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Comment Deadline: June 7, 2014
 
The following drafts are currently being circulated for all interested parties review:
 
Proposed ANSI/ADA Standard No. 27 Polymer-based Restorative Materials
Proposed ANSI/ADA Standard No. 119 for Manual Toothbrushes
Proposed ANSI/ADA Standard No. 128 for Hydrocolloid Impression Materials
Proposed ANSI/ADA Standard No. 136 for Products for Tooth Bleaching
Proposed ADA Technical Report No. 1030 for Dental Providers Guide to the Electronic Dental Record
Proposed ADA Technical Report No. 1041 Content of Electronic Laboratory Prescription
Proposed ADA Technical Report No. 1043 for Use of Computer-based Resources for Access to Information Supporting Oral Health Care
 
The scopes of the proposed documents may be found by clicking on this link.
 
To obtain copies of the complete documents, please send an e-mail message with your request to standards@ada.org or call 800-440-2500, ext. 2506.
 
Please submit your comments using the template provided in the links above and submit by e-mail to standards@ada.org, by FAX to 312-440-2536, or mailed to the Department of Standards, American Dental Association, 211 E. Chicago Ave., Chicago, IL 60611.
 
Thank you.
Kathy Medic  medick@ada.org
Manager, Dental Materials Standards
Standards Administration
312.440.2533
________________________________________________________________________
American Dental Association  211 E. Chicago Ave.  Chicago,  IL 60611  www.ada.org

Integrating the Healthcare Enterprise (IHE) is an initiative which promotes the use of established standards such as DICOM and HL7. Basically, they provide a testing framework against which developers can test their DICOM and HL7 implementations to see if it works. And then, they organize these big LAN (i.e. geek) parties in basements of hotels, where different companies (minimum 3) send 2-3 of their developers with a bunch of laptops and network cables to connect with each other and send files to each other to see if it all works. It's an awesome initiative, and it really shows how medical software standards are becoming always more requested and used!

IHE has already hosted a bunch of these LAN parties (Connectathons) around the world. However, in January 2014, they will hold the first one with the theme "Dentistry", or, more precisely SEDI: Secure Exchange of Dental Information.

Great ADA News article on the EHR incentives, meaningful use, Medicaid and all that jazz.

http://www.ada.org/news/8152.aspx

Dr. Simmons has recently published a chapter in the publication by McNamara JA Jr., ed. (Taking Advantage of Emerging Technologies in Clinical Practice. Monograph 49, Craniofacial Growth Series, The University of Michigan, Ann Arbor 2012;9-18.) entitled The Electronic Patient Record: How it affects the Private Practitioner. This is a very good introduction to the electronic patient record, where the reader can find a long awaited, well formulated, definition and almost-side-by-side comparison of all those "-record" terms that keep floating around, such as: Electronic Health Record (EHR), Electronic Medical Record (EMR), Electronic Dental Record (EDR), Electronic Patient Record (EPR). Yes, they are all different!

A  milestone in the field of medical standards education.

[caption id="" align="alignright" width="300"] English: Electronic Health Records flow chart.jpg (Photo credit: Wikipedia)

In the United States there is a great push from the government to implement medical informatics standards. But is there in Europe? In specific, are there any European countries who mandate some kind of standard for digital medical records? Does the EU have any legislations to control medical software standards?

I have done some superficial investigation by asking people experts in the field, and i found out that most likely there are no mandatory content formats for electronic health records at EU level or at the Member States level. However, since health care is mostly organized at the regional level, there are many projects which follow a standard (or an adapted variant of a standard), for example ISO 18308, 20514.

Apparently there is no legislation at the EU level. At Member States level, we know that for Sweden, Czech Republic and Denmark, although we do not have access to their health projects, they do have specific content formats in their projects which are required. But generally speaking, there is no legislation on content formats, there are only technical requirements for such formats per project.

The EU Commission of march 1 2012 Annual European standardization work program 2012 http://ec.europa.eu/enterprise/policies/european-standards/files/standardization/swd-2012-42_en.pdf states that there are three independent European standardization organizations (ESO) – CEN, CENELEC and ETSI, who are the organizations to deliver standard by 2020 according to a Communication ‘A strategic vision for European standards: Moving forward to enhance and accelerate the sustainable growth of the European economy by 2020’. This document is to be read, as it seems interesting.

See Also:

• CEN TC251 is the organization corresponding to ANSI in Europe.


• In many national procurements, HL7 standards are mandated as part of an EHR tender.


• CDA is part of the epSOS specifications for cross-border e-Perscription (www.epsos.eu)


• http://ec.europa.eu/enterprise/policies/european-standards/harmonised-standards/medical-devices/


• http://www.cenelec.eu/


• http://www.medicaldevicedirective.net/

[caption id="" align="alignright" width="240"] Use Case example (Photo credit: stuart lamour)

The American Dental Association Standards Committee for Dental Informatics has just released one of the milestones for the development of an informatics standard that will allow all orthodontic related software to inter-operate. One of the first steps is to develop a set of use-cases. These act like small storyboards and serve the purpose of identifying what actually needs to get standardized.

Anyone can go to their website, read the draft, ask for the full document for free, and make comments by following the link:

All Interested Parties Review for Proposed ADA Technical Report No. 1065 for Use Cases of the Orthodontic Electronic Health Record

Now that these use-cases are here and ADA approved, it will be possible to investigate current standards, such HL7 and DICOM, to find out if they are fit for these use-cases.

An article was submitted for the 5th International Information and Telecommunication Technologies Symposium (I2TS 2006) in Brazil 2006, and was accepted as poster.

