off the hook. As healthcare providers, dentists are required to comply with this law or they could face significant fines.

The Information Blocking Rule

A regulation implemented as part of the 21st Century Cures Act that went into effect on December 6, 2022, the Information Blocking Rule prohibits healthcare providers, software vendors, or anyone else for that matter, from blocking the sharing of health information. There is a tendency for some entities with access to patient data to refuse to share it in order to avoid losing those patients to competitors or to otherwise protect their own financial interests. This provision prevents the interests of a company or individual from taking priority over a patient’s best interests.

What Is Interoperability?

Interoperability is the ability for different healthcare establishments and applications to exchange patient data despite using different systems and software. Interoperability is all about normalizing patient information so that it can be shared freely without being hindered by system incompatibilities.

How Patients Benefit from Interoperability

ePHI is legally the property of the patients themselves, and dentists are stewards of this vital data. While the company? that supplies the practice management software may facilitate the collection of some of the patient’s information, it is not their property to control at the exclusion of others.?

Interoperability benefits patients by ensuring that they can access the information that they and their treating dental professionals are legally entitled to as and when they need it. Their data is not limited to the confines of one particular software used by the dental practice.

Additionally, the patient’s ePHI is almost never exclusively in a PMS. Digital radiographs, CAD/CAM scans, recall systems, paperless forms and an exponentially growing number of applications collect, house and share—as they are now required to—this information in order to adequately treat patients.

Another benefit of interoperability is that it raises our quality of care. Interoperability allows medical and dental professionals to collaborate freely on treatment cases, resulting in more comprehensive and integrated care for patients.

How Dentists Benefit from Interoperability

Interoperability benefits dentists in multiple ways, as well:

Legal compliance. When dentists follow best practices in regards to interoperability, they keep their practices compliant with the law, avoid heavy fines and reduce liability.

Improved clinical care. Interoperability facilitates improved communication between all dental professionals, specialists and medical care providers. Dentists can easily compare and exchange patient records and communicate with primary care physicians to create treatment plans that take into account all aspects of a patient’s health history.

More new patients. A wave of consumerism is sweeping the health industry at large and transforming the way patients seek care. People want treatment experiences that respect their rights and autonomy, and they have many options to choose from when selecting a provider. Dentists who understand and apply the principle of interoperability can provide the kind of convenient, comprehensive and empowering care that patients want, and this increases the likelihood that their practice will be visited and positively reviewed by patients who are looking for a dentist.

Today’s Patient Data Management Systems Are Broken

Now that we’ve reviewed the concept of interoperability and the legislation supporting it, let’s discuss why the current state of patient data management in the dental industry is so fundamentally flawed.

Electronic patient health data is typically hosted by software that handles the data like it is the property of the company that provided the software.?

On the whole, patient data management systems are not designed to play fair with each other. Practice management systems that exist today want their dental practice customers to be dependent on and loyal to them. The companies want to create a unique and high-value all-in-one kind of product that addresses every organizational need a dental practice could have. They aren’t interested in sharing their trade secrets with their competitors, so their systems aren’t designed to be compatible with other software solutions. In the interest of protecting their product, these companies aren’t just hosting patient data—they’re holding it hostage.

There are two victims of this hostage situation: the patients who are entitled to their own information, and the dentists who could provide better care for their patients if they were able to access their patients’ full health histories and exchange vital information with other medical professionals.

Patient health data legally belongs to the patients themselves. Dentists and dental practices are merely the stewards of that information and must ensure that it remains confidential and utilized for the benefit of patients.

When patient data management systems make it difficult for anyone outside of the software company to access this data, they infringe on the rights and autonomy of the patients who have every right to access their information anytime they want to. This patient data prison also leads to communication delays and errors when dentists attempt to coordinate patient treatment plans with other medical professionals.

The bottom line is this: dental practice owners have the responsibility to ensure that their practices and the vendors they entrust their patients’ data to are all compliant with the laws concerning interoperability, and the vast majority of practice management systems out there are not cutting it. Instead, they are obstructing the open and secure flow of patient data and that is against the law.

Solutions That Support Interoperability

Patient health data is now digital, and that’s how it is going to stay. Patients don’t see one healthcare provider their entire lives; their needs change, their circumstances change and even the circumstances of their care providers change.?

Similarly, dentists don’t use just one software to run their practices. A single office must leverage a growing number of solutions to both elevate their quality of care and to support their valued team members. Not to mention, there’s an explosion of electronic system requirements coming into existence in response to increasing collaboration between all healthcare providers.

Another changing element that all dentists need to be aware of is each patient’s medical history. The record of their past treatments and conditions and current health and medications is an ever changing story that goes wherever the patient goes. This story impacts the treatment decisions made in any practice, so it is essential that this story can be accurately preserved in a portable digital format that can be shared with any healthcare provider anywhere.

Dental care providers also need to understand the ‘big picture’ of each of their patients’ health records and do their part to update, protect and share these records. We dentists have a major role to play in raising the quality of care by advocating for our patients’ best interests and autonomy and for the open sharing of data.

So what can dental practice owners do to stay compliant with the law and promote interoperability?

One way to get started is by checking out the work my team and I are doing over at Toothapps

Toothapps is our answer to the challenge of improving interoperability in dentistry. This platform is designed to help dental practices experience the benefits of seamless digital integration including the unfettered—yet secure—flow of electronic patient health information.?

Additionally, I’m working closely with the American Dental Association Standards Committee and Dental Standards Institute, drafting Standards that will make it easier for dental practices to recognize 21st Century Cures Act and HIPAA compliant solutions that support true interoperability.

If you’d like to get involved in the fight to free patient data, breaking down data prisons and advancing the dental profession through interoperability, then I would love to hear from you!