1

Electronic Treatment Electronic Treatment PlanningPlanning

Prof. Ed YenProf. Ed YenDean, Faculty of DentistryDean, Faculty of Dentistry

University of British ColumbiaUniversity of British Columbia

Map Workflow of Clinical Activities Map Workflow of Clinical Activities Related to Comprehensive Related to Comprehensive

Treatment Planning(1)Treatment Planning(1)

Patient demographicsPatient demographicsMedical and dental historyMedical and dental historyClinical examination and findingsClinical examination and findingsDiagnostic Records and ImagesDiagnostic Records and ImagesAnalysis of recordsAnalysis of records

2

Map Workflow of Clinical Activities Map Workflow of Clinical Activities Related to Comprehensive Related to Comprehensive

Treatment Planning(2)Treatment Planning(2)

DiagnosesDiagnosesProblem lists and problem groupsProblem lists and problem groupsTreatment options per problemTreatment options per problemTreatment Plans with various option Treatment Plans with various option combinationscombinationsPatient informed consentPatient informed consent

Conversion of Paper Process to Conversion of Paper Process to Electronic ProcessElectronic Process

AdvantagesAdvantages–– More robust and secure recordsMore robust and secure records–– Records more accessibleRecords more accessible–– Data input fasterData input faster–– Records require less storage spaceRecords require less storage space–– Easier to train novice cliniciansEasier to train novice clinicians–– Database facilitates research and analysisDatabase facilitates research and analysis

3

Conversion of Paper Process to Conversion of Paper Process to Electronic ProcessElectronic Process

DisadvantagesDisadvantages–– Additional training of students and staffAdditional training of students and staff–– Most software is not intuitiveMost software is not intuitive–– Lack of cognitive ergonomicsLack of cognitive ergonomics–– Most software requires redundant entriesMost software requires redundant entries–– Lack integration of Lack integration of ““windowswindows””

Cognitive ErgonomicsCognitive ErgonomicsData should be gathered and entered in intuitive Data should be gathered and entered in intuitive sequencesequenceMinimal Minimal ““clicksclicks”” to find and enter data fieldsto find and enter data fieldsData once entered should simultaneously Data once entered should simultaneously populate graphics (odontograms) and text populate graphics (odontograms) and text windowswindowsData entry should trigger entry of related Data entry should trigger entry of related information (e.g. procedure cods, fee estimates)information (e.g. procedure cods, fee estimates)Data should be entered only once and Data should be entered only once and automatically populate subsequent windows automatically populate subsequent windows where it may be required (e.g. clinical findings where it may be required (e.g. clinical findings should populate problem list and treatment plan)should populate problem list and treatment plan)

4

UBC Integrated Treatment PlanUBC Integrated Treatment PlanPatient assessment, data collectionPatient assessment, data collectionProblem list(s)Problem list(s)Diagnoses (interface with clinical analytical Diagnoses (interface with clinical analytical software, e.g. Dolphin, Nobel Guide)software, e.g. Dolphin, Nobel Guide)Treatment OptionsTreatment OptionsInformed consent (prognoses, financial)Informed consent (prognoses, financial)Sequenced treatment plan(s)Sequenced treatment plan(s)–– Disease or disorder managementDisease or disorder management–– RehabilitationRehabilitation–– MaintenanceMaintenance

Key Design ConsiderationsKey Design Considerations

Structured menus to guide novicesStructured menus to guide novicesStandard terminologyStandard terminologyAutomated cost estimate for patientAutomated cost estimate for patientApproval by instructor built into each stepApproval by instructor built into each stepFlexibility for student to create and learn Flexibility for student to create and learn through through ““trial scenariostrial scenarios””Data entry cognitively ergonomicData entry cognitively ergonomic

5

UBC ExperienceUBC Experience

AxiUm early versions of Treatment Planning AxiUm early versions of Treatment Planning Module developed with UBCModule developed with UBC–– Lack integration and cognitive ergonomicsLack integration and cognitive ergonomics

Planemca Romexis module developed with UBCPlanemca Romexis module developed with UBC–– Requires review of clinic workflow, and consensus Requires review of clinic workflow, and consensus

between disciplinesbetween disciplines–– Requires link to administrative softwareRequires link to administrative software–– Plans to link with analytical software e.g. Dolphin Plans to link with analytical software e.g. Dolphin

cephalometrics, Nobel Guide implant treatment cephalometrics, Nobel Guide implant treatment planningplanning

Clinical Findings and Problem ListClinical Findings and Problem List

Data entry from previous clinical Data entry from previous clinical examinations automatically populate examinations automatically populate Treatment Planning windowsTreatment Planning windowsProblem lists generated from Clinical Problem lists generated from Clinical FindingsFindings

6

Step 1Step 1

Romexis lists automatically – Chief Concerns, – Exam Findings, – Diagnosis and – Consultations.

Problem groups are created and problems are dragged and dropped to groups.

7

Step 2Step 2

Treatment Options are defined to each group by using the buttons under Plan-tab.Prognosis and cost range is given to each option

8

Step 3Step 3

Alternative treatment plans are created, by choosing the options from problem groupsOne of the plans is selected.

9

Step 4Step 4

Selected Treatment Plan is defined more detailed the dates are given and the plan is approved by intructor.

10

Step 5Step 5

Actual treatment is recorded using the approved treatment plan

11

SummarySummary

Current commercially available electronic Current commercially available electronic treatment planning modules for educational treatment planning modules for educational institutions lack cognitive ergonomicsinstitutions lack cognitive ergonomicsUBC working with Planmeca to develop moduleUBC working with Planmeca to develop moduleIndividual dental schools will want to customize Individual dental schools will want to customize software to match their clinical workflowsoftware to match their clinical workflowTreatment planning module ideally should Treatment planning module ideally should integrate with clinic progress chart and fee integrate with clinic progress chart and fee generation modulegeneration module