A clinical instrument, a computerised system implementing the clinical instrument, and a method of using the computerised system

Abstract

A clinical instrument (3;4;23) having an elongate shaft (3a;4a;23a) with a tool tip end part (7,8;10) and an opposite free end part (6). The opposite free end part (6) is configured with a tip component (1;26) adapted for interacting with a touch user interface (18) via a touch screen (17) of an electronic computing device (12). The clinical instrument is used in computerised system for keeping a dental journal to update said dental journal in real time during a dental procedure.

Description

[0001] A clinical instrument, a computerised system implementing the clinical instrument, and a method of using the computerised system

[0002] The present invention relates to a system for keeping a journal, in particular to a system for keeping clinical records, such as general medical records and dental records, and entering data into such systems.

[0003] Traditionally electronic systems for keeping a journal of a patient's clinical condition is updated by a keeper, such as a health care person, e.g. a physician, a dentist, a physiotherapist, or a pedicurist, at the end of the clinical procedure, thus after completion of the clinical procedure.

[0004] Most clinical staff only has a very narrow time window for attending to both the patient and to the subsequent updating of the patient's electronic journal as well as to issuing a corresponding invoice, if such follows the treatment. So once the treatment is terminated the complete clinical procedure must be dictated, documented and stored in the patient's electronic journal. Often also an invoice must be created to complete the journalling. These administrative procedures take valuable treatment time away from both the health care person and the patient.

[0005] It is a main aspect of the present invention to provide a a computerised system, a clinical instrument, and a method by means of which a health care person has more time with the patient than when using conventional journalling systems that are to be updated after termination of the clinical procedure.

[0006] In yet an aspect of the present invention is provided a computerised journalling system and a method of keeping records by means of which the patient's personal journal is substantially fully updated at the time the clinical procedure is terminated .

[0007] In yet an aspect of the present invention is provided a computerised system and a method of keeping records by means of which the act of recording data in a j ournal can be optimi zed, so that the keeper of the j ournal saves time for other purposes and tasks .

[0008] In yet an aspect of the present invention is provided a clinical instrument specifically adapted for use in said computerised system and method .

[0009] The novel and unique features whereby these and other aspects are achieved according to the present invention consist in the provision of a computerised system configured for the creation and updating of electronic clinical data records , thus for keeping records by j ournalling .

[0010] Said computerised system comprises

[0011] ( a) an electronic computing device with a touch screen and a voice recognition software program,

[0012] (b) a clinical j ournalling software program installed on the electronic computing device , which clinical j ournal ling software program is configured for inputting data into a plurality of electronic clinical data records via at least a voice recognition software program installed on the electronic computing device , and

[0013] (c) at least one further input device selected to communicate with the clinical j ournalling software program installed on the electronic computing device , wherein said at least one further input device comprises one or both of a clinical instrument having an elongate shaft with a tool tip end part and an opposite free end part configured with a tip component adapted for interacting with a touch user interface via the touch screen of the electronic computing device , or a sterili zed or sterili zable touch pen with a tip component adapted for interacting with the touch user interface via the touch screen of the electronic computing device .

[0014] Touch screens tend to be fragile and sensitive , making it crucial to handle them with care . Improper care can lead to scratches , diminished sensitivity, and compromised accuracy . Should a touch screen splinter or break due to impact or force , sharp-edged splinters may result , posing a risk of injury to everybody in the vicinity of the touch screen . In particular in a clinical environment tapping on a touch screen with a metal instrument , such as a dental instrument of steel , would involve a high risk of splintering the touch screen . This risk is advantageously reduced, or even eliminated, by means of the tip component , which serves as a protective means on the opposite free end part of the elongate shaft or on the touch pen against damaging the touch screen .

[0015] Suitable touch screens for use with the present invention includes e . g . a resistive touch screen, an acoustic wave touch screen, and an infrared touch screen . When an external force is exerted on the resistive touch screen by the tip component , a voltage is generated and a command is recogni zed according to the voltage by the electronic computing device . Acoustic waves or infrared rays pass over the surface of the acoustic wave touch screen or the infrared touch screen, so by touching the surface of the acoustic wave touch screen or the infrared touch screen by the tip component , the travelling path of the acoustic wave or the infrared ray is blocked and thus the corresponding command is recogni zed by the electronic computing device . In case of a capacitive touch screen a capacitive tip component is required, e . g . can the tip component be made of a conductive rubber . When the conductive rubber tip touches the capacitive touch screen, a loop is defined by the passive touch pen and the human body and the capacitance value of the capacitive touch screen is subjected to a change because of the static electricity of the human body .

