Objective: This study’s objective was to formally describe the work process for charting and treatment planning in general dental practice to inform the design of a new clinical computing environment. Methods: Using a process called contextual inquiry, researchers observed 23 comprehensive examination and treatment planning sessions during 14 visits to 12 general US dental offices. For each visit, field notes were analysed and reformulated as formalised models. Subsequently, each model type was consolidated across all offi ces and visits. Interruptions to the workfl ow, called breakdowns, were identifi ed. Results: Clinical work during dental examination and treatment planning appointments is a highly collaborative activity involving dentists, hygienists and assistants. Personnel with multiple overlapping roles complete complex multi-step tasks supported by a large and varied collection of equipment, artifacts and technology. Most of the breakdowns were related to technology which interrupted the workflow, caused rework and increased the number of steps in work processes. Conclusion: Current dental software could be signifi cantly improved with regard to its support for communication and collaboration, workflow, information design and presentation, information content, and data entry.
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