Professional Documents
Culture Documents
Review accuracy of diagnosis in determining treat- that can be printed.Besides these general
SUMMARY ment using electronic diagnostic and thera- data Electronic patient record also contains
Introduction: Almost the entire human peutic guidelines. Results and discussion: history data related to allergies and other
creativity today, from the standpoint of its Computerization in dentistry began similarly diseases which existence can significantly af-
efficiency and expediency, is conditioned as in other human activities–recording large fect the treatment, data on current diagnosis,
with the existence of information systems. amounts of data on digital media, and by location of a pathological process in the tooth
Most information systems are oriented to the replacing manual data processing to machine refers to the following location (mesial, distal,
management and decision-making, including one. But specifics of the dental profession vestibular, oral, occlusal), teething, therapy of
health information system. System of health have led to the specifics of the application the tooth , type of material used with location
and health insurance together form one of of information technology (IT), and continue on the tooth. The system may defined also the
the most important segments of society and to require special development of dental surgical procedures that were performed on
its functioning as a compact unit. Increasing oriented and applied IT. Harmonization of the teeth such as tooth extraction or tooth
requirements for reducing health care costs dental software with global standards will root resection with the ability to accurately
while preserving or improving the quality of enable doctors and dentists to with a few indicate that the root is resected. Implants,
services provided represent a difficult task mouse clicks via the internet reach the gen- upgrades, grinding teeth, and independent
for the health system. Material and meth- eral medical information about their patients crown can be defined for each tooth and its
ods: Using descriptive metods by retreiiving from the central national health database. rightful place if a tooth is missing. Specially
literature we analyzed the latest solutions in Standardization will also allow access to designed graphical representation of teeth
information and telecommunications technol- general medical and dental history data on enables to enter data by first clicking on the
ogy is the basis for building an effective and citizens of foreign countries who seek help of tooth or place where it is and also on that
efficient health system. Computerization does doctors or dentists during their vacation. Such occasion to open a menu with options. Con-
not have the primary objective of saving, but a method of using IT will provide a higher trol of data entry prevents entry of illogical
the rationalization of spending in health care. level of health services and better health data. Conclusion: The system according
It is estimated that at least 20-30% of money care. Also, the identification procedures to the HL7 standard represents electronic
spent in health care can be rationally utilized. in mass disasters availability of data can documents which eliminate the need for
Computerization should give the necessary contribute to accelerate the identification of paper documents and a variety of daily and
data and indicators for this rationalization. victims.Dental information systems lately are monthly reports of doctors who are still in use
Very important are the goals of this project based on Web applications to facilitate data today, and the doctor and nurse are almost
and the achievement of other uses and exchange. Electronic patient record contains completely freed of administrative tasks.
benefits, improving overall care for patients basic information and entering of this data is Key words: Information systems, dentistry,
and policyholders, increasing the speed and automatically created the protocol of patients HL7 standard.
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48 Information Systems in Dentistry
ing, analysis and reception of infor- quested by the user, but can explain Computerization in dentistry be-
mation necessary for the organiza- how this information may occur. gan similarly to other human activ-
tion and implementation of health There are many examples of expert ities by recording large amounts of
care, but also research and organi- systems. Up to now, have been de- data on digital media and replacing
zation of health care. veloped as follows: CASNET–con- laborious manual data processing.
Of course, this is not the only sultative system for glaucoma, it is Specifics of the dental profession
definition of HIS. Next tells that the very important in the diagnostics in have led to the specifics of the appli-
HIS is organization of people, ma- ophthalmology; INTERNIST–con- cation of IT, and continue to require
chines and methods which mutu- sultant in internal medicine, etc. special dental development-oriented
ally act to security guards the nec- However, it should be noted that and applied IT.
