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Todays talk
a fundamental question for usability the federal case for usability in healthcare the health care process and health records a brief tour of an electronic dental record sample projects in user-centered design getting you involved
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Introduction
Between June 1985 and January 1987, a computer-controlled radiation therapy machine, called the Therac-25, massively overdosed six people. These accidents have been described as the worst in the 35-year history of medical accelerators [6].
Leveson NG. Medical devices: the Therac-25. In: Safeware: system safety and computers. Boston: Addison-Wesley; 1995. p.515-53.
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Stead WW, Lin HS and editors. Computational technology for effective health care: immediate steps and strategic directions, Washington, DC:National Academies Press, 2009.
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Treatment plan
Treatment
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Clinical documentation
medical and dental history, incl. chief complaint extraoral and intraoral exam radiographs images problem list treatment plan progress notes
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Medical history
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Medication history
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Periodontal exam
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Radiographs
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Images
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Treatment plan
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Progress notes
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Patient Select
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Clinical Exam
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Charting Interface
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Clinical Notes
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Perio Exam
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Medical History
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Imaging: Bitewings
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T. Thyvalikakath
Kochi, India T. Thyvalikakath 2011
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Thyvalikakath T et al. A usability evaluation of four commercial dental computer-based patient record systems. J Am Dent Assoc 2008 Dec;139(12):1632-42
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Results
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User paths
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significant cognitive effort required that did not contribute to task completion
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Results
Average of patient data accessed in 10 high complexity cases
35 Average number of times each patient data accessed 30
25
20
15
10
0 0% Start of 10% 20% 100% Average session time in percentage (normalized) for a case of high complexityEnd of session
Social History Medical Consult Radiographs Oral Pathology Consult Medical History Dental History Hard Tissue Chart Treatment Plan Notes
30%
40%
50%
60%
70%
80%
90%
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Results (cont.)
Average of patient data accessed in 10 low complexity cases
20 Average number of times each patient data accessed 18 16 14 12 10 8 6 4 2 0 0% Start 10% 20% 100% End of Average session time in percentage (normalized) for a case of low complexity sessio
Medical History Radiographs Treatment Plan Notes Dental History Hard Tissue Chart Extra-oral Images Periodontal Exam
30%
40%
50%
60%
70%
80%
90%
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Results
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Results
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T. Thyvalikakath
H. Torres-Urquidy
P. Hernandez
J. Irwin
A. Acharya
M. Song
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References
1. Leveson NG. Medical devices: the Therac-25. In: Safeware: system safety and computers. Boston: Addison-Wesley; 1995. p.515-53. 2. Ash JS, et al. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med Inform Assoc. 2004;11(2):104-12. 3. Han YY, et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2005;116(6):1506-12. 4. Koppel R, et al. Identifying and quantifying medication errors: evaluation of rapidly discontinued medication orders submitted to a computerized physician order entry system. J Am Med Inform Assoc. 2008;15(4):461-5. 5. Cayot-Constantin S, et al. [Assessment of the usefulness to use a software supervising continuous infusion rates of drugs administered with pumps in ICU and estimation of the frequency of rate of administration errors]. Ann Fr Anesth Reanim. 2010;29(3):204-8. French.
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References (cont.)
6. Stead WW, Lin HS, editors. Computational technology for effective health care: immediate steps and strategic directions, Washington, DC: National Academies Press; 2009. 7. Thyvalikakath TP, et al. Heuristic evaluation of clinical functions in four practice management systems: a pilot study. J Am Dent Assoc. 2007;138(2):209-18 8. Thyvalikakath TP, et al. A usability evaluation of four commercial dental computer-based patient record systems. J Am Dent Assoc. 2008;139(12):1632-42.
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