Information Technology

and

Informatics in the

Patient-Dentist Relationship

Iyad ABOU-RABII

DDS, OMFS, MRes, DU, PhD

2

Lecture Plan

• Importance of doctor-patient relationship

• Problem and solutions

• Defining & measuring doctor-patient relationship

• Dental CIT applications

• Role of dental informatics

Introduction

• Technology has allowed the patients to

regain control of their treatment.

• For the modern dentist, it’s important to

understand the different systems that are

available that can assist you in developing

and improving the relationship between

Dentists and their patients.

4

Importance

• Increased treatment adherence

• Reduce malpractice claims

• Fewer tests and second opinions

• Improved quality of life

5

Problem

• Quality of relationship on the decline

• Consumerism

• Healthcare system constraints

• Poor communication skills

6

Solution

• Refocus on patient centeredness

• Communication and information

technology

• Dental Informatics as a model that

integrates CIT with human relationship

7

Doctor-patient relationship defined• Sustained open trusted conversation

• Sharing of information and knowledge

• Exemplified in patient-centered care model

8

Patient-Centered Care Model

Problems

Goals

Roles

Disease

Illness

Enhancing

the Patient-

Doctor

Relationship

Incorporating

Prevention and

Health

Promotion

Being

Realistic

Context

Illness

Disease

Person

Exploring both

disease & illness

experience

Understanding

the whole person

Finding

common

ground

Mutual

Decision

Patient

Presents

Cues

9

Relationship Building - PCC

PCC

Hi Quality Doctor-Patient

Relationship = ImprovedOutcomes

• PCC - Patient-Centered Care

10

Personal Relationship Scales

• Communication and decision support

• Interpersonal caring and social support

• Contextual knowledge

• Trust

11

Personal Relationship Scales

• Communication and decision support

• Thoroughness of questions about symptoms,

attention to what patients say, clarity of explanations,

instructions, and advice and help in making

decisions.

12

Personal Relationship Scales

Communication and decision support

Interpersonal caring and support Patience, friendliness, caring, respect, and time spent

with the patient. Sharing power and enhancing self-

awareness.

13

Personal Relationship Scales

• Communication and decision support

• Interpersonal caring and support

• Contextual knowledge of the patient

• Knowledge of the patient’s life history, medical

history, responsibilities at work, home or school,

principal health concerns, values, and beliefs.

14

Personal Relationship Scales

Communication and decision support

Interpersonal caring and support

Contextual knowledge of the patient

Trust Integrity, honesty, competence, and role as the

patient’s agent. Expressing a sense of security

and well-being.

15

Relationship Building - CIT

• CIT - Communication and Information

Technology

• PCC - Patient-Centered Care

PCCHi Quality

Doctor-Patient Relationship =CIT +

ImprovedOutcomes

16

Communication & Information

Technology

• What aspects of CIT affect patient-dentist

relationship

• Use existing models

• PCAS for relationship

• Schleyer’s taxonomy of dental CIT

17

Dental CIT

• Schleyer’s Categories

• Internet

• Clinical

• Administrative

18

CIT Internet Devices

19

CIT Clinical & Administrative

Devices

20

Mobile & Wearable Devices

21

Internet

• Office Web portal

• Email

• Personal Health Record

• Teledentistry

22

Web Portal

• Service

• Doctor and Staff info

• Location, hours

• Practice philosophy

• Office policies

• Patient education

• Automated scheduling

• Automated reminders

• Patient testimonials &

images

• Relationship Benefit

• Informed patient

• Match & shared values

• Set expectations

• Sense of control

• Build trust

23

Email

• Service

• Secure

• Web-based

• Triaged

• Linked to EOHR

• Becomes part of PHR • Relationship Benefit

• Ease of access

• Open communication

• Trust

24

PHR

• Service• Treatment history

• Dental history

• Meds

• Family history

• Radiographs

• Relationship Benefit

• Sharing & participation

• Access & control

• Level power asymmetry

• Trust and confidence

25

Teledentsitry

• Service

• Remote care

• Consultations

• X-rays and images

• Teleconference

• Real-time, store and

forward

• Relationship Benefit

• Communication

• Decision support

• Contextual knowledge

• Convenience

• Continuity of care

• Trust

26

Clinical

• EOHR

• Digital Imaging

• Treatment Planning

27

EOHR

• Service

• Exam

• Charting

• Treatment Planner

• Clinical and

psychosocial data

• Preference data

• History and trends

• Knowledge-based

• Relationship Benefit• Communication

• Contextual knowledge

• Confidence

• Continuity of care

• Trust

28

Imaging

• Our patients want to be able to see

what we see and to understand

why we make the treatment

recommendations that we make.

• Co-diagnosis ( to involve the

patient in the diagnostic process).

29

Imaging

• Service

• Visual record

• Treatment planning

• Trend analysis

• Simulations

• Relationship Benefit

• Communication

• Patient preferences

• Control

• Trust

30

Treatment

Planning

• Service

• Values-based options

• Link medical and oral

factors

• Consider patient

preferences

• Decision making aids

• Relationship Benefit• Communication

• Decision support

• Patient preferences

• Control

• Trust

Administrative: Practice Mgt.

• Using the phone and paper-based

systems is

• time-consuming,

• expensive,

• No interaction from patients.

• Newer electronic systems involve

the patient in the process.

32

Administrative: Practice Mgt.

• Services

• Appointment

scheduling

• Patient registration

• Tailored messages

• Demographics

• Insurance billing

• Claims submission

• Recall

• Relationship Benefit

• Communication

• Access

• Confidence

• Convenience

• Trust

33

Conclusion

PCCHi Quality

Doctor-Patient Relationship =CIT

ImprovedOutcomes

DI

+

• PCC - Patient-Centered Care

• CIT - Communication and Information Technology

• DI - Dental Informatics