Much more efficient way of charting

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notsosuperman1
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Much more efficient way of charting

Post by notsosuperman1 » Wed Oct 23, 2019 6:04 pm

I'm a dentist, but also have a background in computer science. I've found all the EHRs that I've used so far, dental and medical, severely lacking in the efficiency and UI/UX department. Charting is a prime example. Every EHR that I have used relies on some method of manually entering data one tooth at a time, or at best a couple teeth with the same condition at a time.

https://www.youtube.com/watch?v=p63J234 ... e=youtu.be is a video of a new way of charting. I created an AutoHotkey script that creates an input box that always floats on top. This way you can review radiographs and still enter charting, even with only one monitor. The left side of the box is existing, the right side treatment planned. Instead of trying to keep up with the dentist, clicking on the tooth, the type of treatment, and entering surfaces, while also juggling the radiographs, or worse writing it down on paper and entering it later, the hygienist or assistant types charting into the box using a easy-to-use syntax. For extractions, you just put the tooth, for fillings, the tooth and the surfaces, no commas, and using certain modifiers (R-Referred, A-Amalgam, C-All Ceramic). For example, charting restorations would look like "3mod 6dl 8ml 14moda." Once the charting is finished, click OK and the script enters everything into the chart, including popups.

My assistants and hygienists love this. It improves efficiency, accuracy, eliminates treatment plans getting lost, etc. The limitation of my current setup is that it is a program that runs on top of Open Dental, so it still has to enter everything in through the front door. If this charting method were hardcoded into the software, it would be instantaneous. Even with this limitation, my script is 30% faster than doing it by manually, and requires 99% less keystrokes/mouse clicks (measured from after the time that the assistant has written everything down on paper or typed it into the script's box).

Are there any EHRs that have anything remotely similar to this? If not, why not? I've emailed Jordan Sparks this video but never got a response. I'm posting here because I'd love for someone at Open Dental to steal this idea. Open Dental, If you need my help with ideas like this or other suggestions, let me know.

I am willing to email anyone my script, but it isn't going to work out of the box for you. We use an old version of Open Dental bridged with eCW, so everything is going to be in a different place in your version of Open Dental. I made the script as coordinate agnostic as possible, using keyboard shortcuts rather than mouse coordinates whenever possible, but it will still take a fair amount of tweaking. But if you are handy with AutoHotkey, my script with give you a huge jumpstart. PM me if you want it.
Last edited by notsosuperman1 on Thu Oct 24, 2019 12:17 pm, edited 1 time in total.

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Rickliftig
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Re: Much more efficient way of charting

Post by Rickliftig » Thu Oct 24, 2019 5:18 am

Darn that's an interesting concept. Good job! You've got my mind going on on how else this could be used in Open Dental. Plus, the interface is clean and straightforward.

These are the types of additions that take OD to the next level.

best,

RL
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
West Hartford, CT 06110
srick@snet.net

notsosuperman1
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Re: Much more efficient way of charting

Post by notsosuperman1 » Thu Oct 24, 2019 4:39 pm

Thanks! Since you asked for it, here is the other GUI that I created to code for recall visits (both billable codes as well as our dummy codes to track metrics) and create a custom note tailored off what options were selected. https://youtu.be/wfvtfY3QEDQ

I have also created a bunch of keyboard shortcuts. Click on a tooth and press Ctrl-A to set it as adult, Ctrl-Q to set it as primary, Ctrl-M for missing, Ctrl-H for hidden, Ctrl-X to treatment plan extractions (quickly press an R for it to be referred), Ctrl-R for a resto (type the surfaces in the next 3 seconds). It makes charting so much easier on the fly. Or, highlight over a restorative and press Ctrl-U (and then the updated surfaces) to update a resto to new surfaces for when that O turns into an OL.

I also have remapped the middle mouse button to check if there is a Dexis window open for the patient, and if so switch to it, otherwise click the Dexis button (no more accidentally double-opening it).