[0016] Within the scope of the present invention the term "touch user interface"' ( TUI ) is used in its conventional meaning, thus as a computer-pointing technology based upon the sense of touch . The touch user interface enables the sense of touch to innervate and activate computer-based functions . Within the scope of the present invention the term "electronic computing device" refers to any electronic equipment control led by a CPU ( central processing unit ) , including desktop and laptop computers , smartphones and tablets .

[0017] The clinical instrument or the touch pen of the present invention for use in the computerised system facilitates fast selection of features , procedures and functions offered by the clinical j ournalling software program in real time without the operator, e . g . a dentist , needs to put down the instrument currently being used, or soiling the medical touch screen by tapping with his / her soiled fingers , in order for being able to update a clinical j ournal . Instead the operator is able to continue with real time process registration during treatment by opening and actuating different record keeping functions of the j ournalling software program using the clean end of the dual-function clinical instrument of the present invention . Such features , procedures and functions may be associated with an icon, code , image or text that visually informs the operator of the associated computational properties and functions .

[0018] Once a feature , procedure or function has been activated by tapping with the clinical instrument or the touch pen according to the present invention on a relevant part of a touch user interface displayed on the touch screen, said feature , procedure or function opens a window for inputting data via the voice recognition software program to update the patient ' s personal j ournal as the treatment is ongoing . A dentist can e . g . dictate any information that he / she wants to add to the patient ' s personal j ournal , and select where to input and / or add the information by using the clinical instrument to navigate around the clinical j ournalling software program using said clinical instrument to actuate the appropriate parts of the touch user interface .

[0019] A further advantage of real time dictating a patient ' s personal journal is that the patient is concurrently kept updated on his / her treatment , as the patient can hear what is being dictated, and optionally make objections thereto . Once the treatment is completed the dentist can complete updating the j ournal and issue the invoice immediately with a few taps on the touch screen, so that when the patient gets up from the couch or chair, such as a dental chair he / she need not wait long for his / her invoice , nor does staff need to forward it later to a patient . As dictating and j ournalling are made concurrent with the treatment without the need to later use a keyboard more time than usually allotted to the treatment itself is free for the actual treatment and care of the patient . No post dictating, inputting text via keyboard or subsequent writing of an invoice is needed .

[0020] The at least one further input device may further comprises one or more of a headset in electronic communication with the voice recognition software program to provide input to the clinical j ournalling software program via speech, and a switch to switch the headset on and off . Preferably the switch is a foot pedal .

[0021] The voice recognition software program is able to convert speech to text thereby allowing the operator, such as the dentist , to open applications and dictate text for j ournalling . The voice recognition software program understands the sound of a voice , and responds accordingly to write text into the patient ' s clinical j ournal . Once the dictation function is active , the operator is able to dictate text as wel l as punctuation marks, special characters, and cursor movements. The dictation function can advantageously be switched on or off, e.g. using the foot pedal, to allow the operator to talk to the patient without the speech is recorded in the patient's journal. In the alternative the dictation function can be switched on or off by inputting speech instructions to the voice recognition software program.

[0022] The journalling system of the present invention may be compatible with e.g. current operative systems Windows 10 and 11, and the dictation functions for use in the present invention may be that of said operative systems. The skilled person is aware that the concept of the journalling system of the present invention can easily be made compatible with future versions of operative systems, such as future versions of Windows and updates thereof.

[0023] To avoid that sounds and noises that come from the clinical procedure and the environment around the patient and the operator, and not being relevant for journalling, does not interfere with the dictation function, the operator may conveniently use a headset in electronic communication with the voice recognition software program to provide input to the clinical journalling software program via speech.

[0024] When the health care person, during the clinical procedure, wants to interact with the touch screen, he / she only needs to direct the tip component of the clinical instrument or the tip component of the touch pen in contact with a relevant part of an electronic journalling system's touch user interface displayed on the touch screen to thereby open a selected window and the associated operative function (s) and feature (s) of the electronic journalling system. Then data can subsequently be inputted to the journalling system, e.g. by speech-to-text recognition software program, or by further tapping the way to the relevant procedures via the touch user interface. The speech-to-text recognition software program may include a dictionary of technical terms within the relevant field of technology . In case the field of technology is odontology the speech-to-text recognition software program can be developed to recogni ze dental terminology and codes . In case the speech-to- text recognition software program is used by a phys iotherapist , the speech-to-text recognition software program can be developed to recogni ze terminology relating to e . g . the skeleton, bones , j oints or muscles and codes therefore . Similar applies if the system is used by a medical pract itioner or a vet , where the technical dictionary is adopted for treating the human or animal body . These examples should not be seen as limiting the potential uses of the computerised system of the present invention .

