Clinical computing in general dentistry

Abstract

Objective: Measure the adoption and utilization of, opinions about, and attitudes toward clinical computing among general dentists in the United States.

Design: Telephone survey of a random sample of 256 general dentists in active practice in the United States.

Measurements: A 39-item telephone interview measuring practice characteristics and information technology infrastructure; clinical information storage; data entry and access; attitudes toward and opinions about clinical computing (features of practice management systems, barriers, advantages, disadvantages, and potential improvements); clinical Internet use; and attitudes toward the National Health Information Infrastructure.

Results: The authors successfully screened 1,039 of 1,159 randomly sampled U.S. general dentists in active practice (89.6% response rate). Two hundred fifty-six (24.6%) respondents had computers at chairside and thus were eligible for this study. The authors successfully interviewed 102 respondents (39.8%). Clinical information associated with administration and billing, such as appointments and treatment plans, was stored predominantly on the computer; other information, such as the medical history and progress notes, primarily resided on paper. Nineteen respondents, or 1.8% of all general dentists, were completely paperless. Auxiliary personnel, such as dental assistants and hygienists, entered most data. Respondents adopted clinical computing to improve office efficiency and operations, support diagnosis and treatment, and enhance patient communication and perception. Barriers included insufficient operational reliability, program limitations, a steep learning curve, cost, and infection control issues.

Conclusion: Clinical computing is being increasingly adopted in general dentistry. However, future research must address usefulness and ease of use, workflow support, infection control, integration, and implementation issues.

Figure 1.

Percentage of all dentists who have a computer in their office (1984 to 2000 American Dental Association surveys6,7,8) and percentage of general dentists who have a computer at chairside (1999 to 2004; data provided by the Dental Products Report [DPR] [Gail Weissman, personal communication, 2005). (DPR data were obtained through a mail survey [single mailing without follow-up] of subscribers to the DPR. Sample sizes and response rates were as follows: 1999: 5,000/19.1%; 2000: 5,000/15.8%; 2001: 2,000/12.2%; 2002 and 2003: no information available; 2004: 2,000/20.4%.)

Figure 2.

Storage of major clinical information categories on paper/computer, sorted by utilization of computer-based storage in descending order (Paper = information stored only on paper; Computer = information stored only on the computer; Both = information on paper duplicated on the computer; Not at all = information not recorded at all).

Figure 3.

Year of adoption of chairside computing and cumulative percentage of respondents (n = 99).

Figure 4.

Charting interface of the Dentrix Digital Office application (image courtesy and copyright of Dentrix Dental Systems, American Fork, UT).