Design And Realization Of Electronic Medical Record Template Of Temporomandibular Disorders

Objective Temporomandibular disorders (TMD) has a complex and uncertain etiology. The present method of diagnosis on TMD primarily depends on personal experiences of clinicians and accessory examinations such as arthroscopy, arthrography, or x-ray, which lags behind the first-onset TMD. It's crucial for diagnosis and treatment of TMD to evaluate psychophysiological characters which provides a potential mechanism for TMD. In addition, to determine cause of TMD early is vital for improving cure rate and better prognosis. At present, the traditional medical record has lots of defects such as spelling errors, content omission, unrecognized writing, or easy losing, which inevitably result in misdiagnosis, delaying diagnosis and missing the best opportunity for treatment. Due to building stomatological hospital informationization and overcoming the flaws of the traditional medical record, to design and develop a TMD electronic medical record system for guiding the diagnosis and treatment of TMD which aims at achieve the goal of informationization management of TMD records.Methods The system was realized based on Research Diagnostic Criteria for Temporomandibular Disorders(RDC/TMD), the clinical record recommended by Temporomandibular Disorders and Occlusion Committee of Chinese Stomatological Association and Windows XP platform, with Microsoft Access 2007 serve as the database and Delphi 7.0 serve as develop environment to implement the operative interface and medical logic. The medical records which collected by TMD checklist and TMD medical history questionnaire in Stomatological hospital of Tianjin Medical University was used to modify and complete the system.ResultsThe system has been used in TMD clinic for almost one year. During the process of using, the professionals from stomatology and computer modified and completed to make it run stably constantly and gradually. The main feature of the system as follows: (a) The operative interface is displaying clearly, easy and convenience to operate. You only use mouse to finish it besides little free text input.(b)The system highlights the notion of normalization and flow management. It establishes a normal and professional flow for TMD diagnosis and treatment, which guides doctors to collect clinical data of TMD correctly and completely according to pre-provisioning procedure.(c)Both independence and extendability are the significant character of the system. There are a great deal of repetitive modifications and changes through the process of development of the system. In order to decrease impact during development process, we should consider the necessity to make the system independent and extendable. The present single version also can upgrade to local area network even in internet.Conclusion1. The system has made to manage TMD record information and adapted to the development of the construction of the hospital informationization. It provides a new way for doctors to collect clinic data through a guiding principle normally and professionally. This system has greatly enhanced the quality of diagnosis and treatment of TMD and also benefited for teaching and researching.2. We will confront plenty of difficulties such as how to meet the standard of nation in the future, how to accelerate the speed of the system which may run more and more slowly due to the increasing data constantly. So, there are much more work to do for us to make the system become even more stable and perfect.3. It's an inevitable trend to research and develop electronic medical record for the construction of Health Information System, and also the only way for Electronic Health Record.