[0025] In accordance with the present invention one and same clinical instrument has a dual functionality whereby the health care person easily can point the clinical instrument towards the touch screen and touch it without soiling the touch screen . Optionally, depending on how the health care person is oriented towards the touch screen, he / she may turn the clinical instrument back again if it has been turned for input on the touch screen, to continue working with the tool tip part on the patient . Accordingly, the clinical instrument can be orientated for use as either a touch pen or a clinical instrument as many times as needed during the clinical procedure . Overall this saves time , as the health care person does not need to make the j ournalling after having terminated the clinical procedure , nor does the health care person need to put the clinical instrument down and grasp a separate touch pen . Thus using the clinical instrument of the present invention results in very fast and real time input to the j ournalling system, as operation of the touch user interface by means of the clinical instrument of the present invention results in faster process registration, as this process registration can be conducted in real time during the clinical procedure . No change of gloves and unhygienic clicking on a keyboard is required . The one and same clinical instrument can be used in both the clinical procedure and to interact with the touch user interface , optionally by turning the clinical instrument about 180° in the hand about its longitudinal axis , e . g . to start up and close various procedures and open windows on the touch user interface of the touch screen without directly needing to touch any other hardware than the clinical instrument already included in the clinical procedure . In many operative positions of the clinical instrument turning need not be performed, as the operator can reach out to the touch screen with the opposite free end part of the elongate shaft simply by stretching his / her arm .

[0026] A sterili zed or sterili zable touch pen may be configured for one or more of sterili zation by autoclave , however any other sterili zation method can be used instead, thus the touch pen may be manufactured of materials that tolerate sterilization by autoclave . Further, sterili zation can be done at the clinic or by the manufacturer of the clinical touch pen of the present invention . Advantageously the tip component may be non- detachable to an extent that it does not drop off during use and sterili zation .

[0027] The invention further relates to a clinical instrument as described above .

[0028] The tip component of the clinical instrument can be detachably fitted at or on the opposite free end part , e . g . sleeved onto the opposite free end part . In the alternative the tip component can be non-detachably fitted at or on the opposite free end part , e . g . glued thereto .

[0029] In case the tip component is detachable any existing clinical instrument can be customised ad hoc for use with the touch screen . So health care persons already having a set of clinical instruments can modify these clinical instruments ad hoc by applying the tip component . Additionally one tip component may fit several different clinical instruments to thereby reduce costs . Disposable tip components are however within the scope of the present invention . The advantage of a non-detachable tip component may be the complete elimination of the ri sk that the tip component drops off the clinical instrument during the clinical procedure , and that just one clinical device component for several clinical tools is to be sterili zed .

[0030] In a preferred embodiment the tip component can be substantially dome-shaped, substantially ball-shaped, substantially hemispherical , or any hollow shape with an opening for passage of a free end of the opposite free end part of the elongate shaft . An expedient dome-shaped tip component may be similar to a hollow ball with a top cut off along a chord offset the diameter of the ball . In such a design of the tip component the opposite free end part of the elongate shaft of the clinical instrument is simply inserted into the opening of the tip component , which is thereby fitted with the tip component to stay put on said opposite free end part during use of the clinical instrument . The above-mentioned shapes of the tip covering part are all of the kind that can apply a sufficient touch pressure to the touch screen to open a window or function without damaging the touch screen .

[0031] Optionally the opposite free end part of the elongate shaft may be inserted into the tip covering part in a way that leaves an air-filled space between the end face of the opposite free end part of the elongate shaft and the interior apex wall of the tip covering part in its fitted position . The air-filled space provides a cushion effect that facilitates the actuation of the touch screen without damaging the touch screen .

[0032] The tip component may preferably be flexible , elastic and / or resilient to protect the touch screen against the contact with the clinical instrument . The tip component can e . g . be made of rubber to obtain proper flexibility and / or resiliency . Optionally the tip component may be sterile or may be adapted to be sterili zed .

[0033] In a preferred embodiment the tip component can have an opening with an opening diameter that is smaller than the diameter of the opposite free end part of the elongate shaft for the tip covering part to be firmly fitted on the opposite end part due to the flexible , elastic and / or resilient properties of the material that the tip covering part is made of .

