A preliminary model of work during initial examination and treatment planning appointments

Irwin, Jeannie; Torres-Urquidy, Miguel Humberto; Schleyer, Titus; Monaco, Valerie

doi:10.1038/sj.bdj.2008.1151

Cited by 11 publications

(16 citation statements)

References 13 publications

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“…As previous studies have shown, the clinical workflow in dentistry tends to be highly collaborative, complex and non‐linear (Irwin et al , 2009). Technology often results in breakdowns, which interrupt the workflow, cause rework and increase the number of steps in the work processes.…”

Section: Needs Of and Requirements For Information Technology Supportmentioning

confidence: 99%

“…Technology often results in breakdowns, which interrupt the workflow, cause rework and increase the number of steps in the work processes. Irwin et al concluded that current dental software could be significantly improved with regard to its support for communication and collaboration, workflow, information design and presentation, information content, and data entry (Irwin et al , 2009). This likely applies to the oral medicine arena as well.…”

Section: Needs Of and Requirements For Information Technology Supportmentioning

confidence: 99%

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Advancing oral medicine through informatics and information technology: a proposed framework and strategy

et al. 2011

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The implementation of information technology in healthcare is a significant focus for many nations around the world. However, information technology support for clinical care, research and education in oral medicine is currently poorly developed. This situation hampers our ability to transform oral medicine into a Ôlearning healthcare discipline' in which the divide between clinical practice and research is diminished and, ultimately, eliminated. This paper reviews the needs of and requirements for information technology support of oral medicine and proposes an agenda designed to meet those needs. For oral medicine, this agenda includes analyzing and reviewing current clinical and documentation practices, working toward progressively standardizing clinical data, and helping define requirements for oral medicine systems. IT professionals can contribute by conducting baseline studies about the use of electronic systems, helping develop controlled vocabularies and ontologies, and designing, implementing, and evaluating novel systems centered on the needs of clinicians, researchers and educators. Successfully advancing IT support for oral medicine will require close coordination and collaboration among oral medicine professionals, information technology professionals, system vendors, and funding agencies. If current barriers and obstacles are overcome, practice and research in oral medicine stand ready to derive significant benefits from the application of information technology.Oral Diseases (2011) 17 (Suppl. 1), [85][86][87][88][89][90][91][92][93][94]

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Section: Needs Of and Requirements For Information Technology Supportmentioning

confidence: 99%

Section: Needs Of and Requirements For Information Technology Supportmentioning

confidence: 99%

Advancing oral medicine through informatics and information technology: a proposed framework and strategy

et al. 2011

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“…This finding is significant because previous studies of EDRs indicated significant usability problems as a result of information that is fragmented across multiple screens [15, 17, 19, 20]. EDR users must remember key information while navigating through different screens, requiring them to focus on locating information and avoiding mistakes, rather than on the task itself.…”

Section: Discussionmentioning

confidence: 96%

“…Lab studies are typically more appropriate for studying clinical decision-making than field studies. In the clinic, dentists often combine data gathering and treatment planning into a single activity [20], making it difficult to “tease out” specific cognitive processes. Our participants were able to focus their attention completely on the patient case and verbalize their thoughts, thus facilitating data collection in ways that would have been difficult to achieve in the clinical setting.…”

Section: Limitationsmentioning

confidence: 99%

Advancing cognitive engineering methods to support user interface design for electronic health records

Thyvalikakath¹,

Dziabiak²,

Johnson³

et al. 2014

International Journal of Medical Informatics

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Background Despite many decades of research on the effective development of clinical systems in medicine, the adoption of health information technology to improve patient care continues to be slow, especially in ambulatory settings. This applies to dentistry as well, a primary care discipline with approximately 137,000 practitioners in the United States. A critical reason for slow adoption is the poor usability of clinical systems, which makes it difficult for providers to navigate through the information and obtain an integrated view of patient data. Objective In this study, we documented the cognitive processes and information management strategies used by dentists during a typical patient examination. The results will inform the design of a novel electronic dental record interface. Methods We conducted a cognitive task analysis (CTA) study to observe ten general dentists (five general dentists and five general dental faculty members, each with more than two years of clinical experience) examining three simulated patient cases using a think-aloud protocol. Results Dentists first reviewed the patient’s demographics, chief complaint, medical history and dental history to determine the general status of the patient. Subsequently, they proceeded to examine the patient’s intraoral status using radiographs, intraoral images, hard tissue and periodontal tissue information. The results also identified dentists’ patterns of navigation through patient’s information and additional information needs during a typical clinician-patient encounter. Conclusion This study reinforced the significance of applying cognitive engineering methods to inform the design of a clinical system. Second, applying CTA to a scenario closely simulating an actual patient encounter helped with capturing participants’ knowledge states and decision-making when diagnosing and treating a patient. The resultant knowledge of dentists’ patterns of information retrieval and review will significantly contribute to designing flexible and task-appropriate information presentation in electronic dental records.

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“…Nevertheless, previous studies have demonstrated that limited consideration of HCI related issues often interferes with the dental clinic workflow. For example, Irwin et al showed that over 60 % of the 27 "breakdowns" during initial examination and treatment planning using EHRs in general dentist practices were associated with technology (Irwin et al 2009). Usability issues and unfamiliarity with chair-side use of clinically relevant electronic data were major barriers to EHR adoption for dental practitioners, (Schleyer Fig.…”

Section: Workflow In the Dental Operatorymentioning

confidence: 99%

Cognitive Informatics for Biomedicine

Patel¹,

Kannampallil²,

Kaufman³

2015

Health Informatics

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A preliminary model of work during initial examination and treatment planning appointments

Cited by 11 publications

References 13 publications

Advancing oral medicine through informatics and information technology: a proposed framework and strategy

Advancing oral medicine through informatics and information technology: a proposed framework and strategy

Advancing cognitive engineering methods to support user interface design for electronic health records

Cognitive Informatics for Biomedicine

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