Plugged In: Electronic Records Management: The Problem with Email


Dr. Jeff Glaizel

The Problem with Email

Dentists today commonly use email to confirm appointments, discuss treatment options with patients, and talk over cases with colleagues. In 2006, 43% of dental offices were using email for office communications1 and undoubtedly this number is higher today. However, there are 2 fundamental concerns related to the transmission of personal health information by email: lack of interoperability and potential breaches in privacy and security.


Health care is moving towards systems that are interoperable—ones that can seamlessly share and store clinical information. Interoperability of patient records is not possible with email. Information contained in patient records, such as completed treatments, diagnosis and medications, cannot be taken from an email message and easily transferred to patient records. Some of you reading this might think, “Why not just cut and paste the email into a clinical record?” However, this is not the essence of interoperability.

Interoperability of a dental record would allow a dentist to view the medical history of a patient from another dental office and—at the click of a button—add a diagnosis and treatment plan. All oral health team members involved in the treatment plan, as well as the patient, could access the record and cooperate in the patient’s care.

From a dentist’s perspective, interoperable patient records would make life easier. If a patient forgets the name of a medication they are taking, consulting an interoperable patient record would reveal up-to-date information related to the treatment plan, integrated in one location. We would never have to fumble through a stack of treatment reports searching for one small bit of vital information.

Interoperable dental records would also help the dental profession gather data on a variety of dental-related issues. An analysis of this data could highlight issues relevant to advancing the profession. Rather than compiling information from traditional surveys and questionnaires, up-to-date information could be readily available and retrievable from your dental records.

Privacy and Security

As I’ve discussed in previous columns, I believe many dentists do not have the requisite knowledge to ensure that they are in compliance with all federal, provincial and regulatory guidelines related to privacy and security. Using a third-party service for email raises many issues that are often not addressed or mitigated, including:

  • Who owns the data?
  • Where are the data and/or backups being stored?
  • Who has access to your messages?
  • Is there an appropriate audit trail for your info@dentaloffice account, if everyone in the office has access to the password?
  • Is the third party email service secure enough and does it meet regulatory guidelines?

The eReferral Pilot: a Solution for Canadian Dentists

CDA recognizes the challenges facing dentists and the profession in electronic records management. CDA has partnered with Continovation Services Inc. (ITRANS) to initiate a centralized, secure, communication service for dentists. The eReferral Pilot exceeds record keeping guidelines and evolving privacy legislation and is free to all member dentists and their office team members. I encourage dentists to register for the eReferral Pilot by visiting and clicking on “Join.” This portal will mitigate dentists' risks sharing patient information and improve practice efficiencies.


  1. Schleyer TKL, Thyvalikakat TP, Spallek H, Torres-Urquidy MH, Hernandez P, Yuhaniak J. Clinical Computing in General Dentistry. J Am Med Inform Assoc. 2006;13(3):344-52.