[0034] In any of the embodiments of clinical instruments disclosed herein the tip component can have an interior circumferential bead at or close to the opening for engaging a circumferential recess at the opposite free end part of the shaft , to thereby further improve fastening the tip component to the elongate shaft . The circumferential recess is advantageously provided a distance from the free end face of the opposite free end part of the elongate shaft , and the circumferential bead is provided a distance from the opening of the tip component , which distance ensures that the tip component can mate firmly inside the circumferential recess , optionally leaving an air-filled space , as described above .

[0035] In some embodiment the tip component may have a vent hole to allow the tip component to be compressed and to revert to its start condition .

[0036] The clinical instrument according to the present invention may be particular useful for use by dentists , in which case the clinical instrument may be a dental instrument , such as a dental instrument selected from the group comprising e . g . a dental mirror, an explorer, single-ended poche meter, or a single-ended periodontal probe . This list of dental instruments should not be construed as limiting the scope of the present invention, as any instrument with an elongate thin shaft and an opposite free end part can be f itted with a tip component to convert such an instrument into a dual-function instrument of which one function is as a touch pen and the other function is the original function of the instrument . It should thus be emphasised that the concept of providing the free end of any instrument type of the kind having an elongate shaft with a tip component , to also confer touch pen functionality to said instrument , is within the scope of the present invention .

[0037] In the context of the present invention a "dental instrument"' is a tool used by a dentists to provide dental treatment . A "dental mirror" is a mouth mirror used to e . g . provide indirect vision, retracts lips , cheeks and tongue . It redirects light into the mouth to make it easier for the dent ist to see what he / she is doing . The "explorer instrument" is a dental tool used to e . g . examine the teeth for decay, calculus , furcations and other abnormalities . The "periodontal probe" is used to measure the depth of periodontal pockets in millimeter increments . The single-ended poche meter may serve similar purpose .

[0038] Although dental instruments are described above emphasis is made that the present invention is not limited to dental instruments . Other clinical instruments , such as medical instruments , are within the scope of the present invention .

[0039] The invention also relates to a method of creation and updating of electronic clinical data records simultaneous with treating a patient .

[0040] The method comprises the steps of

[0041] ( a) providing the computerised system described above ,

[0042] (b) opening the patient ' s personal j ournal amongst stored electronic clinical data records representing personal j ournals if the patient is known to the computerised system, or creating a new electronic clinical data record if the patient is unknown to the computerised system,

[0043] ( c) during the clinical procedure providing input to the j ournalling system by switching between at least the electronic data input procedures selected from voice recognition speech input enabled by the voice recognition software program, preferably by providing speech to the voice recognition software program using a headset , or touch screen input using the clinical instrument described above , and

[0044] (d) during the clinical procedure providing real-time electronic data input to the patient ' s personal j ournal using one or both of the electronic data input procedures of step ( c) to continuously update the patient ' s personal j ournal with real-time data reflecting the ongoing clinical procedure and the result of the clinical procedure .

[0045] The method may further comprise switching the voice recognition software program on or off by means of a foot pedal during performing steps ( c) and / or (d) so that the operator is able to talk with the patient and other persons in the room without said talk is automatically logged into the patient ' s journal . The voice recognition software program may in the alternative be switched on or off by means speech input .

[0046] The computerised system of the present invention may in particular be configured for the creation of electronic clinical data records , e . g . by a dentist . The computerised system applies a new dictating and j ournal writing principle , which is compatible for use with any dental j ournal ling systems , e . g . for in real time associating information with a specific tooth that is being treated, - thus in real time during treating said specific tooth . The invention will now be described in further details below with references to the drawing in which fig . 1 is a side perspective view that conceptually shows a first embodiment of a tip component of the present invention, fig . 2 is a sectional view along line I I - I I in f ig . 1 , fig . 3 shows a first embodiment of a dental instrument with the first embodiment of a tip component , fig . 4 shows a second embodiment of a dental instrument with the first embodiment of a tip component , fig . 5 schematically shows the computerised system of the present invention, and fig . 6 conceptually shows a third embodiment of a fragment of a dental instrument with a second embodiment of a tip component .

[0047] Below the invent ion is exemplified with reference to a dental patient being treated by a dentist . This exemplification should not be construed as limiting the present invention, as the invention can be used by other operators in other technical fields , such as in general medicine , forensic medicine and pathology, where the operator is enabled by the invention to work directly with a computer without being contaminated or contaminating the computer .

