Dentistry is facing some significant challenges where the use of Information and Communications Technology (ICT) in dental practice is concerned. I am left with a strong feeling that the tail is wagging the dog at present and a dangerous situation is gathering momentum very quickly.
The problem arises from the fact that the dental profession (unlike the medical profession) has not had the benefit of significant taxpayer investment dedicated to post graduate education and training where the use of computers and ICT is concerned. Computers first appeared in schools in about 1985 and those under 36 years of age have all had the benefit of being taught computer studies as part of their formal education. There is, as a result, a massive knowledge gap that places senior members of the dental profession together with their colleagues in other regulated professions at a serious disadvantage. Practice principals are placed at particular risk as the buck stops in their hands.
The Leveson Inquiry and headline news stories concerning computer hacking should have alerted dental professionals to the risks involved with the use of electronic and wireless communications. What is the nature of the problem? Is it widespread and is it serious? The answer to all of these questions is yes, and if you are left in any doubt you may be guilty of criminal activity already and ignorance of the law cannot be offered as an excuse. The General Dental Council (GDC) has powers to strike you off the register, the Information Commissioner's Office has statutory powers to fine you up to £500k and the Care Quality Commission (CQC) has powers to close your practice down. Any of these sanctions can be imposed as a result of failing to implement parliamentary statutory instruments arising from EU directives and the Data Protection Act 1998. This act incidentally is now the subject of a major review in Brussels and new EU legislation will be enacted to ensure that every member state complies.
Believe me this is serious stuff and some of the practice principals I have spoken to recently have made it very clear they have had enough of being regulated and any more will drive them to the exit marked 'retirement'. If I was in charge of the GDC revenues I would be looking at the implementation dates for this new raft of data protection legislation as large numbers of their older registrants will be baling out of the dental register to inhale the oxygen of real freedom. Private practice is no longer an alternative.
I recognise this is all rather depressing stuff but the Customs and Revenue has already forced some accountants out of their cosy offline professional niche and from April 1, 2012, all VAT returns have to be completed in electronic format and submitted online in addition to annual tax returns. There is no hiding place for any member of a regulated profession – it is not just dentists that are suffering.
Enough of the gloom, what are the benefits? For the most striking just take a glimpse at the latest computer assisted design and manufacturing (CADCAM) technology being used in the production of ceramic crowns and laser sintering processes embraced in the manufacture of chrome cobalt denture frameworks. Better quality products, benchmarked processing standards, lower production costs and deskilling are at the top of a burgeoning list. So how is the tail wagging the dog? Simply because the technology and those who make a living from promoting this extraordinary revolution often call the shots without any knowledge of the regulations that our clinical responsibilities bring. Whilst the benefits can be massive, things can go horribly wrong in nanoseconds and the practice principal left with a bout of depression and possible legal proceedings.
The offline data protection (traditional paper and pen) now seems simple by comparison with the online (ICT) world of the internet. The former has metamorphosed with practice management and digital radiography being introduced but we are now faced with a 'Big Bang' situation.
A quick trawl through the British Dental Journal classified section reveals the extent of the problem as the largest provider of e-communications is Hotmail. Job applicants are instructed to transfer their personal CVs via a hotmail email account. Very few advertisers embrace a secure e-communications network such as NHSnet, and one wonders why the British Dental Association does not seem to have a proper policy in place to ensure the DPA law is not infringed.
It is odd that the brave new world of the internet and the use of mobile communications technology have not arrived with a health warning for dental professionals. Anarchy exists and not even the GDC see fit to include the use of ICT in the list of compulsory verifiable CPD subjects!