The potential of computerized health records to support clinical decision making is well documented. We investigated user opinions and recommendations regarding capacity of an electronic dental record (EDR) to provide clinical decision support through provider focus groups.
Objectives: To gather input from users on how the EDR can support patient care, to identify common utilization patterns and best location for clinical reminders, and to use this information to develop a tobacco cessation decision support tool.
Methods: Three groups – dentists, hygienists, and one mixed group of EDR users employed by HealthPartners Dental Group – were recruited. Questions regarding practice patterns and preferences for clinical decision support were developed by the study team and framed around improving tobacco cessation services. Participants received EDR screen shots and were instructed to mark the sequence typically followed when entering patient tobacco information and to rate specific locations for reminders that would best support patient care. Responses to sequencing and reminder preferences were aggregated and utilized to develop a pilot tobacco cessation intervention.
Results: A total of 23 providers participated. While there were differences in frequency of use, sequence patterns were very similar among dentists and hygienists. The health history screen was accessed first by 86% of participants, the risk assessment screen was used second by 71%, and the hygiene visit screen was the third choice by half of the participants. The health history screen received the most favorable rating as a location for clinical reminders.
Conclusions: User utilization patterns and preferences indicate that it is appropriate to locate a pilot tobacco cessation intervention in the health history section of the EDR. Engaging practitioners in developing modifications to electronic records may improve patient care and speed adoption of tools supported by research results.
Acknowledgements: This project was supported in part by grant R21 DE017325-02 from NIDCR.