essary data and information about more work is in progress on the de- It is widely accepted and in prac-
the health of the population for the velopment of such system or pro- tice proven that with moving from
purpose of planning and manage- gram. paper-based administration to com-
ment in health care. Use in therapy and rehabilita- puter processing of data is obtained
Basic components of health in- tion–the beginning of computer at least a threefold increase in effi-
formation system are: applications in medicine is related ciency and huge material savings in
•• Personnel (the organizers, plan- with software for the planning of any sphere of modern business.
ners, designers, managers, devel- radiation of the tumor (calculated The development and purpose of
opers, users) dose, field size). Today this method information systems in health care
•• Database is very widely used and practically implementation
•• Technical basis and cannot be imagined without com- The establishment and develop-
•• Software support. puters. When it comes to therapy, ment of an information system is
Information that are generated we mean follow up of patients and set as a tool for earning money and
and transmitted within the health- its medical condition in the inten- is being implemented with the aim
care information systems has specif- sive care unit. of completely controlling and ratio-
ic purposes: The organization of medical nalizing consumption, thereby sav-
In the operational management work – if we discuss this issue, we ing money.
of health and medical records.– will say that the most important ar- In EU countries, at least 1-2% of
When it comes to this subject should eas of information the following health budgets is spent on informa-
be noted that the amount of data methods (6, 7, 8, 9, 10, 11): tion, while in the U.S. that share is
collected in health facilities is very •• Arranging visits of patients in 2-3%. The share of investment in in-
large. Provision of medical services ambulances formation systems is directly pro-
is very specific and complex work •• Admission to hospital portional to the financial perfor-
whose basic feature is the number •• Prescription mance of the system (3).
and variety of data and informa- •• Sick leave IT with big steps came in con-
tion. Modern processes of health •• Records of medical work, etc. temporary life and work of many
care are built on the fact that infor- 5. In medical research–the appli- people. Decline in prices of comput-
mation must be easily accessible in cation of computers in medical re- ers and software enabled that com-
time and place where it is needed. search is very broad and still is very puters in the last ten years become
On this set, can be answered only difficult (impossible) to engage in accessible to most households, insti-
by using computers. research without a computer or the tutions and offices. Primary health
In medical diagnostics–comput- use of complex processing of infor- care and dental clinics have also fol-
ers in medical diagnostics are used mation and computer work. In ad- lowed this pattern. Since the begin-
in the processing and analysis of dition to data analysis, research is ning of the nineties, first individual-
biophysical signals (electrocardi- increasingly improved by computer- ly and later more massive, comput-
ography, electroencephalography, ized systems for documentation of ers are introduced and become one
electromyography, measurement of the medical literature (MEDLARS of the basic tools in their work. Af-
blood pressure), then the process- and Expert Medica). ter “computer shock”, that is, except
ing and analysis of medical imag- In medical education–now large- for younger colleagues, the expect-
ing procedures for computerized to- ly used in educational materials that ed event of an encounter with com-
mography–CT, then the image ob- are distributed electronically. They puter-technology, for a short time,
tained with MRI, which will be dis- are very suitable type of simulation and even the most hardened oppo-
cussed more later. programs (for the patient or gener- nents of the computers are becom-
In addition it should be noted al population), where the student ing aware of the benefits and relief
that computers play a significant learns, guided by a computer to that are available to them.
role in the diagnosis, or the process- solve a medical or health problem. Hundreds of different data on in-
ing and analysis of clinical laborato- Electronic dental record is an im- surers, patients, and work is need-
ry tests. To set the diagnosis, using portant part of medical informa- ed to be written on daily basis in
the so-called expert systems and, tion systems of health care institu- their practices. Some of them will
in essence, provide information re- tions that include a dental office. be daily, weekly, monthly or yearly
vol 20 no 1 MARCH 2012 Review | ACTA INFORM MED. 2012; 20(1): 47-55
Information Systems in Dentistry 49
integrating and print the forms that holders, increasing the speed and the health care system using
will be regularly submitted to the accuracy of diagnosis in determin- barcode.
