A little background

The dental domain is complex, and we wanted to understand it from many different angles. One method successfully used was contextual inquiry, but we used a handful of other approaches as well.

Literature Review

With the help of our knowledgable clients, we reviewed literature on Medical and Dental records, Collaboration Aspects, Usability evaluation, safety, and errors, 3D and Advanced Imaging. Key findings included:

Software Review

To make sure we didn't commit the same sins as current dental software, we briefly reviewed eight dental software including Eaglesoft, Dentrix, PracticeWorks, DentiMax, Prime Dental, Softdent, ACE Dental, and Dental Symphony. Our conclusions:

Charting Comparison

One important visual element of a dental record is the chart. The chart shows a dentist, at a quick glance, the status of a set of teeth. However, there is no dental standard for these charts. Instead, each office seems to have their own preferred symbols and colors to represent decay, fillings, and other dental pathologies. We took two approaches towards making the perfect dental chart.

First, we sent out a survey to dentists around the country, asking them to fill out a chart for a fake patient we had created. This fake patient had a representative set of all the dental pathologies. The results from this survey would have allowed us to understand which symbols were most common and which were rare. As a second approach, we used each dental software to create one of these reference charts. The pictures are below, and they demonstrate the amount of variety between the applications -- not just in the symbols used, but even in which problems each application chose to show.

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Eaglesoft Chart
PracticeWorks chart thumbnail
PracticeWorks Chart
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Softdent Chart
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Dentrix Chart

Cognitive Task Analysis

Our clients at the University of Pittsburgh Center for Dental Informatics provided us with data from their Cognitive Task Analysis (CTA) study. In these CTAs, dentists prepared treatment for patients based on a controlled set of information. Although the patient was not present, a wide range of data including charting, radiographs, intra-oral photos, and other written material about the patient's history was available. How the dentists went about preparing the treatment, and when they accessed each different peice of information, was analyzed and broken down into a spreadsheet. We took this data and re-visualized it, creating elaborate timelines of the information.

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Cognitive Task Analysis Timeline

The timeline is a rich visualization that is a bit difficult to interpret alone. Although there is no common pattern in later stages of analysis, all three dentists do start out with patient info, then medical history, and most go on to dental history. This led to the creation of DMD's overview page for each patient, which dentists loved.

In the CTA data, dentists often switch between artifact types quickly and repeatedly, or look at several artifacts at the same time. In DMD, switching between information can be done with a single tap. The 'View by Tooth' tab enables dentists to see multiple types of information at one time, reducing the need to search for data.