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Orthodontic Informatics

Data, Imaging, and Standards in Orthodontic Practice

Module 1
Data Sharing, Integration, and Transition in Orthodontic Informatics

toni magni, BME - afm@case.edu

Why am I here?

Alex Moullas
  • What is the most used tool by the orthodontist and their staff?
  • Because many orthodontists have complained. They are frustrated.
  • Because I am frustrated.
  • Because nobody else is.

What is the Problem?

Screen capture of the Dental monitoring website dentalmonitoring.com showing their solutions: DentalMonitoring, SmileMate and DM Insights Screen capture of the main landing page of the Dental monitoring website dentalmonitoring.com

What is the Problem?

Screen capture of the iTero website itero.com showing their solutions: iTero Element Plus Series, iTero Element 5D and iTero Element 2.

How do I share data?

Problem 1

The cartoon depicts a humorous and exaggerated scene of two people in white coats, presumably medical professionals or researchers, working at desks. They each have a computer monitor, and their desks are side by side. One medical provider leans dramatically over their desk and through their own monitor, reaching into the screen of the other providers's computer. The other doctor tries to do the same, stretching in an attempt to see the screen of their colleague. The scene suggests a struggle trying to align or synchronize something on their screens, indicating difficulties with compatibility or communication between systems or devices. The overall tone is playful and illustrates a humorous take on a technical or interoperability challenge.

How do I share data?

What's wrong with sharing data this way?

A person in a blue shirt is taking a photo of a dental X-ray displayed on a laptop screen using their smartphone. The image on the phone shows the X-ray they captured on the phone's photos app. A cup of tea and a name tag are visible on the desk beside the laptop.

How do I share data?

What's wrong with sharing data this way?

  • Efficiency: procedure is extremely inefficient
  • Security: clinical data on device not controlled by medical institution, maintainer of the data.
  • Privacy: some friend of family member might look at your phone and find sensitive data they are not supposed to see, while simply scrolling through photos.
  • Accuracy: procedure is error prone, it is very easy to send the wrong patient to the wrong person.

How do I connect my systems together?

Problem 2

This cartoon depicts a person in a dress and a doctor in a lab coat stand facing each other, holding two plugs that don't seem to fit together. They both have confused expressions, with question marks above their heads. In the background, on the doctor's side, a patient is reclining in a dental chair, while the person on the other side stands near an office desk with a computer. The scene humorously suggests a communication or compatibility issue between the two sides.

How do i transition to a new system?

Problem 3

A long line of patients stands outside the dental department at the University of Illinois at Chicago (UIC). They are waiting on the sidewalk, with a nearby grassy area and trees, to re-register into the dental clinic's new practice management system. The queue formed because the new software company was unable to import basic demographic information, necessitating re-registration. A man in a blue shirt walks past the line, and several cars are parked along the adjacent road.

Patients waiting for their turn to re-register after the department switched from Windent to AxiUm.

How do I crunch a lot of data?

Problem 4: AI and Research

Front pages of three scientific journals: Orthodontics & Craniofacial Resarch, American Journal of Orthodontics and Dentofacial Orthopedics and Journal of Orthodontics.

How do I crunch a lot of data?

Problem 4: AI and Research

  • Today's research is embarrassingly based on a tiny fraction of our population (< 100 patients)
  • A large fraction of orthodontic patient data is siloed behind the local network of the orthodontic practice, and their closed orthodontic software.

How do I crunch a lot of data?

Problem 4: AI and Research

  • We have the technology (AI, Big Data, Cloud, High Speed Internet) make all this data accessible to research.
  • This could potentially bump up sample size by at least 2-3 orders of magnitude.

How do I give data to my patients?

Problem 5

Schematic drawing showing a nurse sitting a desk on the left, a dotted arrow pointing from her to a paitent on the right, and an icon represening clinical documents in the middle. The drawing is supposed to represent clinical staff giving medical records to a patient.

How do I give data to my patients?

Problem 5

  • Awareness of data ownership is growing and governments are adding regulations (21st Century Cures Act, Information Blocking, GDPR)
  • How? Doctors don't know how to give patients their data.
  • Lawsuits will probably come soon.

Data Conversion Wasted Resources

Problem 6

An illustration depicting a data conversion process. The diagram shows data being transformed from one format or structure to another, with arrows indicating the flow between different stages or steps of conversion. This could represent migrating data between software systems, such as converting patient records into a new format for compatibility with a new practice management system.

Data Conversion Wasted Resources

Problem 6

  • A lot of time and resources spend for data conversion (import and export)
  • Data conversion is a tedious repetitive process: developers keep reverse engineering and don't share their work.

open-ortho.org