Integrated Electronic Health Records in Dentistry: A Seven‑Year Experience with Epic Wisdom and its Impact on Comprehensive Patient Care

Background: Historically, dental and medical records have existed in separate systems, limiting the ability of providers to access comprehensive patient information¹⁻³. Prior to 2017, our dental clinic relied on standalone paper charts and patient‑completed intake forms for medical histories, medications, and allergies⁴. This fragmented workflow created clinical blind spots and increased the risk of incomplete or inaccurate information¹⁻⁵.
Objective: To evaluate how the implementation of Epic Wisdom, an integrated electronic health record (EHR) system, improved patient safety⁵⁻⁷, care coordination⁸⁻¹⁰, and clinical decision‑making³,¹¹ by unifying medical and dental data into a single longitudinal chart⁹,¹².
Methods: This original research study uses a mixed‑methods design combining retrospective workflow analysis, clinical case review, and provider‑reported outcomes¹¹. Data were collected from 2015–2024, comparing pre‑integration (paper‑based) and post‑integration (Epic Wisdom) periods⁴.
Results: Integration of Epic Wisdom resulted in (1) 100% real‑time access to medical histories, medications, allergies, and laboratory values⁹,¹²; (2) a significant reduction in medical history discrepancies⁴; (3) a major decrease in delayed or cancelled dental procedures due to missing medical information⁵,⁷; and (4) improved interdisciplinary communication through shared charting and messaging⁸⁻¹⁰. A representative case demonstrates how integrated EHR access altered treatment planning, prevented complications, and enabled targeted care⁵,¹¹.
Conclusion: Integrated EHR systems significantly enhance dental care quality by improving diagnostic accuracy³,¹¹, reducing risk⁵⁻⁷, and enabling personalized, medically informed treatment planning⁹,¹². Epic Wisdom transformed our clinic’s workflow from isolated paper charts to a unified, data‑driven care model that supports comprehensive oral–systemic health management³,⁸.

Integrated Electronic Health Records, Epic Wisdom, Medical–Dental Integration, Dental Informatics, Patient Safety, Care Coordination, Inter-professional Collaboration

1. Bates DW, Singh H. Two decades since To Err Is Human: Progress and priorities. Health Affairs. 2018;37(11):1736‑1743. [Google Scholar] [Crossref]

2. Institute of Medicine. To Err Is Human: Building a Safer Health System. National Academies Press; 1999. [Google Scholar] [Crossref]

3. Schleyer T, Spallek H. Dental informatics and practice transformation. J Dent Res. 2019;98(12):1335‑1342. [Google Scholar] [Crossref]

4. Kalenderian E, et al. Achieving meaningful use of EHRs in dentistry. J Am Dent Assoc. 2016;147(12):948‑956. [Google Scholar] [Crossref]

5. Walji MF, et al. Improving dental patient safety through EHR integration. J Am Med Inform Assoc. 2013;20(2):292‑298. [Google Scholar] [Crossref]

6. Acharya A, et al. Integration of medical and dental care in EHRs. J Dent Educ. 2017;81(9):1103‑1110. [Google Scholar] [Crossref]

7. Weiner JP, et al. Paper-based vs. electronic medical records: A systematic comparison. Ann Intern Med. 2016;165(3):205‑213. [Google Scholar] [Crossref]

8. O’Malley AS, et al. Provider-to-provider communication in integrated systems. J Gen Intern Med. 2015;30(3):381‑389. [Google Scholar] [Crossref]

9. Adler‑Milstein J, et al. EHR interoperability and clinical outcomes. Health Serv Res. 2017;52(3):1187‑1208. [Google Scholar] [Crossref]

10. Slight SP, et al. Medication safety and clinical decision support. BMJ Qual Saf. 2018;27(9):725‑733. [Google Scholar] [Crossref]

11. Sittig DF, Singh H. A new sociotechnical model for EHR safety. Qual Saf Health Care. 2010;19(Suppl 3):i68‑i74. [Google Scholar] [Crossref]

