Finding Dental Harm to Patients through Electronic Health Record-Based Triggers

Area of Science:

• Dental medicine
• Patient safety
• Health informatics

Background:

• Dental treatments can inadvertently cause patient harm.
• Identifying adverse events (AEs) in dental practices is challenging.
• Electronic health record (EHR) data mining offers a promising solution for detecting AEs.

Purpose of the Study:

• To develop and evaluate EHR-based triggers for identifying AEs in dental patients.
• To determine the frequency and types of AEs experienced by dental patients.
• To establish a systematic method for measuring patient harm in dentistry.

Main Methods:

• Developed 7 EHR-based electronic triggers to flag potential AEs.
• Manually reviewed flagged patient charts to confirm AEs.
• Analyzed the prevalence and types of identified AEs.

Main Results:

• 16.2% of reviewed charts (1,885 total) contained an AE.
• Top AEs included pain (27.5%), hard tissue (14.8%), soft tissue (14.8%), and nerve injuries (13.3%).
• Most AEs resulted in temporary harm (89.2%), with 9.6% causing permanent harm and 1.2% requiring emergency room transfer.

Conclusions:

• EHR-based triggers provide an effective method for dental practices to identify patient harm.
• Measuring AEs through systematic review is the first step toward mitigating harm.
• This approach enhances the safety and quality of dental care delivery.