Adoption of Electronic Dental Records: Examining the Influence of Practice Characteristics on Adoption in One State.

OBJECTIVE:  Compared with medicine, less research has focused on adoption rates and factors contributing to the adoption of electronic dental records (EDRs) and certified electronic health records (EHRs) in the field of dentistry. We ran two multivariate models on EDR adoption and certification-capable EHR adoption to determine environmental and organizational factors associated with adoption.

METHODS:  We conducted telephone survey of a 10-item questionnaire using disproportionate stratified sampling procedure of 149 dental clinics in Tennessee in 2017 measuring adoption of dental information technology (IT) (EDRs and certification-capable EHRs) and practice characteristics, including region, rurality, specialty, and practice size. We used binomial logistic regression models to determine associations of adoption with predictor variables.

RESULTS:  A total of 77% of surveyed dental clinics in Tennessee had adopted some type of EDR system. When the definitions of certification capable were applied, the adoption rates in dental clinics dropped to 58%. A binomial logistic regression model for the effects of rurality, specialization, and practice size on the likelihood that a clinic would adopt an EHR product was statistically significant (chi-square (3) = 12.41, p  = 0.0061). Of the three predictor variables, specialization and practice size were significant: Odds of adopting an EHR is 67% lower for specialists than for general dentists; and clinics with two or more practicing dentists were associated with a much greater likelihood of adopting an EHR-capable system (adjusted odds ratio = 3.09, p  = 0.009).

CONCLUSION:  Findings from this study indicate moderate to high levels of overall dental IT adoption. However, adoption rates in dental clinics do remain lower than those observed in office-based physician practices in medicine. Specialization and practice size were significant predictors of EHR-capable system adoption. Efforts to increase EHR adoption in dentistry should be mindful of potential disparities in smaller practices and between dental specialties and generalists.