The condensed two-page poster abstract: A proposal of a digital cephalogram standard using DICOM Abstract

The proposed article: A proposal of a digital cephalogram standard using DICOM

The full poster (more than 20MB in size): A proposal of a digital cephalogram standard using DICOM Full Size Poster

A proposal of a digital cephalogram standard in DICOM

This page contains the original masters thesis submitted and approved at the Universidade de Brasília, department of electrical engineering, networking laboratory for the obtainment of a degree in telecommunications.

Download

Below you can find a link to both versions, and to the PDF presentation, which was very successfully held on August 24th, 2006 in Brasília at the Universidade de Brasília (UnB).

• UMA PROPOSTA DE UM PADRÃO PARA SOFTWARE ORTODONTICOS (pt)


• UMA PROPOSTA DE UM PADRÃO PARA SOFTWARE ORTODONTICOS (en)


• Slideshow Presentation of Master's Thesis

Abstract



As of today the exchange of orthodontic clinical information between different software systems is a challenge: there is no standard written or
developed specifically for orthodontics. The widespread use of medical informatics systems has caused this problem to require immediate attention. This work proposes a detailed methodology on how to proceed to create an orthodontic electronic patient record standard by integrating three well established and developed medical informatics standard developing organizations: HL7, DICOM and the ADA Standards Developing Committee (SCDI). It then limits its scope to digital cephalograms, a fundamental part of the orthodontic clinical record, by proposing a standard for digital cephalogram, and a JAVA implementation of it. This work offers a practical contribution to the development of an orthodontic informatics standard, hence addressing directly orthodontic software interoperability.

Structure

The document addresses directly the issue of solving incompatibilities between orthodontic software through the development of a software standard. The thesis is divided in 5 chapters and appendix:

Introduction: Explanation of the problems, and the reason of the work.

Orthodontics: A quick review of orthodontics and its patient record elements.

Literature review: A review of HL7, DICOM and ADA SCDI, both as an organization and as standards.

Scientific contributions: A proposal for the process required for the development of an orthodontic electronic patient record standard, a proposal for a DICOM digital cephalogram standard, and a simple JAVA implementation of the proposed standard.

Conclusions

Appendix: More details on ADA SCDI Specification 1000 by Mark Diehl, mathematical explanations and my contribution in the LaTeX world (document typesetter).
The document was originally written in English and translated into Portuguese by Emerson Ribeiro. Further refinement was then performed to conform with Brazilian writing style. Please note that the English version was written as a draft for the Portuguese version, which is therefore more organic, complete and better written.

 

Abstract

Today orthodontists need not burden their work load with tasks such as figuring out how to send patient information to colleagues or how two share the same patient record across different software programs. As a long term attempt to alleviate these tasks, we are working on developing a standard for the orthodontic electronic patient record to enable a seamless interchange of patient data between software programs. This article describes a practical proposal that integrates two existing standards, HL7 and DICOM, to create a standard for the orthodontic electronic patient record.

Solving incompatibilities between Orthodontic Electronic Patient Records

After having attended the HL7 Tutorial Sessions, it became clear that the document could have been revised. New revision of HL7 paper available here:

The Applicability of HL7 to Orthodontics rev1

We attended introductory and advanced tutorial session and established contacts in order to inestigate the possibility of creating a new HL7 orthodontic domain.

Taking a frist look at HL7: is it adequate to represent orthodontic electronic data?


The Applicability of HL7 to Orthodontics

See also:

Application of XML in orthodontic computerized patient records system based on HL7--《Chongqing Medicine》2008年05期

We have officially started the effort of defining an informatics standard for orthodontics, and have deadlines! We decided to divulge the news through a scientific posterboard at the biggest orthodontic convention in the world. Software vendors, doctors or anyone interested should know about this project.

Our posterboard got accept before we started to collaborate with the American Dental Association (ADA) Standards Committee for Dental Informatics (SCDI). What this means is that the course of the prject changed quite a bit from when we wrote the initial abstract for the poster until when it was up on display. The title of the project, for instance, probably would have never been PANIO had I been introduced to the ADA SCDI earlier. But we figured PANIO actually sounded pleasing to the ear in all languages, and that we should therefore take advantage of this opportunity and keep the name.

The scientific poster occupies the full 8'x4' provided tackboard. It provides the viewer with a broad perspective of what a software standard is and why it is needed in the field of orthodontics. At it's center there is a description of the ADA SCDI and DICOM structures. This part was influenced by the newly established collaboration with them.

In addition, PANIO: The First Orthodontic Standard (handout) was provided for the more interested. All four sides of the handout were printed on a single Letter size booklet, and provided the reader with a little extra information such as references, more names on collaborators and more detail on the individual working groups.

Abstract

Software standards are becoming increasingly popular in the medical
field, reducing the risk of patient data loss and allowing for greater
patient data interchange. Many medical fields have either already
developed or are currently developing standards like DICOM and ADA
SCDI. Yet there still exists no software standard in the orthodontic
field. Our goal is to develop a public orthodontics software standard,
approved by clinicans, developers and accredited instututions
worldwide. In collaboration with: ADA and DICOM.

Plan: 1) extend DICOM to accommodate all orthodontics data needs. 2)
Include the instructions of the extended DICOM standard in an ADA
Techincal Report; 3) prove the functionality of the standard by writing
a program that directly implements it. The final products (all standard
definitions and the implemented software) are meant to be pucliblicly
available free of charge to facilitate their distribution. We hope our
presentation will stimulate interest among individuals and institutions
to joins us in this project.