FAQ: What is the difference between
dental IT and Dental Informatics?
Ten Questions You Always Wanted to Ask
There is a definite distinction between Dental Informatics (DI) and Information Technology (IT) use in dentistry. IT provides the hardware devices and software programs that capture, store, retrieve and display information (i.e., data), whereas, DI focuses on the creation, management, modeling, structure and usability of the information (i.e., data) within and across different systems.
However the two domains are not mutually exclusive, the primary focus of each is different. IT focuses on hardware and software devices, whereas Dental Informatics focuses on research, development, and evaluation of information models and computing applications.
Most dentists are familiar with IT used in the dental practice. Some examples of dental practice IT includes, computerized billing, insurance form generation, intra-oral cameras and digital x-ray machines. Dental informatics uses IT as a source of data but takes it a step further by using data (often from multiple inputs) and by evaluating, massaging, enhancing and managing the data. With the ultimate goal of presenting the data back to the user in ways that will improve the quality, efficiency, safety and effectiveness of care. Examples of applied dental informatics applications includes, alerts and reminders, decision support, secure messaging, terminology and nomenclature standards, and e-prescribing.
Many dental information technology tools incorporate and embed dental informatics in the technology. For example, a practice management system is an information technology that captures and stores data. The system also provides reports and analyses that utilize decision algorithms and data mining capabilities both of which are considered informatics tools.
Another example of a Dental Informatics role is defining
nomenclature, standards and protocols for the exchange and sharing of
information across disparate systems to support integration,
interfacing and interoperability, such as dental office and lab,
dentist referral to specialist, tele-dentistry and secure
dentist-patient and dentist-dentist communication.
The next generation of Dental Information Technologies, particularly those used by dentists in their practices, will depend on the results of Dental Informatics research and infrastructure. The table below presents four areas where Dental IT will be impacted by Dental Informatics – Clinical, Imaging, Bioinformatics, and Population. In each of these areas informatics research must be conducted, challenges overcome and applications designed, developed, tested and implemented. In some areas the work is well underway with applications now being used by practitioners while others require additional research and development.
Dental informatics is the “application of computer and information science to improve dental practice, research and program administration” (Eisner, 1999). Applied dental informatics is often thought of in terms of the use of hi-tech devices and appliances by dentists, for example intra-oral imagery, laser handpieces, and office management systems. However, it is the clinical content (i.e. data, information and knowledge) that is captured and utilized by the devices and applications that falls more directly into the realm of applied dental informatics and serves as the foundation for the next generation of informatics-based applications.
Dental Informatics has the potential to improve the effectiveness, efficiency and overall quality of oral care dental professionals are able to provide to patients as well as enhance patient experience and office management processes. The following applications leverage the foundations of dental informatics from the perspective of the use of a knowledgebase derived from large data sets.
Dental Informatics Applications:
Originally the sole component of computerization in the dental office, computerized practice management systems, are no longer restricted to automating insurance claims processing and generating periodontal recall lists. Today the business of running a dental practice includes managing the practice, reaching out to patients and colleagues through applications such as dental practice web portals, secure messaging, online patient registration and appointment scheduling as well as connectivity to personal health records and specialty referrals. Practice management involves marketing, promotion, recruitment, and retention and above all customer service. Customer (i.e. patients) relation management is a key component of a successful dental practice.
Dental Informatics plays a significant role in patient relation management. DI is involved in defining data elements that are mined to create business intelligence used to support patient relations management. The accumulation of both identified and anonymozied patient data can be used within and among dental practices to build large data sets which can be mined to learn more about patient behaviors and preferences. These data become essential components of business intelligence that will be used to target and tailor customer relation activities.
Some practice and patient management application in which Dental Informatics and business intelligence data are involved are listed below.
Personal interaction with computerized information and communication is becoming widespread in health care, including dentistry. Whether it is learning about diseases and treatments from the Internet, viewing intra-oral images in a dental office, blogging on the web to learn about ‘someone like me’ or using a patient decision aid to decide on the most appropriate treatment plan, patients and care-givers use dental informatics applications to seek and receive information related to dental procedures and dental care.
The role of Dental Informatics in relation to patient experiences is centered on providing the knowledge and data to support targeted and tailored information. Getting the right information to the right person at the right time in the right way from the right source will most often lead to an enhanced and meaningful patient experience. However, getting to that point is no simple task and it can not be accomplished with IT alone. It is the role of Dental Informatics to determine the “what” and combine with IT to provide the “how”.
Throughout these processes the quality of the patient experience is paramount. The following informatics-based applications are used to inform and education patients, and at the same time enhance the experience of patients with their dentist and the dental team.