Ministry of Health, or other institu- ing treatment using electronic diag- •• Electronic medical record.
tion insured or other claimant. The nostic and therapeutic guidelines. •• Global registration and database
records shall be conducted through The system should allow better uti- of the insured.
special book that was supposed to lization of capacity, reduce waiting •• A global database on Codes
enter each event studied, and en- times, and reduce the time spent in (ICD-10, ICPC-2, LOINC–Log-
rollment had to be recorded in the health care facilities and clinics, en- ical Observation Identifier
board to avoid multiple reporting suring equality in obtaining prompt Names and Codes, list of drugs,
and ensure data quality. However, and quality care for all patients. classification of medical proce-
although slowly and painstakingly, Creating reports and automat- dures, classification of orthope-
the data were standardized, clear- ic delivery in the file format is one dic devices, registration records,
ly numbered, controlled and pro- of the most important information etc.).
cessed. system functionalities. In the future •• Provided access to external
Relief in work is only possible information system reports will not databases.
with the introduction of computer be created, it will be as a result of •• E-prescriptions, e-referrals, e-
technology in collecting and pro- routine work and automatically commerce, etc.
cessing data. Ideally, work with each generated, in real time be available •• A standardized and measurable
insured, measures and procedures to teams and doctors, as well as all use of diagnostic and therapeu-
should only enter into a computer the experts who work on the plan- tic guidelines.
which will by the rules and needs ning and evaluation of results in Such a system should enable the
generate data and reports. Or, ide- health care, from level of teams to cooperation of all public-health in-
ally, computers should help to all level of cantons and the state. stitutions, expert groups and in-
transactions (processes and services) Computerization of health for dividuals, linking and sharing the
quickly implement a reporting data the first time means the introduc- work, multiplication of the results
and information should be the re- tion of electronic smart cards for (3).
sult of a routine job and not a sepa- all doctors in the health care sys- The introduction of integrated
rate activity for the teams (5). tem. So the new information sys- information systems in health care
The project of computerization tems to every patient examination system will achieve particularly
of the health system involves the will at the same time check the sta- good results, because such compre-
implementation of certain technol- tus and rights of both the insured hensive systems provide:
ogy, communication, organization- and the doctor. Only a “merge” ac- More efficient way to create a
al and professional standards nec- cess through the magnetic card and medical and nonmedical informa-
essary for the functioning of an in- smart card of the insured and doc- tion, i.e. more efficient conversion
tegrated health information system tors will allow the transaction, as in of data into information,
(6). banking or other credit card opera- Better, more effective and mean-
Computerization does not have tions. ingful way to share information.
the primary objective of saving, The system should support in- More successful way to communi-
but the rationalization of spending ternational and EU data standards cate with patients (7).
in health care. It is estimated that such as HL7 version 3, ICPC-2, CEN
at least 20-30% of money spent in TC 251 and others. As a result of the 2. Model of Health In-
health care can be rationally uti- project and trial operation of the formation System
lized. Computerization should give system imposed are the following To explain the work of HIS we
the necessary data and indicators requirements: can use the same model that has
for this rationalization. •• A joint system with more li- been very extensive applied in prac-
Great help which is generously censed software solutions. tice, or to say that this model is used
offered by IT refers to quickly find- •• VPN (Virtual Private Network) by many hospitals in our country
ing of the documents and insured, infrastructure (providing “pa- and abroad. The aforementioned
replace the manual writing and typ- perless” operations). model is called MEDICAS and it
ing on the typewriters, printing pre- •• XML/HL-7 norm. is a medical information system
scriptions, referral forms, accounts, •• The standards of system safety for healthcare facilities that cover a
individual forms and reports. The (doctors smart cards, digital sig- very wide range of activities in con-
information system should provide natures, data encryption, fire- junction with patients, providers
insight into the data and informa- walls, separation of the person- and health care system. It contains
tion in real time and prompt inter- al data from health data, data a comprehensive electronic health
vention in the system. repositories, PKI–Public Key In- record of the patient and is intend-
Very important are the goals of frastructure, systemic anti-virus ed to be implemented in all health
this project and the achievement of protection, etc.). facilities. In addition, possible is a
other uses and benefits, improving •• Designation of clinical and oth- connection and exchange of data
overall care for patients and policy- er documents circulating in with regional and central structures
ACTA INFORM MED. 2012; 20(1): 47-55 | Review vol 20 no 1 MARCH 2012
50 Information Systems in Dentistry
gral parts of the system, a modular resources has become a topic of re-
MEDICAS
system allows any combination of GPsearch.- Subsystem
For example, the forstudy
basic in health care facilities.
