Chairside software puts dental students in the know

by Hilary Thomson
Staff writer

Probes, drills and mirrors are the chairside utensils found in most dentists' offices.

But at UBC's Dental Clinic students are using a new tool that examines everything from gum disease to grades.

Called AXIUM, it's a computerized dental clinic management program and UBC is the first dental school in the world to put such a program in each clinic workstation.

"We knew we had to replace our old system before we ran into Y2K problems," says Faculty of Dentistry Dean Ed Yen. "We decided to get the best value we could with a system that has both versatility and potential for expansion."

Before AXIUM was installed one hectic weekend in the spring of 1997, students had to leaf through paper charts to review patient histories, fill out treatment records by hand and then submit them to staff who entered the information into databases.

The new AXIUM system is like one-stop shopping.

Patient information, billing and insurance transactions, detailed dental chart, periodontal chart and online student evaluation is all available in one program.

The faculty initially installed 18 chairside computers. The clinic now has 120 workstations outfitted with AXIUM.

The system was developed with a local software supplier under the leadership of Jim Stich, who was the faculty's clinic director when the program was first installed. Stich now works half-time as director of the team of 12 UBC employees who provide technical support to the program and half-time with the software supplier.

"There was no commercial product available to us so we contracted Exan Academic, a B.C.-based software supplier, to build us something from the ground up," says Stich. "The system is so flexible it has been marketed to dental schools at universities across Canada, in the U.S. and now into European dental schools."

The AXIUM dental chart is displayed in a three-dimensional image that can be rotated, magnified and manipulated. It shows crowns, bridges, posts and root canals and other work done on each tooth and surface.

Using a sheath-covered light pen that allows the work area to remain sterile, students simply touch the screen to enter details of tooth and gum condition, procedures completed and treatment plans.

Fourth-year dental student Ryan Bulat says the system is an improvement because information can be accessed more efficiently.

"The system tells me tooth by tooth what's happening and it's updated immediately so I can see what's been done and what needs to be done," says Bulat.

When students book their appointments and treatment plans, staff in the clinic dispensary can access the information and pre-fill instrument trays rather than supplying equipment on demand at the time of treatment.

UBC clinical office assistant Joan Inglis says the new system is easy to navigate and reduces the potential for error. Her job has more variety now that all transactions are consolidated into one system, she adds.

Faculty, staff and students use individually coded identity cards to gain varying levels of security access to confidential information such as medical records or student marks.

Making a continuous move from a paper environment to an electronic one in a busy teaching clinic is a challenge for students and faculty supervisors.

"Overall it's been a tough period for students because in the transition we've had to make data entries in both paper and computer charts which is time-consuming," says Bulat. "But in this litigious society, we need the precision and accuracy the system provides -- it's a natural progression."

The system is expected to run independently within two years.

In addition to serving as a management tool, the system has enormous potential for teaching and research applications, says Stich.

The chairside computer screens can be used to display live video demonstrations of procedures and the faculty is currently testing Web-based delivery of course material to the computers.

The system will also be useful in cross-country multi-site research projects because of the volume of comprehensive and detailed patient information being compiled.

"This is a constantly evolving program," says Stich. "We're improving and expanding the capabilities from week to week."

The Faculty of Dentistry admits 40 new students per year. The UBC Dental Clinic is the largest in the province with 32,000 patient visits per year. In addition, the Summer Clinic for Children sees up to 2,000 patients annually.