Assessing oral healthcare delivery process for proposing a framework to establish a dental electronic registry at Arab American University - Palestine رسالة ماجستير

Abstract

The oral healthcare delivery within university dental teaching clinics depends on timely access to complete and accurate patient information. Yet in many low and middle-income settings, documentation is primarily in paper-based form. This impacts continuity of care, auditability and educational supervision that is driven by data. The objective of this thesis was to assess the current oral healthcare delivery and documentation workflow at the Faculty of Dentistry, Arab American University–Palestine (AAUP) in order to generate evidence to inform the design of a feasible, user centred electronic dental registry and phased implementation roadmap. A mixed-method cross-sectional design, a combination of a quantitative survey, and qualitative inquiry. Between February and July 2023, quantitative data were collected from undergraduate dental students (n = 319) and clinical instructors (n = 75). These were done through a structured questionnaire that examined patient management and administrative processes, record keeping, educational & clinical training instruments (Logbooks and feedback), internal system integration and organisational performance. Organized interviews were conducted with the management of dental schools to obtain qualitative data in regard to contextual challenges, facilitators, and strategic priorities. The quantitative data was analyzed using descriptive statistics (means, SDs, percentages, frequencies) while the qualitative data was analyzed thematically. Qualitative findings were integrated with survey results to develop an evidence-based framework. The findings indicated that paper-based medical records are heavily relied on as a central element of clinical workflow. This resulted in variations in ease of retrieval, fragmentation of information across departments, limitations in longitudinal follow-up, as well as institutional reporting. Although these barriers identified in the literature to the adoption of health information systems (i.e. infrastructure readiness, training capacity, cost) were a concern, both students and instructors were highly ready for digitisation. Both groups were confident that electronic systems would improve documentation quality, workflow efficiency, and patient care. Participants believed that the electronic logbook was a tangible tool to start the digitalisation journey. The ease of data entry was highlighted, as was the opportunity to receive quick feedback that is trackable and educational. Based on evidence collected through mixed methods, the thesis proposes a three-phase user-centred framework for an electronic dental registry for the AAUP. The phases included planning and design for standardisation and participation, implementation and training according to the clinic and academic settings, and monitoring and sustainability for continual evaluation, governance and adaptiveness. The suggested framework for the registry contains a contextually relevant pathway designed for institutional digital transformation as it relates to Palestinian dental education and provides a basis for future interoperability with national IT systems for health, quality improvement initiatives and oral health policies