University of Pittsburgh School of Dental Medicine Dr' Heiko Spallek Center for Dental Informatics

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University of Pittsburgh School of Dental
Medicine Dr. Heiko SpallekCenter for Dental
Informatics
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Dental Informatics Strategic Plan
Comprehensive IT Infrastructure

• Patient Care

• Education

• Research

• Administration

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• For each area

• Current Status
• Plan
• Level 1
• Level 2
• Level 3

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Patient Care

• Status

• 2000 Installation of QSI Dental Systems
  (predoctoral clinics)
• Main areas of a clinical management system
• Patient demographics billing area OK
• Clinical record area none
• Student progress monitoring grading area none
• Installation uses outdated technology
• CDA requirement 2-24 Graduates should be
  competent in the use of information technology
  resources in contemporary dental practice.
• Quality Systems, Inc., Irvine, CA

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Patient Care

• Plan

• The paperless school!
• Comprehensive multi-year effort
• Different levels of IT sophistication in the 3
  areas of a clinical information system

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• Patient Demographics and Billing

Patient Care

• Level 1
• Keep QSI Dental Systems, but upgrade or
• Implement new system
• Level 2
• Integrate our system with the UPMC hospital
  system
• Share demographic data across healthcare
  providers (LHII), e.g. medical and medication
  history
• Optional Patient Portal Layer
• Electronic scheduling and confirmation for
  patients
• Complete electronic submission of
  pre-registration information
• Review of account history and payment by credit
  card

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• Clinical System

Patient Care

• Level 1
• Complement QSI with QSI's Clinical Product Suite
  (CPS)
• Limited diagnostic and treatment charting
• 1 clinical computer workstation for 6 dental
  units
• Level 2
• Chairside computing during patient care
• Clinical findings, treatment plan, progress notes
• 1 clinical computer workstation for 1 dental
  unit
• Level 3
• More advanced clinical applications, such as
  imaging
• Semi- or automatic recording of clinical findings
• dental units with integrated computing
  capabilities

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Patient Care

• Clinical System

• Optional CAD/CAM Layer
• 1-2 CAD/CAM systems
• Optional Imaging Layer
• Only for levels 2 and 3
• Digital cameras
• Intra-oral cameras
• Digital radiography

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Patient Care

• Radiology Digital Imaging

• Imaging
• Transition to digital to be implemented in phases
• Competing technologies selection based on
  diagnostic task and imaging volume for each area
• Mostly centralized imaging for QA purposes

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Patient Care
Radiology Digital Imaging

• Capture technology to be implemented
• Radiology combination of CCD/CMOS and SP (FMS,
  extra-oral) bulk of imagingSelected PAs/BWs
  only
• Endodontics CCD/CMOS in each graduate cubicle
• Implant clinic, urgent care, all graduate
  clinics, CCP clinics, pediatric dentistry,
  anesthesia, AEGD CCD/CMOS

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Patient Care
Radiology Digital Imaging

• Cone Beam CT Unit
• Implant surgical treatment planning
• TMJ studies, evaluation of osseous pathology
• Endodontic, and apical surgery treatment planning
• Orthodontic treatment planning
• Pre-surgery planning orthognathic surgery, other
  corrective (clefts/defect repair/reconstruction)
  procedures
• Localization of critical anatomy (removal of
  impacted teeth) OSA, tongue posture volume,
  tonsils, mastoid area
• Evaluate nasal septum, turbinates, maxillary
  sinuses, upper airway

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Patient Care
Radiology Digital Imaging

• Phase 1
• Facilities modification to continue through
  phase 4
• Dedicated maxillofacial cone beam CT unit in
  radiology networked with oral surgery
• One digital extra-oral, and intra-oral imaging
  unit in radiology - for patients referred from
  OMS
• Students rotated, exposed to technology, and
  trained

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Patient Care
Radiology Digital Imaging

• Phase 2
• Orthodontics for extra-oral imaging only
• Endodontic graduate clinic area to use
  intra-oral units

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Patient Care
Radiology Digital Imaging

• Phase 3
• Full implementation of an EPR (Electronic Patient
  Record) as network ports, viewing stations in
  each operatory/cubicle
• Other graduate student clinics to be included

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Patient Care
Radiology Digital Imaging

• Phase 4
• Operators school-wide will have been trained in
  EPR use
• Extensive training of first professional
  students, all remaining staff, faculty in digital
  radiology equipment and software
• Most time-consuming and labor-intensive phase

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Patient Care

• Students Progress and Grading

• Level 1
• Keep QSI Dental Systems, but augment with a
  customized version with grading module
• Level 2
• Only for clinical system levels 2 and 3
• Students enter completed procedures
• All entries are approved and graded by
  instructors
• Students accumulate credits and grades toward
  clinical progression

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Patient Care

• Implementation

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Education

• Status

• Limited educational technology
• Some syllabi and course materials available
  through intranet
• CDA requirement 2-10 school must have a
  curriculum management plan to avoid, for
  instance, unwarranted repetition...