these levels, depending on the spe- Australia found that GPs used on- 4. The information sys-
cific structure of theMEDICAS
health facili- Hosp - Subsystem
line searches for hospitals
during consultations temsandfor medical
dentalfacilities of the s
ties. with patients. In dentistry, a pro- services
MEDICAS Poly fessional- Subsystem for specialist
course, dental journal and Theclinics
appearanceor ofclinics,
Internet and
3. INFORMATION IN further education were declared as spread of computer use in the eight-
DENTISTRY MEDICAS Lab the top-three
Subsystem for medical
sources of information ies laboratories
and nineties of the last century
Doctors and dentists have differ- in dentistry. has led to major changes in dentist-
ent information needs MEDICAS
when mak- Dent While - Subsystem
approximately for 25% dental
of ry.clinic
Dentistry as a branch of med-
ing diagnoses and medical deci- all general dentists in the United ical science is always forefront in
sions. While medical Identification
knowledge modules
States are integral
use computers since 2006, parts
lit- ofuse
the theof system,
sophisticateda technolog-
modular system
continues to grow at a steady pace, tle is known whether these dentists ically advanced materials and tech-
of these
clinicians spend less time levels,
on clinical are depending on theof specific
using on-line sources clini- structure
niques of the
used because of thehealth
severityfacilities.
trial issues and develop a plan to set cal practice. In order to meet the in- of the biological environment of the
up clinical questions. formation needs of clinicians, vari- mouth. Specifically, physical and bi-
Numerous tests were conducted ous strategies have been proposed, ological processes in the oral cavity
on the use of information in den- 4. INFORMATION IN DENTISTRY
and implemented. One solution is are a complex system of mechanical-
tistry: to offer them clinically based guide- physiological conditions by its com-
Only a very small number of lines in an easily accessible format, plexity and variability are always
studies were based on the informa- and the second is that their diagno- looking for new achievements and
tion needs of dental research. For sis and treatment support informa- technological advances. Computer-
example, Strother, Doctors
Lancaster andand dentists have different information
tion systems such as clinical deci- ization inneeds
dentistrywhen making diagnos
began similarly
While medical
Gardiner interviewed 500 dentists
and found that the most needed in-
knowledge continues to grow
sions support systems (CDSS) that
are able to handle large amounts of
at a steady pace, clinicians sp
as in other human activities–record-
ing large amounts of data on digi-
formation are on newtrial issues
techniques in and develop a plan to set up clinical
information. tal media,questions.
and by replacing manual
dentistry, followed by information Dentist’s information needs vary data processing to machine one. But
about the products and Numerous
equipment, tests were
by the conducted
nature and numberon the usespecifics
depend- of information
of the dentalinprofession
dentistry:
and the practice management and ing on the clinical condition of the have led to the specifics of the ap-
medical complications. Only patient.