12. Classen DC, et al. Adverse events in outpatient care. J Patient Saf. 2018;14(3):e45‑e52. [Google Scholar] [Crossref]

13. Makary MA, Daniel M. Medical error as a leading cause of death. BMJ. 2016;353:i2139. [Google Scholar] [Crossref]

14. Schiff GD, et al. Diagnostic errors and information gaps. JAMA Intern Med. 2015;175(3):402‑404. [Google Scholar] [Crossref]

15. Epic Systems Corporation. Epic Wisdom Dental Module Overview. Epic; 2020. [Google Scholar] [Crossref]

16. Friedman CP, et al. Toward learning health systems. J Am Med Inform Assoc. 2015;22(1):43‑50. [Google Scholar] [Crossref]

17. Creswell JW, Plano Clark VL. Designing and Conducting Mixed Methods Research. Sage; 2017. [Google Scholar] [Crossref]

18. Menachemi N, Collum TH. Benefits and drawbacks of EHR systems. Risk Manag Healthc Policy. 2011;4:47‑55. [Google Scholar] [Crossref]

19. Wright A, et al. Clinical decision support and patient safety. JAMA. 2017;317(22):2273‑2274. [Google Scholar] [Crossref]

20. Singh H, et al. Case-based analysis of EHR-related safety events. BMJ Qual Saf. 2012;21(10):840‑848. [Google Scholar] [Crossref]

21. Health Resources and Services Administration. FQHC Program Overview. HRSA; 2022. [Google Scholar] [Crossref]

22. Formicola AJ, et al. Dental education in community-based settings. J Dent Educ. 2012;76(1):98‑109. [Google Scholar] [Crossref]

23. Mertz EA, et al. Training dental students in underserved settings. Am J Public Health. 2016;106(12):2181‑2187. [Google Scholar] [Crossref]

24. Vest JR, Kash BA. Organizational readiness for health IT. J Med Syst. 2016;40(6):1‑10. [Google Scholar] [Crossref]

25. McCarthy DM, et al. Interprofessional communication in integrated care. Acad Med. 2018;93(10):1500‑1506. [Google Scholar] [Crossref]

26. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2024;47(Suppl 1):S1‑S200. [Google Scholar] [Crossref]

27. Douketis JD, et al. Perioperative management of anticoagulation. Chest. 2012;141(2 Suppl):e326S‑e350S. [Google Scholar] [Crossref]

28. Fihn SD, et al. Evaluation of stable ischemic heart disease. Circulation. 2012;126(25):e354‑e471. [Google Scholar] [Crossref]

29. KDIGO. Clinical practice guideline for chronic kidney disease. Kidney Int Suppl. 2013;3(1):1‑150. [Google Scholar] [Crossref]

30. Kripalani S, et al. Hospital discharge communication failures. J Hosp Med. 2007;2(5):314‑323. [Google Scholar] [Crossref]

31. American Association of Clinical Endocrinology. Guidelines for endocrine disorders. Endocr Pract. 2022;28(1):1‑120. [Google Scholar] [Crossref]

32. Bates DW, et al. Medication errors and adverse drug events. JAMA. 1995;274(1):29‑34. [Google Scholar] [Crossref]

33. Kohn LT, Corrigan JM, Donaldson MS. To Err Is Human. National Academies Press; 2000. [Google Scholar] [Crossref]

34. Fleisher LA, et al. ACC/AHA perioperative cardiovascular evaluation guidelines. Circulation. 2014;130(24):e278‑e333. [Google Scholar] [Crossref]

35. Naughton CA. Drug-induced nephrotoxicity. Am Fam Physician. 2008;78(6):743‑750. [Google Scholar] [Crossref]

36. Ammenwerth E, et al. Patient portals and engagement outcomes. J Med Internet Res. 2012;14(6):e162 [Google Scholar] [Crossref]

• Migrant Health in Morocco: Between Law and Reality
• CaknaMinda: An Educator-Centred Mobile App for Early Screening of Mental Health and Schizophrenia Risks
• Health System and Nursing Strategies for Enhancing Male Participation in Family Planning: Evidence from Tema General Hospital, Ghana.
• From Īśvara-Praṇidhāna to Parā-Bhakti: Convergent Paths of Aṣṭāṅga Yoga and Bhakti Yoga
• Evidence-Based Psycho-Oncological Interventions: A Multimodal Approach to Supportive Care