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Education

• Plan

• Level 1
• Presentation of learning material
• Exploit new intranet
• Electronic curriculum management tool
• Automatic matching between lectures to find
  repetition and opportunities for integration
• Level 2
• Development of educational software
• Innovative and effective teaching tools

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Research

• Status

• Rapidly growing area
• Use of IT and informatics often a core review
  criterion
• Funding for required computing support through
  individual projects
• Overburdened research staff grant submission
  process and post-award administration
• Limited involvement of students

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Research

• Clinical Research

• Level 1
• Integration of research into clinic
• Implementation of a clinical information system
• Researchers query patient data for epidemiology
  studies, identification of study subjects
• Level 2
• Integration of the research process into the
  workflow of the clinical operation
• Upon patient enrollment alerts about study
  eligibility
• Facilitate the enforcement of research protocols

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Research

• Grant Submissions

• Level 1
• NIH electronic grant submission
• Centrally maintained information store for NIH
  biosketches
• Reduction of overhead for the research staff
• Level 2
• Easy access to the salary and benefit information
  
• Efficient development of budget overviews
• Use of intranet to
• Identify researchers with matching research
  interests
• Facilitate student involvement in faculty
  research

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Research

• Collaborative Research

• Level 1
• State-of-the-art collaborative work environment,
  e.g. Groove
• More research projects group effort
• Integration into office environment and
  research-specific workflow
• Facilitates real-time data sharing, common
  scheduling, seamless project management
• Level 2
• Site license for collaborative work environment,
  e.g. Groove University Department Kit
• Groove Networks, Inc., Beverly, MA

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• Post-award Administration

Research

• Level 1
• Centralized post-award management process
• Deployment of electronic means to manage this
  process

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Research

• Personnel and PR

• Application Development/Database Support
• Point to existing expertise and resources
• Maintain central personnel and infrastructure
  resources
• Designate 1 FTE for research projects 50 funded
  through school
• Informational/PR Needs
• Distribution of time-sensitive information
• Research opportunities
• Newly funded awards
• New NIH regulations and policies

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Research

• Dental Informatics

• Research Funding
• Since inception 777,485
• Submitted 3,042,511
• Plan
• Maintain leadership in the field
• Add 2 additional faculty positions (1½ financed
  through soft money)
• Add 1 applied informatician (for clinical
  information system)
• Add 1 full-time administrative assistant financed
  through school

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• In-class assignment

Five members of the Executive Committee (EC) are
in favor of implemeting a laptop program in the
school, requiring all students to purchase a
laptop upon admission. Five other members of the
EC are in favor of deploying computer
workstations throughout the building instead of
requiring students to purchase laptops. Collect
5 strong pro and 5 con arguments for each
proposal (total of 20 arguments). Be prepared to
defend your arguments!
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Administration

• Status

• Intranet not yet utilized to fulfill its
  potential
• Web site missing some functionality
• Common problems affecting productivity
• Servers hardware and facility upgrades
• Resolution and response time improved through
  streamlining IT requests
• No software asset inventory

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Administration

• Core Components

• Software upgrades and maintenance
• Hardware upgrades and new systems
• Server room climate control and status monitoring
• Network ports and security
• Multiple databases and excel documents will
  continue to be consolidated into database server
  to eliminate redundant data

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Administration

• Productivity Enhancements

• Intranet deployment and development
• Improve current utilization
• Improve the functionality of current features
• Develop new features
• User identification and authentication
• Biometric finger print authentication
• Establish an enterprise-level spyware protection

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Administration

• Training

• Delegate 10 effort of dental informatics faculty
  to manage a comprehensive training plan
• Identify IT competencies necessary for each job
• Provide qualified trainers, facilities, and
  courses
• Encourage one-to-one training through a mentoring
  program
• Utilize University resources

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Administration

• Web Site

• Enhancing the site through improving the look and
  functionality
• Continuing education online registration
• Online registration integrated with student and
  course administration

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Administration

• Support Infrastructure

• New administrative/junior technical phone support
  position that will
• Provide administrative functions, such as
  purchasing
• Provide full-time phone service
• Maintain software and hardware asset inventory
• Track the status of purchase and help requests
• Locate IT service to the 3rd floor of Salk Hall
• Establish regular customer service surveys
• Provide periodic analysis to measure affectivity
• Establish a system for feedback from users
• Continue to utilize the POC group feedback