Andrew Traub
|Medical Malpractice

Audit shows dental data is unreliable

The state dental board gives the public “inaccurate, incomplete, and inconsistent data,” about Texas dentists and other dental professionals, a long-standing problem that a state audit released last week says weakens the Texas State Board of Dental Examiners’ ability to police dental professionals.

The report by the State Auditor’s Office notes that unreliable and inaccurate data were recurring themes in the most recent audits in June 2002 and August 2005 and could hamper the agency’s ability to make enforcement and licensing decisions.

For the public, inaccurate information means that some dentists the board has disciplined are shown as having clean records on the board’s Web site, the audit says. “This puts the public at risk of receiving services from licensees who have committed repeated violations.”

The board’s site shows only whether a dental professional has been disciplined; a public records request is required to find what the person did and what the penalty was.

Various data the board reports to the state about its licensing and disciplinary actions are inaccurate, the audit said.

That’s despite the, fact that the agency spent $118,000 in 2005 on an automated system, activated in 2007, which was designed to improve accuracy. It didn’t work as expected, the agency said, so now the board has obtained money from the Legislature to buy a $644,000 system to fix the problems, according to the audit.

The audit makes a series of recommendations to strengthen accuracy, including using edit checks and other data verification measures.

Auditors making spot checks of internal records identified three complaint records against dentists that the agency listed as “resolved” even before they were received and five complaints that were closed before an investigation was completed. The agency used five different database systems for licensing and enforcement that have various inherent weaknesses and inconsistencies, the audit said. All had missing, contradictory or incorrect information, the audit said, and the agency on its own stopped using one of them.

The 2005 audit said staff members lacked a system to determine whether disciplined dentists were actually doing what the board ordered, and this week’s audit indicates that the problem persists.

“The Enforcement Division assigned one employee part-time to have sole responsibility for ensuring that board-ordered sanctions are enforced,” the new audit said, saying the person relies on “a reminder note previously placed on an electronic calendar.”

“The Agency intends to manually track the compliance cases until it implements a reliable information system. This process and the use of multiple lists rather than one comprehensive list increases the possibility that cases that need Agency follow-up will not be addressed.”

The audit said the dental board reported unreliable information on eight, or 67 percent, of 12 key performance measures that auditors tested for in fiscal year 2008. State Auditor John Keel said the unreliability rate was “on the high end” of performance problems auditors see. He considered the audit “tough but fair” and said he was pleased the agency acknowledged the report’s accuracy.

During the first quarter of the current budget year, the auditors noted an improvement at the agency, saying it reported reliable results for four, or 57 percent, of seven performance measures.

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