Abstract
BackgroundA major challenge in designing useful clinical information systems in dentistry is to incorporate clinical evidence based on dentists' information needs and then integrate the system seamlessly into the complex clinical workflow. However, little is known about the actual information needs of dentists during treatment sessions. The purpose of this study is to identify general dentists' information needs and the information sources they use to meet those needs in clinical settings so as to inform the design of dental information systems.MethodsA semi-structured interview was conducted with a convenience sample of 18 general dentists in the Pittsburgh area during clinical hours. One hundred and five patient cases were reported by these dentists. Interview transcripts were coded and analyzed using thematic analysis with a constant comparative method to identify categories and themes regarding information needs and information source use patterns.ResultsTwo top-level categories of information needs were identified: foreground and background information needs. To meet these needs, dentists used four types of information sources: clinical information/tasks, administrative tasks, patient education and professional development. Major themes of dentists' unmet information needs include: (1) timely access to information on various subjects; (2) better visual representations of dental problems; (3) access to patient-specific evidence-based information; and (4) accurate, complete and consistent documentation of patient records. Resource use patterns include: (1) dentists' information needs matched information source use; (2) little use of electronic sources took place during treatment; (3) source use depended on the nature and complexity of the dental problems; and (4) dentists routinely practiced cross-referencing to verify patient information.ConclusionsDentists have various information needs at the point of care. Among them, the needs for better visual representation and patient-specific evidence-based information are mostly unmet. While patient records and support staff remain the most used information sources, electronic sources other than electronic dental records (EDR) are rarely utilized during patient visits. For future development of dental information or clinical decision-support systems, developers should consider integrating high-quality, up-to-date clinical evidence into comprehensive and easily accessible EDRs as well as supporting dentists' resource use patterns as identified in the study.
Highlights
A major challenge in designing useful clinical information systems in dentistry is to incorporate clinical evidence based on dentists’ information needs and integrate the system seamlessly into the complex clinical workflow
Procedure We contacted 159 general dentists within the zip codes of the Pittsburgh area from a list of 228 American Dental Assocation (ADA) members by telephone or email to invite them to participate in our study
We present the categories of information needs and source use found, followed by the themes that emerged from the thematic analysis
Summary
A major challenge in designing useful clinical information systems in dentistry is to incorporate clinical evidence based on dentists’ information needs and integrate the system seamlessly into the complex clinical workflow. One approach was to identify the differences in information needs with respect to characteristics of clinicians, such as specialty and practice setting [4,5,6,7]. Another was to examine the nature of clinical questions posed by physicians and to build taxonomies of questions to identify the most common generic types [8,9]. The use of case-specific questions has been advocated as a more valid way to understand physicians’ information needs at the point of care, with distinct characteristics exhibited by physicians according to search context and case scenarios [10]. Duxbury and Leach [12] identified drug interactions and adverse reactions, precautions and dosage as top inquiries related to drug use
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