I don't know why these options aren't baked into Open Dental. It's a no brainer. These type of user interface tricks have no negative impact on the users that don't know they exist, but make the power users so much more efficient.

I'll try to send you all my AHK script that pertains to Open Dental.

peterskuben
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Joined: Wed Aug 19, 2009 8:38 am

Re: Much more efficient way of charting

Post by peterskuben » Sun Oct 27, 2019 10:26 pm

I submitted this as a feature request #10191. Search for it by typing "Automation of Charting"

Please cast your vote so we can get it implemented into the next version of OD.

Thanks to notsosuperman1 for coming up with the idea and writing the script.

Tom Zaccaria
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Re: Much more efficient way of charting

Post by Tom Zaccaria » Mon Oct 28, 2019 1:58 pm

Correct me if I am wrong but doesn't scripting like this pose a security risk?
I may have read something somewhere to that effect.

drtmz

notsosuperman1
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Re: Much more efficient way of charting

Post by notsosuperman1 » Mon Oct 28, 2019 2:50 pm

Scripts in general are sometimes associated with a security risk, but that generally refers to the risk of downloading a script that you are assuming does X, when the developer has hidden malicious code in it and it really does X + Y without you knowing.

This type of automation doesn't really pose a security risk if you are using a reliable scripting program (AutoHotkey is pretty well-regarded) and programing your own scripts. Downloading others scripts that are already compiled, where you can't see the source code to confirm exactly what it is doing, would be risky.

Is that what you were asking?

Tom Zaccaria
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Re: Much more efficient way of charting

Post by Tom Zaccaria » Tue Oct 29, 2019 12:58 pm

That seems to be what I have read in several places. Thanks for clearing it up.

drtmz

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jordansparks
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Re: Much more efficient way of charting

Post by jordansparks » Mon Nov 11, 2019 5:47 pm

I like it. I think the example is a pretty extreme scenario. The current process typically involves about 4 clicks per item and usually doesn't involve opening a window. Yours involves about 4 keystrokes instead. It might be fun for us to add keyboard shortcuts for the frequent mouse actions when charting. I keep thinking everyone will move to touch screens any day now. Our interface is optimized for that future, which I think will be much faster.
Jordan Sparks, DMD
http://www.opendental.com

notsosuperman1
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Re: Much more efficient way of charting

Post by notsosuperman1 » Mon Nov 11, 2019 10:02 pm

jordansparks wrote:I like it. I think the example is a pretty extreme scenario. The current process typically involves about 4 clicks per item and usually doesn't involve opening a window. Yours involves about 4 keystrokes instead. It might be fun for us to add keyboard shortcuts for the frequent mouse actions when charting. I keep thinking everyone will move to touch screens any day now. Our interface is optimized for that future, which I think will be much faster.
Thanks for checking it out Jordan! I actually cold-emailed Nathan a year ago with a longer cut of this video (coupled with a couple other GUIs I'd created via AutoHotkey), but never heard back. I'd love to see if my experience, or at least some of my ideas, as a dentist with a computer science background could be helpful to Open Dental.

You're right about the treatment plan being complex, but we see these regularly at my community health center. We see several new patients daily, and it is not uncommon for almost all teeth to have treatment planned restorations.

On its own, adding a single restoration may have a similar number of clicks/keystrokes regardless of whether you use the native UI or my UI. The benefits of my UI are more pronounced when you consider that the native UI requires relatively precise clicks involving much of the screen (click on treatment planning/existing radio button, then the tooth, then the surfaces, then composite, with endos/crowns/posts a few clicks deeper), then consider switching back and forth between existing and treatment planned as you would with a new patient, and finally consider switching back and forth between DEXIS and Open Dental if you don't have two monitors. In fact there is a post (viewtopic.php?f=1&t=7142) from a couple weeks ago where you'll see that it is common for workflows to involve writing treatment plans on paper and entering them later due to the difficulty in keeping up.

