Open Dental is one possible acquisition source. No PMS is represented as available until permitted access and required field depth are proven for the cohort.
Start with the question, not the endpoint list
To reconcile longitudinal care, the approved scope may require patient identity, chart notes, periodontal history, treatment plans, procedure status, benefit context, and dates. A connection that reads only appointments or demographics cannot answer the Care Ledger question.
Preserve source identity
Every extracted object should retain the practice, patient, source table or record type, source identifier, author where available, and timestamp. Normalization can support analysis, but it should never erase where a fact came from.
Model time explicitly
The ledger compares what existed at different points: evidence, later narrative, plan state, completed procedures, and elapsed time. Overwriting historical states with the latest value makes reconciliation impossible.
Read-only means no hidden write path
The current product does not change charts, diagnoses, treatment plans, appointments, or communications. Any later workflow would require separate authorization, testing, ownership, and audit controls.
State what is missing
Exports, access modes, and practice configurations vary. A credible review lists unavailable fields and unsupported history instead of converting absence into a conclusion.
Evaluate the extraction before the model
- reconcile record counts against a known sample;
- spot-check dates and source identifiers;
- compare note rendering with the PMS;
- document excluded record types;
- have a dentist trace returned items back to the chart.
The integration succeeds when the reviewer can trust the provenance—not when a connector badge turns green.