a veryDentists
smallneed number of studies
quick access were
plication based on
of information the information
technology
Duxbury and Leach have identi- to information on various topics. (IT), and continue to require special
fied drug interactions and side ef-
For example, Strother, Lancasterdevelopment
Because of rapid schedule in a den-
and Gardiner interviewed 500 de
of dental oriented and
fects, precautions and dosagemost as needed
tal information
office, quick are on new
access to clinical appliedtechniques
IT. in dentistry, follow
well as top queries related to drug the products and equipment, and the practice management
and other information considered During the recording and dataand medic
use. Research on the clinical use of very important the patient’s diagno- entering the problems in adapting
information sources gave less varia- sis and treatment. the system of marking teeth for me-
Duxbury
tion than the research on their in-
and Leach have identified
In the standards of evidence
drug interactions and side effect
chanical processing occured. The
formation needs during the years. as wellbasedas medicine,
top queries related
dentists have toto drug
method use.
wasResearch
developed on the clinical u
precisely
gave less variation than the research on their information needs durin
vol 20 no 1 MARCH 2012 Review | ACTA INFORM MED. 2012; 20(1): 47-55
In a study from 1991, the medical literature is listed as the number o
on medicinal products for dentists, followed by consultation wit
Information Systems in Dentistry 51
ACTA INFORM MED. 2012; 20(1): 47-55 | Review vol 20 no 1 MARCH 2012
52 Information Systems in Dentistry
vol 20 no 1 MARCH 2012 Review | ACTA INFORM MED. 2012; 20(1): 47-55
Information Systems in Dentistry 53
ternational Classification of
Historical overview of all are
illness- allor the
the teeth theindividual
otherteethstandard modules
by using electronic dental records is
readily available from the moment you open the record or the moment of eruption of teeth to
es–ICD-10). The same control the current moment. Thisfor
is used the can
functionality administration
to some extent facilitateand work
dental decision-making
regarding further treatment.
for placing and invoicing of servic- with the patients in their offices.
Through an electronic dental record is possible to configure the appropriate access rights to
the dentist to provide insight into some important medical information of their patients, such
es provided. In the lower left cor- Each dental office is assigned a set
as allergies, sensitivity to medications, chronic diseases.
ner of the form are two buttons to of dental services which they can
open a historical review of the situa- provide. Dental 14
practice is treated
tion of the teeth. One button opens as a reference drug store with appro-
an overview of all the teeth on the priate drugs, dental materials and
selected date. The second button preparations, whose use is automat-
opens an overview of all states of ically recorded.
selected teeth from the time when The advantage of using elec-
teeth starts to grow to the current tronic dental records
situation. The advantages of using electron-
This review was not readily avail- ic dental records in relation to work
able by using printed dental re- with the printed one, especially for
cords, and it can significantly assist larger dental clinics, are multiple. Source: Figurewww.singipedia.com
7. Historical overview of (Dec. 22,and
diagnosis 2011)
the dentist in making decisions so Here are just some of them: therapy of a tooth (white color indicates the
surface of healthy tooth, red caries, and blue
that it currently provides an insight •• Improved control over the
This review was not readily available by using
fillings) Source: printed dental records,
www.singipedia.com (Dec. 22, and it can significa
into the development, disease and record, dentist in making decisions so2011) that it currently provides an insight into the developmen
therapy applied to the tooth to the dentist then analyzed.
ACTA INFORM MED. 2012; 20(1): 47-55 | Review vol 20 no 1 MARCH 2012
8. Display of patients processing with the information system in dentistry – Medicas Dent
54 Information Systems in Dentistry
entific research, and can help den- What in everyday work to den- vices provided to patients, debt-
tists to make decisions in everyday tists may be a problem are some re- ors, invoices, payments, payments,
activities in clinical practice. Also, cord fields that were free-filled in current account office, treasury, fi-
properly inputted data base for den- the traditional record, and now are nance, suppliers, employees wages,
tal patients who are treated in a filled with a value from a pre-de- office costs and expenses).