Luckily these methods aren't mutually exclusive, and there is room for for both without one affecting the other. The native UI is certainly the most intuitive, but my UI is worth investing the effort to learn the syntax. My hygienists and assistant much prefer this method, even those that are not tech literate. Recently we upgraded to Windows 10 and it broke my program. They weren't happy until I get it back up and running.

As for touchscreens: We have touchscreens on most of our operatories. From an infection control perspective, wiping a stylus is a lot less of a hassle than covering keyboard or degloving/regloving. So, I use them when gloved-in. However, any of the difficulties involved in precisely clicking controls or moving from one side of the screen to the other is greatly magnified when using touchscreen over a mouse. So, in my experience, charting by touch is a lot slower than a mouse, and I would be surprised if that changed any time soon. In fact, the only way that I see a touch interface becoming more efficient than a keyboard and mouse would involve using a stylus to scribe things in a syntax similar to what I've developed (writing 5MOD on the screen and having it OCR that into a restoration). You'd still probably have a similar GUI to what I've created, with different areas so that, depending on where you scribed, it would be interpreted as existing/treatment planned, a crown, an endo, an extraction.

Anyway, thanks again for looking this over. I was really excited to see you post. Let me know if I can get involved, if you'd like my code, or just wanted to talk more about this idea. I've also got an idea of making a Shortcut via iOS to allow a hygienist to pop in an AirPod and use the native iOS voice recognition to dictate perio charting. Then it'd be great to have a way to copy and paste those numbers right into Open Dental. It'd basically be an expensive voice recognition perio charting, only probably more accurate, comfortable, and free.

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Rickliftig
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Re: Much more efficient way of charting

Post by Rickliftig » Thu Nov 14, 2019 10:16 am

notsosuperman1 wrote:
jordansparks wrote: As for touchscreens: ... However, any of the difficulties involved in precisely clicking controls or moving from one side of the screen to the other is greatly magnified when using touchscreen over a mouse. So, in my experience, charting by touch is a lot slower than a mouse, and I would be surprised if that changed any time soon. In fact, the only way that I see a touch interface becoming more efficient than a keyboard and mouse would involve using a stylus to scribe things in a syntax similar to what I've developed (writing 5MOD on the screen and having it OCR that into a restoration). You'd still probably have a similar GUI to what I've created, with different areas so that, depending on where you scribed, it would be interpreted as existing/treatment planned, a crown, an endo, an extraction.
Gotta agree with you about touchscreens - I love the idea too, but the precision is lacking. Perhaps the future will be a very efficient voice control, but that has its limitations too. I'll never forget some years ago I was using viaVoice, followed by Dragon - I dictated, "the tooth was treated with 'Brush and Bond'" which was recognized as ' Russian bombs'. When it started misspelling my name, I gave it the heave ho!
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
West Hartford, CT 06110
srick@snet.net

KevinVan
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Re: Much more efficient way of charting

Post by KevinVan » Sat Nov 30, 2019 5:06 pm

notsosuperman1 wrote:I'm a dentist, but also have a background in computer science. I've found all the EHRs that I've used so far, dental and medical, severely lacking in the efficiency and UI/UX department. Charting is a prime example. Every EHR that I have used relies on some method of manually entering data one tooth at a time, or at best a couple teeth with the same condition at a time.

https://www.youtube.com/watch?v=p63J234 ... e=youtu.be is a video of a new way of charting. I created an AutoHotkey script that creates an input box that always floats on top. This way you can review radiographs and still enter charting, even with only one monitor. The left side of the box is existing, the right side treatment planned. Instead of trying to keep up with the dentist, clicking on the tooth, the type of treatment, and entering surfaces, while also juggling the radiographs, or worse writing it down on paper and entering it later, the hygienist or assistant types charting into the box using a easy-to-use syntax. For extractions, you just put the tooth, for fillings, the tooth and the surfaces, no commas, and using certain modifiers (R-Referred, A-Amalgam, C-All Ceramic). For example, charting restorations would look like "3mod 6dl 8ml 14moda." Once the charting is finished, click OK and the script enters everything into the chart, including popups.

