DENTISTRY

"By 2015 or 2020, there will only be a few global educational institutions of higher learning. Others will become regional, specialty education institutions or relegated to oblivion."

Dr. James Woolliscroft, Dean, University of Michigan Medical School Remarks at School of Dentistry Convocation, August 2007

The Robert W. Browne Orthodontics Clinic is the first of the School's clinics where patient information is now available electronically at chairside. Dr. Sunil Kapila (right), chair of the Department of Orthodontics and Pediatric Dentistry, watches Dr. Scott Conley (left), who coordinated the department's transition to a paperless environment, retrieve a patient's records. Roger Gillie (center) led a Dental Informatics team that installed the hardware and software in the clinic.

A compelling need exists among health care faculty and administrators to develop a new approach to educating students in dentistry, medicine, public health, nursing, and other health care professions. The approach must be integrated, encompassing all disciplines.

That was the message from the Dean of the University of Michigan Medical School, Dr. James Woolliscroft, to administrators, faculty, staff, and students during the School of Dentistry's fourth annual convocation ceremony in August. The event celebrates the start of a new academic year.

In developing a new model of educating health care professionals, Woolliscroft emphasized the importance of being proactive.

"Society is demanding change," he said. "Those involved in health care must take the lead because if we don't, government will mandate change, and mandates may not be what any of us will be happy about."

Tracing the evolution of health care education and treatment, he said the Civil War was a major turning point that affected educators and the public.

"There was an incredible outcry then about deplorable medical conditions because of the way soldiers were treated for their wounds," he said. The outcry led to a handful of the nation's institutions of higher learning, including the University of Michigan, to pioneer what turned out to be major reforms in health care education and training in medicine, dentistry, and other professions.

"Those reforms were things that we as educators now take for granted, including educational prerequisites, clinical training, more classroom training, and research," he continued.

Because U-M and the other colleges and universities responded, they survived and thrived.

For those that didn't, the future was bleak.

"The colleges and universities that did not embrace change then, including many that were prominent at the time, are now historical asterisks because they didn't respond or they didn't have a vision," Woolliscroft said.

That lesson from the past is the lesson for today. However, today, medical and dental schools and other health care professionals must be in the vanguard.

A confluence of events, he said, is driving the need for an integrated approach to health care at colleges and universities.

They include changing demographics, globalization, higher levels of education, an explosion of knowledge fueled by advances in technology, and a growing need to provide health care that is affordable.

"Paperless" is now a reality in one School of Dentistry clinic.

In late July, the Robert W. Browne Orthodontics Clinic completed a transition from an environment where patient information, for decades, had been stored on paper to one that is now completely electronic.

The move is one of many technological initiatives in recent years

"This is a major milestone for the School," said Dr. Sunil Kapila, chair of the Department of Orthodontics and Pediatric Dentistry, who said the paperless clinic would be a model as other clinics throughout the dental school become paperless in the future.

"Our faculty, residents, and staff are now able to electronically retrieve a wealth of information about our patients instead of having to sift through mounds of paper," he said.

"Every necessary piece of information about each patient," Kapila continued, "including his or her dental history, appointments, treatments, radiographs (x-rays), photographs, payment history, and more is now available at chairside."

The information is accessible at 27 computers in the clinic.

Being able to instantly retrieve information, Kapila added, will save valuable time, benefit patients, and help those providing oral health care.

Dr. Scott Conley, clinical assistant professor of dentistry, coordinated the Department's efforts with the School's Department of Dental Informatics.

Another Important "First" for U-M

However, there is another important "first" worth noting about the paperless clinic.

According to Roger Gillie, director of programming services in the School's Department of Dental Informatics, the School of Dentistry has become the first and only unit in the entire University of Michigan system that allows faculty members, since they have final authority for patient care, to access patient records using their university-approved identification card.

"They swipe the card in a slot near the computer monitor the same way they do when buying something at a store using a credit card," he said. "However, it's important to emphasize that there are security measures in place designed to prohibit unauthorized access."

Gillie and members of his team installed the hardware during a weekend in May and then tested the hardware and software, MiDent, for several weeks.

They also took advantage of new technology to minimize costs.

Behind each computer monitor is a "Mac mini" from Apple Inc. About seven inches square and two inches deep, the unit is the smallest desktop computer marketed by the company and can be used as a Mac or a Windows personal computer. "Their small size cuts down the need for counter space or storage space and cables too," Gillie said.