• L C Peterson, D S Cobb, and D C Reynolds.
• University of Iowa, College of Dentistry, Iowa City 52242, USA.
• Medinfo. 1995 Jan 1;8 Pt 2:1709.

AbstractThe majority of work on computer use in the dental field has focused on non-clinical practice management information needs. Very few computer-based dental information systems provide management support of the clinical care process, particularly with respect to quality management. Traditional quality assurance methods rely on the paper record and provide only retrospective analysis. Today, proactive quality management initiatives are on the rise. Computer-based dental information systems are being integrated into the care environment, actively providing decision support as patient care is being delivered. These new systems emphasize assessment and improvement of patient care at the time of treatment, thus building internal quality management into the caregiving process. The integration of real time quality management and patient care will be expedited by the introduction of an information system architecture that emulates the gathering and storage of clinical care data currently provided by the paper record. As a proposed solution to the problems associated with existing dental record systems, the computer-based patient record has emerged as a possible alternative to the paper dental record. The Institute of Medicine (IOM) recently conducted a study on improving the efficiency and accuracy of patient record keeping. As a result of this study, the IOM advocates the development and implementation of computer-based patient records as the standard for all patient care records. This project represents the ongoing efforts of The University of Iowa College of Dentistry's collaboration with the University of Uppsala Data Center, Uppsala, Sweden, on a computer-based patient dental record model. ICOHR (Intelligent Computer Based Oral Health Record) is an information system which brings together five important parts of the patient's dental record: medical and dental history; oral status; treatment planning; progress notes; and a Patient Care Database, generated from their clinical care information (the database is also stored in the ICOHR). ICOHR is designed to be integrated into a traditional practice management system. The components of the ICOHR system support the use of various types of clinical care quality management tools, including medical alerts, clinical care guidelines, care modifiers, and diagnostic decision support. Data input is multimodal, so the user may use both voice recognition and direct input with a digitizer board to enter information into the database. ICOHR is designed to be integrated into the clinical environment in an ergonomic fashion in order to facilitate the unobtrusive and efficient acquisition of patient information. ICOHR is currently under clinical evaluation in both private practice and institutional environments. The private practice is a large general dentistry practice with over twenty sites scattered throughout a large metropolitan area. The institutional settings are a College of Dentistry and a Hospital Dentistry program. The evaluations have started in two of the sites and the other site will be phased in during the next six months. Our demonstration of the system will include both prepared presentations of the system's various functions and provide an opportunity for hands-on use of the system for interested attendees.

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