My assistants and hygienists love this. It improves efficiency, accuracy, eliminates treatment plans getting lost, etc. The limitation of my current setup is that it is a program that runs on top of Open Dental, so it still has to enter everything in through the front door. If this charting method were hardcoded into the software, it would be instantaneous. Even with this limitation, my script is 30% faster than doing it by manually, and requires 99% less keystrokes/mouse clicks (measured from after the time that the assistant has written everything down on paper or typed it into the script's box).

Are there any EHRs that have anything remotely similar to this? If not, why not? I've emailed Jordan Sparks this video but never got a response. I'm posting here because I'd love for someone at Open Dental to steal this idea. Open Dental, If you need my help with ideas like this or other suggestions, let me know.

I am willing to email anyone my script, but it isn't going to work out of the box for you. We use an old version of Open Dental bridged with eCW, so everything is going to be in a different place in your version of Open Dental. I made the script as coordinate agnostic as possible, using keyboard shortcuts rather than mouse coordinates whenever possible, but it will still take a fair amount of tweaking. But if you are handy with AutoHotkey, my script with give you a huge jumpstart. PM me if you want it.

You got a pretty neat concept there. I would like to give your script a go. If you don't mind sharing, I'll take a wack at it.

notsosuperman1
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Re: Much more efficient way of charting

Post by notsosuperman1 » Sun Dec 01, 2019 8:35 pm

KevinVan wrote:You got a pretty neat concept there. I would like to give your script a go. If you don't mind sharing, I'll take a wack at it.
PM me your email address and I'll send it on.

dqadri
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Re: Much more efficient way of charting

Post by dqadri » Mon Dec 02, 2019 4:38 pm

jordansparks wrote:I like it. I think the example is a pretty extreme scenario. The current process typically involves about 4 clicks per item and usually doesn't involve opening a window. Yours involves about 4 keystrokes instead. It might be fun for us to add keyboard shortcuts for the frequent mouse actions when charting. I keep thinking everyone will move to touch screens any day now. Our interface is optimized for that future, which I think will be much faster.
I would opine that this is definitely not an extreme scenario. I would love to chart all existing treatment on my new patients, except it takes my assistants and hygienists too long to get it into the OD UI to make it worthwhile.

That being said, I do think OD has definite feature bloat issues, which is kind of the way we like it :-).
--
Danish Qadri, DMD

Lake Family Dentistry
296 Lake Ave
Colonia, NJ 07067

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wjstarck
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Re: Much more efficient way of charting

Post by wjstarck » Mon Dec 02, 2019 8:39 pm

Rickliftig wrote: Gotta agree with you about touchscreens - I love the idea too, but the precision is lacking
To some degree - you just have to get creative. :D

For instance, on our anesthetic record, we employ expandable keypads for just this purpose. It takes some creative coding to get the font sizes to enlarge, but clicking on a touchscreen sure beats scrolling with a OSHA-approved sterilization wrap covered mouse scroll wheel any day :twisted:

Here's the original form:


Image


and the expanded keypad (with some practice I can even operate the dropdown menus):

Image


Once you get adapted to keypads thusly, they'll have to pry your touchscreen from your cold, dead fingers :lol: :lol: :lol:
Cheers,

Bill Starck, DDS
Big Idea Software, LLC
Developer, EASy(Electronic Anesthesia System) for Open Dental
TX, USA

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Rickliftig
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Re: Much more efficient way of charting

Post by Rickliftig » Tue Dec 03, 2019 10:23 am

Nice Bill! As a retirement gig, I suggest that Jordan and Nathan hire you on as Chief Technology Officer!
Another Happy Open Dental User!

Rick Liftig, DMD FAGD
University of CT 1979
West Hartford, CT 06110
srick@snet.net

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