Project Proposa 

 

Introducing Electronic Medical Record System to

Dental hospitals / Dental Clinics.

 E . A . V . Prasad    BMI 3    PGIM/2136/11-23934

Supervisors  

Prof. Jayantha Werasinghe 

Consultant in O M F,

Oral Surgery Unit. 
Dental Hospital,

Peradeniya.

 

Dr. Priyake Palipan 

Consultant in Restorative  Dentistry,

Institute of  Oral Health,

Maharagama.

Title: 

Introducing Electronic Medical Record System to Dental hospitals / Dental Clinics.

Introduction: 

Medical records are essential part of the relationship between patients and their doctors. There are many challenges and difficulties in keeping Electronic Medical Record (EMR) system. But considering the benefits of the EMR over paper records, so many health care facilities are considering the switch to EMR system. This technology makes accessing and updating records faster and easier, improve daily activities for doctors and health care providers  as well as satisfaction of the patients.[1] 

If we can introduce Electronic Medical Record to Dental hospitals, it will help in many ways to improve daily activities.

Electronic Medical Record (EMR) represents electronic repositories of patient medical information, in other terms it is an electronic form of a patient's paper medical record. EMRs provide continuity of care, or information for further management of the patients. It provides information about treating a patient from one health care provider to another. The EMR makes up a legal record of patient treatment within a health care provider organization. The organization, such as a hospital or physician's office, owns the record. However the right of ownership is with the patient. This means that the patient has access to the information listed in the record, unless it is deemed harmful to the patient.[2] [3]        

The following are examples of what is typically included in the patient’s dental record,

• Name, birth date, age, address, and contact information.
• Telephone numbers (home, work, mobile).
• Medical and dental histories, notes and updates
• Progress and treatment notes.
• Diagnostic records, including charts and study models.
• Medication prescriptions, including types, dose, amount, directions for use and number of refills
• Radiographs.
• Treatment plan notes.
• Patient complaints and resolutions.
• Laboratory work order forms.
• Referral letters and consultations with referring or referral dentists and/or physicians.
• Follow-up and periodic visit records.
• Consent forms.   

Dental records includes, [4]

• Present teeth and their characteristics
• Missing teeth and the reasons why they are missing
• Dental caries and the surfaces involved
• Dental restorations, surfaces involved, and materials used
• Dental prosthesis, their types, and materials used
• Dental anomalies
• Dental spacing and their dimensions
• Positions of supernumerary teeth
• Dental surgical procedures
• Dental Radiograph ( Peri Apical (IOPA), Ortho Pantomo Graph (OPG), Cephelogram)

 

Justification:

               

In Sri Lanka, different types of EMR systems were introduced and they are improving with time. But there is no such EMR system for dental hospital of Colombo or Maharagama.

There are so many advantages of electronic system over paper base. The Data is more accurate, as record system eliminates the possibility of errors as result of misreading hand writing and spelling check could be added. The Data can be accessed to several health workers at the same time. Easy storage and less space requirement are major advantages. It is easy to transfer from place to place. Less cost, less paper works, easy data handling, data input and data retrieval will be easy. Quick ordering facilities like requesting lab test, radiograph and prescribing drugs. It improves overall quality of patient care. Records can be standardized.[5, 6]

As mentioned above, there are many benefits with EMR system. In paper based system, records are recollected and at the end of the treatment all the records are sent back to the stores. At any point there is high chance of record misplace by negligence of the patient or staff. By introducing EMR system this problem could be easily eliminated.

When multidisciplinary treatment two or more clinician or consultant involved in the treatment, EMR system show all the record about the patient. No need of sending records from a place to place. All the team members can plan best treatment option for the patient.

               

Therefore by introducing good EMR system we can improve,

• ·         Patient care, as EMR system give good answers to lot of problem related current situation,
• ·         Patient satisfaction, as we can reduce patient waiting time,
• ·         Health workers satisfaction, as we can reduce work load of them,
• ·         Maintain of the record

Dental records that are used to provide patients with optimal dental service could also be beneficial to management of the patient care. Therefore, all forms of dental treatments should be recorded and kept properly. And we have to maintain central registry of dental records in government and private sector to gain good benefits of this system.

Activities of the Dental Hospital

 Objectives:

 General Objective;

• Introduce Electronic Medical Record system for Dental Hospitals / Dental Clinics.

Specific objectives; 

•  Identify Disadvantages of Paper-based system (Existing system)
• Identify problems in Current data entry system and hospital management system
• Identify IT knowledge of attendant, Nurses, Doctors, Pharmacist, technician
• Train hospital staff
• Choose best EMR tool
• Improve general activities of the hospitals/clinics,
• Maintain dental records,

 

Methodology:

• Study and analysis of existing system to identify problem in paper base system. It will be helpful to identify areas that should be improved by introducing new system.
• Study and identify difficulties that have to be faced when introducing Electronic Medical Record system.
• Technical problems, training problems, installation problems, etc...
• Study and identify the areas to be improved in IT knowledge of the staff, as data entry mainly done by staff 
• Select best EMR tool, study EMR systems on action and their capability of working.  Then define the functions needed and select best tool which fulfills the most requirements. 
• System Designing/System Development/System Evaluation/System Implementation. 
• Identify best storage that we are going to use, local server or centralized server. 
• Backup system (as backup data storage should be there in an emergency). 
• Training in for Electronic Medical Records Keeping 
• Identify and overcome dangers of Electronic Medical Records, as

Ø Ensure complete confidentiality of the records (Privacy),

Ø Health workers complain that using a computer to log medical data is difficult and time consuming. This leads to delay in treatment and lengthened appointment times (Productivity).

Ø So many Information security technologies are available to block unauthorized access to medical records, security breaches happen all the time (Security Breaches).

• Maintain dental records and keep them ready to use when necessary.

 

Analysis of result:

To see all the objective are achieved or purpose of the project is fulfilled, results should be analyzed.

• Before and after questionnaire to measure patient satisfaction.
• Before and after questionnaire to measure health workers satisfaction.
• Quality of the Dental records.

 

References:

1.            Contributor, T.D.e. Benefits of Electronic Medical Records.  1999-2012; Available from: http://www.ehow.com/about_5439548_benefits-electronic-medical-records.html?ref=Track2&utm_source=ask.

2.            Wilson, J. What Is EMR & EHR?  1999-2012; Available from: http://www.ehow.com/about_6299571_emr-ehr_.html#ixzz1uvOzAmKF.

3.            Hersh, W.R. The Electronic Medical Record: Promises and Problems Journal of the American society for information science  1995  [cited 46 10]; 4]. Available from: http://skynet.ohsu.edu/~hersh/jasis-95-emr.pdf.

4.            Sleight, K. Why Teeth Are Important Forensic Identification Tools.  Jul 18, 2010; Available from: http://kenneth-sleight.suite101.com/why-teeth-are-important-forensic-identification-tools-a263164#ixzz1vIo5KuxE.

5.            Yookyung B, N.Y., Min-gyung K, Sukil K. A study of the difference in volume of information in chief complaint and present illness between electronic and paper medical records. Health Information Management Journal [serial online]. April 2012;41(1):11-16. Available from: Academic Search Complete, Ipswich, MA. Accessed July 7, 2012.

6.            Deutsch, J. Clinical Benefits of Electronic Medical Records - EMR Digimedica [EMR] 2005 September 26th, 2005  2]. Available from: http://www.digimedicacorp.com/Clinical%20Benefits%20of%20EMR.pdf.