Investigate Dentists’ Needs and Expectations in Patient Medical Summary Application

Objectives: Patient medical information is critical for dentists to make clinical decisions. However, several studies have found issues in patient reported medical histories. The objective of this study was to investigate dentists' information needs and expectations in a newly developed Patient Medical Summary (PMS) application which can retrieve patient medical information from a Health Information Exchange (HIE).
Methods: We conducted 23 informant interviews. These semi-structured interviews had two sections. First, participants followed think-aloud protocol to review up-to six patients’ medical information using PMS and to make clinical decisions regarding whether the patients fit for common dental procedures. Second, participants answered nine open-ended questions and completed a system usability scale (SUS) questionnaire. All interview sessions were recorded. The audio transcripts were imported in to NVivo for qualitative analysis, and the video recordings were further reviewed manually.
Results: Three themes emerged from audio transcripts review: information needs, information display and arrangement, and clinical decision-making. Under information needs, ten categories of information were identified. Under information display and arrangement, we collected participants’ feedback on location/position, grouping/sorting, and display font/color/style of different information items and their comments on PMS functions such as “Show All”, “Trend”, “Filter”, and “Expand”. We gathered the participants’ clinical decisions regarding common dental procedures including restoration, oral prophylaxis, scaling and root planning, tooth extraction, wisdom tooth extraction, and implant placement under clinical decision-making theme. Further manual review of the video recordings revealed that participants frequently cross-checked different categories of information during their review. We also learned that most of the participants spent the longest time reviewing patients’ medical conditions. The average SUS score was 75.
Conclusions: Dentists generally held positive attitudes toward PMS and acknowledged the benefit of such an application. The study findings can help to understand dentist’s information needs and expectations in PMS and to further improve the application.