Dear Neil, and colleagues,
Thank you for this — the Epic example makes the point better than I did, and I would underline one thing in it: combining medical and dental records is not merely a convenience of filing. It is a matter of safety.
In a clinic like ours, where a patient may see the dentist but not a physician — or the reverse — each visit is a rare point of contact, and an integrated record turns it into a chance to catch what the other side would otherwise miss. A dentist who can see a patient’s medications and allergies avoids a dangerous interaction; one who notices a raised blood pressure, or signs of diabetes or another systemic illness first visible in the mouth, can refer before harm is done. As the Epic figures show — hundreds of thousands of drug interactions averted in a single year — this is prevention, not paperwork.
We are pursuing the same integration by a different road: an open-source system suited to a low-resource setting, so that a small rural clinic can hold in one record what a large hospital system offers at scale. The principle is identical; only the budget differs. And in our setting, where continuity is already fragile, having the whole patient — medical and dental — in a single record is arguably more important, not less.
Thank you again for looking into it, and for such a thought-provoking example.
With best wishes,
Frank Brightwell
Founder and Executive Director
Somos Amigos Medical Missions
El Naranjito, San José de las Matas, Dominican Republic
HIFA profile: Frank Brightwell is Executive Director at Somos Amigos Medical Missions, in the United States. Email: frank AT somosamigos.org