medical institution are significant fined set (e.g. diagnosis). There are Material management practic-
source of data for assessment of the restrictions and conditions for plac- es provide a complete record turn-
teeth of inhabitants of some areas. ing the tooth in the graph because over of dental materials as well as
Information relevant to decision in classical record it was drawn by the formation of lager with indi-
making in the administration of the hand, and in the case of electron- vidual cards for each material. The
clinic/dentist office, can be easily ic record is selected from a pre-de- card provides complete information
obtained from a database which em- fined set. on the status and origin of materi-
ployees regularly input using elec- However, research shows that al (inputs and outputs, the suppli-
tronic dental records during their precisely these restrictions improve er). Each intervention has a defined
daily work. the quality of dentists who use an norm (the amount of material used)
Electronic exchange of data be- electronic patient record in respect that each intervention is recorded as
tween remote dental clinics/offices, of those who use the dental record an input the output from the clinic,
which are allowed to use electron- in paper form. Specifically, they ful- which gives the possibility of exact
ic dental records, can significantly ly document the status of their pa- cross-section consumption of sub-
contribute to the overall increase in tients and appropriately document stances in analytical form for any
knowledge in this field. Electronic the decisions they make because services performed.
data exchange between the distant they were given the opportunity
offices which by organization be- and obligation to follow the history 7. The importance of im-
longing to the same health institu- of the disease the patient. plementation of elec-
tion should make easier and speeds tronic health records
up the daily work of these clinics. 6. The concept of the in dentistry
Dental record also has a status of virtual waiting room Dental electronic record is a re-
official court documents and it can The concept of the virtual wait- cord of the patient, which includes
be used in identifying persons. And ing room provides the dynamism all medical and dental data, present-
for this purpose an electronic for- and flexibility in the work of den- ed in the form of a computer. One
mat has the advantage over paper tists and assistants. Planners offer a can say that this is the foundation
because it provides a higher level of high degree of setup options, it dis- for building health information sys-
data protection from unauthorized plays appointments in the date and tems. The importance and use of
reading or registration. time range for which the planners electronic records and information
Protection of electronic dental adjust for dentists in which plan- system in the field of dental practice
records will be achieved through ner is the patient. This mode allows are multiple.
user accounts which are unique to you to schedule surgery for their pa- During the treatment the doctor
each employee. The rights of access tients schedule follow-up examina- has access to all relevant patient re-
to dental data of the patients can tions at three or six months. cords, personal information (gener-
be set for individual users or user The software offers the possibil- al data), medical history, documen-
groups, each with a change in the ity of direct communication with tation and a complete graphical and
database is memorized and who is patients in several ways: a) by e-mail tabular presentation of the status of
here modified so that the possibility messages; b) by SMS messages and the teeth and carried out interven-
of abuse is minimized. c) by sending written notice to pa- tions to date. Thus, all patient data
We should indicate some ob- tients in envelopes. can be found in one place and clear-
jective difficulties in the introduc- Dentists and teams from differ- ly presented, with the possibility
tion of electronic records in every- ent practice can achieve outstand- of coping. Also, doctors and teams
day dental practice in an institu- ing communication in the interest from different practice can achieve
tion. The biggest problem is the cost of improved treatment of the pa- superior communications in order
of this process, which initially in- tient and easier to exchange expe- to exchange experiences and opin-
volves the cost of computer equip- riences and opinions. All forms of ions with respect to rights of priva-
ment, software cost, training of staff electronic communication (SMS, e- cy of the patient. This significant-
and any changes in work processes. mail) are supported in automatic ly reduces the possibility of setting
However, in institutions where such form (reminders), mass sending (cir- incorrect diagnosis, it is possible
information systems are introduced cular) and a single sending form. to operate more efficiently and im-
into use has been shown that this Software provides complete sup- prove the quality of healthcare ser-
initial investment pays off by reduc- port for financial management of of- vices. Dental nurses are largely re-
ing other costs and increase service fices through a number of standard sponsible for administrative tasks.
quality through the use of informa- schemes (modes) financial manage- With application of electronic den-
tion systems. ment (tracking and billing for ser- tal records administrative tasks are
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Information Systems in Dentistry 55
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