Electronic Health Records in Continuous Shared Dental Care

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1 Electronic Health Records in Continuous Shared Dental Care Taťjana Dostálová 1, Jana Zvárová 2, Zuzana Teuberová 1, Michaela Seydlová 1, Martin Pieš 2, Josef Špidlen 2 1 Department of Prosthodontics, First Faculty of Medicine of Charles University and General University Hospital, EuroMISE Centre, Prague, Czech Republic 2 Department of Medical Informatics, Institute of Computer Science, Academy of Sciences of the Czech Republic and EuroMISE Centre, Prague, Czech Republic

2 INTRODUCTION The hospitals use an electronic form of health records as a part of their hospital information systems. Practitioners often use varied proprietary solutions based on MS Access databases or MS Excel Sheets. The health record is not structured as much as necessary; it includes a lot of free-text information, and the set of collected attributes is fixed and practically impossible to be extended.

3 INTRODUCTION The EuroMISE Centre is developing an electronic health record (EHR) application MUDRLite, which could easily fulfill the gap among existing EHRs. Špidlen J., Pieš M., Teuberová Z., Nagy M., Hanzlíček P, Zvárová J., Dostálová T.: MUDRLite an electronic health record applied to dentistry by the usage of a dental-cross component EMBEC 05, IFMBE Proceeding vol. 11, pp , 2005.

4 INTRODUCTION MUDRLite itself is represented by a configuration XML file. The XML file completely describes the visual aspects and the behavior of the EHR application. It includes simple 4GL-like constructions written in the MUDRLite Language. MUDRLite can be tailored to particular needs of any health care providers. That makes the MUDRLite application easy to use in a specific environment for instance in dentistry.

5 Aim of study Department of Prosthodontics of the Charles University, 1st Medical Faculty and the Department of Medical Informatics, Institute of Computer Science, Academy of Sciences of the Czech Republic developed software tools provided by interfaces enabling to connect graphic and high advanced functional components. The goals of this applied research are data structuring and modeling of health documentation in the electronic form.

6 Materials and methods The MUDRLite architecture is based on two layers. The first one is a relational database. Currently, MS SQL server versions 7 and 2000 are supported. The second layer is a MUDRLite User Interface running on a Windows-based operating system. To gain MUDRLite s user-acceptance in the field of dentistry we have developed a highadvanced component representing the interactive dental cross, which is a graphic part of dental documentation.

7 Materials and methods The data model of this component originates in the so called Dental Medicine Data Structuring Technology Using a Dental Cross. This technology was applied by the authors of this paper for a Czech national patent under the No. PV

8 Materials and methods A dentist can choose among about 60 different actions, treatment procedures or tooth parameters that are displayed graphically and lucidly. The main features of the component can be stated as follows: form and shape of a tooth exact position of a tooth, unerupted tooth, agenesis of a tooth primary and secondary caries filling of a tooth pulp and periodontal pathology, root canal treatment inlay, onlay and overlay, post and core, crowns, partial veneer crowns, bridge dentures complete denture, overdenture, as well as removable partial denture implant dentoalveolar surgery calculus, pbi, tooth movement, periodontal pocket, bone resorption temporomandibular joint

9 Healthy teeth

10 Orthodontic + restorative treatment

11 Implants - restorative + prosthodomtic treatment

12 53-years-old man, diabetes mellitus

13 Dental Cross Periodontitis Composite filling Root canal treatment Post and core History of the tooth treatment Secondary caries Movement PBI Pocket depth Amalgam filling Bone resorption History of appointments Root canal treatment

14 Stage of the upper jaw before prosthodontic treatment Fixed bridge and crown 43 linked with a bar

15 Lower denture with hard clips Denture in situ

16 Telescopic abutments and gold veneer crown in the mouth

17 Removable bridge in the mouth Final solution

18 61 -years-old woman, excellent general health

19 Composite fused to gold crown PBI Post and core Root canal treatment

20 X-ray image after the therapy Metalceramic bridge in situ

21 Discussion The development of information technologies brings changes in the view on storage and classification of data in health care. In dentistry this need is stressed by the necessity of a transparent record of the whole dentition and individual accomplished examinations in a concentrated form. The information record in a graphic structure accelerates dentist's decision - making and it enables a more complex view in suggesting a treatment plan.

22 Conclusion For the end user the DentCross component looks like a kind of a dental X-ray image. The interactive information can be related to a particular tooth or to a set of teeth that can be treated in various ways.

23 Acknowledgements This project has been supported by Academy of Sciences of the Czech Republic No. 1ET

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