Dental Informatics plays a significant role in the continuum of patient care from the pre-visit preparation, to treatment delivered in the dental operatory, to the after visit summary, to follow up and ongoing treatment outside the dental office. This role will increase as access to and integration of patients’ medical histories become part of the patient clinical record and as more health care is delivered outside the clinical setting. Effective, efficient, safe, high quality dental care is enhanced through the availability of a wide range of Dental Informatics-based applications utilized in the course of clinical care. The following lists many Dental IT applications that may be considered part of the clinical process. For each application a list of Dental Informatics dependencies are included.
Electronic health records are gaining use in dentistry and they will likely replace paper-based records in the future. For now the use of EOHR chair-side is limited, yet it offers a number of distinct advantages over paper-based records. In addition to being available at all times at multiple locations, being legible, and being transferable, an essential quality and safety value electronic records can provide is decision support and evidence-based guidelines. The following are some examples of specific informatics-based clinical records applications that may become standards of care in dentistry.
Clinical Records & Charting
Professional education, especially continuing dental education, is already benefiting from information technologies and dental informatics through online courses and virtual experiences and simulations. Additional areas where Dental Informatics will support education for dentists include tele-consultation and virtual reality simulations.
The answer to this question will be determined with the evolution of the next generation of dental information technology and communication based tools. For example, if large generalizable data sets of treatment outcomes combined with evidence-based treatments procedures become available and are incorporated into effective treatment planning tools that are used by dentists, then one expects the quality of care to increase.
Many aspects of Dental Informatics can have a large and positive impact on the quality of care delivered by clinicians. However, the challenges for Dental Informatics, like those facing Medical Informatics, are significant and require effort from a wide range of stakeholders in many sectors – government, industry, academia, clinical practice and consumers.
In order to consider the design and development of many of the applications mentioned a core set of data/information/knowledge is required. The acquisition, classification, storage and retrieval of this information are necessary steps that must precede the possibility of realizing the envisioned applications. The grand challenge of Dental Informatics is not to dream up possible applications that may be beneficial and move dentistry into the information age; rather the grand challenge of dental informatics is to figure out what information to collect, how to collect it, and then how to use it. The following challenges are a view from 50,000 feet rather than from the clinicians’ chair-side perspective.
To develop a knowledge-based ontology of dental concepts from which one could extract a standardized controlled clinical terminology to describe dental signs, symptoms, conditions, diseases, and treatments (i.e., procedures, methods, techniques, materials, and devices). Such an ontology forms the basis of the field of Dental Informatics. This ontology must contain elements, such as permanent clinical concepts and non-semantic identifiers; allow for a polyhierarchy; include formal definitions; not allow “not elsewhere classified” terms; employ multiple granularities; and allow for recognized redundancy (Cimino, 1998; Rector, 1999). Without such a standardized controlled terminology, all other clinical data and knowledge bases will not be of much use.
To develop an evidence base of etiology, diagnosis, prevention, treatment, and treatment outcomes (including materials, methods, techniques, and usage) for a large proportion of dental patients and dental practices. Such a knowledge base would require tracking of genomic, psychosocial, and physiologic dental health markers; prevention regimens; materials; techniques; treatments; outcome results; side effects; and environmental influences (local and global). Some of the key informatics contributions to such an effort would include the development of large, integrated clinical databases of de-identified patient data (Tierney and McDonald, 1991; Hayden, 1997).
To develop a comprehensive electronic oral health record that is seamlessly integrated into the automated medical record. Such a system would consist of a database of patients’ health-related information entered by any healthcare worker. It would allow clinicians to document findings and plans, provide links to online information resources, facilitate real-time clinical decision support, and facilitate the transmission of information to other clinicians.
To develop a nationwide oral health database that contains basic patient-level diagnostic, treatment, and outcome data linked to a nationwide medical database (Heid et al. 2002; ANSI 2003). Such a resource would allow dentists to identify relationships between dental diseases or conditions, and medical diseases, conditions or medications.
To automate data capture, integration, and synthesis to create
real-time, knowledge-based, clinical monitoring systems based on both
continuously and intermittently available analog and digital data.
These systems must allow data from multiple input sources of widely
varying degrees of accuracy and reliability. These monitors will
require the development of robust algorithms for information and
knowledge processing and must also be capable of determining how, when,
and whom to notify if a significant clinical event is detected.
To develop a standardized clinical terminology to describe dental signs, symptoms, conditions, diseases, and treatments (procedures, methods, techniques, materials, and devices). Such a terminology forms the basis of the field of Dental Informatics. Without a standardized terminology, all other clinical data and knowledge bases will not be of much use.
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