[0048] Figs . 1 and 2 show in a side perspective view and in sectional view respectively, a first embodiment of a tip component 1 . The tip component 1 is overall shaped like a hollow ball without a chord part to thereby define an opening 2 for inserting an elongate shaft 3a, a of a dental instrument 3 , 4 , as seen in figs . 3 and 4 . The opening 2 is enforced by an elastic circumferential bead 3 to improve the grip on the dental instrument 3,4, which as seen in figs. 3 and 4, is exemplified as a single-ended probe 3 and a mirror 4, respectively. Emphasis is made that an elastic circumferential bead 3 is optional .

[0049] As seen in fig. 2 the tip component 1 has a smaller diameter d in vicinity of the opening 2 than at its largest diameter D, so that an air-filled space 5 is free to act as a cushion once the tip component 1 has been mounted on the elongate shaft 3a, 4a of the respective dental instrument 3,4. This simple way of mounting of the detachable tip component 1 is illustrated best in fig. 4 with arrow A, where the opening 2 of the tip component 1 is moved towards the opposite free end part 6' ' of shaft 4a opposite the tool tip end part 7 with the mirror 8.

[0050] In the mounted state of the tip component 1 the tip component 1 is firmly fitted onto the opposite free end part 6' ; 6' ' of the shaft 3a; 4a, as illustrated in figs. 3 and 4, where a tip component 1 is fitted on the free end 9' ; 9' ' of shaft 3a; 4a of the clinical instrument 3; 4 opposite the tool tip end part 7, 8; 10. The tool tip end part seen in fig. 3 is a probe 10.

[0051] It should be noted that dental instruments may have different diameter shafts 3a, 4a, and different diameter opposite free end parts 6' ; 6' ' , which is the case in figs. 3 and 4. The probe 3 has a larger diameter shaft 3a than the mirror 4 and therefore a larger diameter D of a tip component 1 is needed. Accordingly, a dentist may have several sizes of tip components 1 at his / her disposal. The largest diameter D of a tip component 1 may preferably be larger than the diameter D^D' ' of the respective opposite free end parts 6' ; 6' ' of shaft 3a, 4a to provide an efficient cushion effect as a supplemental means not to risk damaging the touch screen 17 of a computing device, exemplified as a laptop 12 in fig. 5, of the computerised system 13 when used in the method of the present invention. The computerised system 13 also has a foot pedal 14 and a head set 15 , and the laptop 12 has a touch screen 17 with a touch user interface 18 . When the dentist 16 wears the head set 15 he / she can make his / her notations directly into the patient 19 ' s clinical j ournal provided by a clinical j ournalling software program operating on the laptop 12 by using a voice recognition software program stored on said laptop 12 for converting speech input into text notations .

[0052] In the exemplary scenario seen in fig . 5 the dentist 16 has tapped on the tooth 20 marked grey of the visually displayed set of teeth 21 on the touch screen 17 . The tooth 20 is the tooth to be treated and thus any speech and comments that is subsequently transferred via speech to the voice recognition software program, and thus to the patient ' s clinical j ournal , will concern treatment of this specific tooth 20 in the set up of fig . 5 . Emphasis is made that the situation seen in fig . 5 is just one exemplary situation that arises along a clinical treatment . The dentist can activate any code , macro , text window, etc . by using the touch pen functionality of the clinical instrument 3 , 4 , to tap with the tip component 1 on any icons , text windows and other displayed features of any displayed touch user interface 18 , or on keys of the keyboard, to open features and procedures for speech-to-text input during the clinical procedure . Icons , text windows and other displayed features are not shown in fig . 5 . Layers of input windows can be opened by touching the touch user interface 18 on the touch screen 17 with the tip component . Once a window is opened the dictating function can become active .

[0053] The headset 15 may be in wired or wireless connection with the computing device . An example of a suitable voice recognition software for a dental computerised system is Dictus SUN obtainable from Dictus ApS , H . J . Holst Ve j 3-5C, DK-2605 Brondby . Dictus SUN is developed based on app . 55 mill , words associated with making dental notations into clinical journals . There exist several other electronic j ournalling systems on the market , and all will be eligible for use in the computerised system and method of the present invention . Initial tests have been made on the digital j ournalling program " Dentalsuite" , used by about 45% of Danish dental clinics . ' ' Dentalsuite" is obtainable from Plandent A / S , Jydekrogen 16 , DK-2625 Vallensbaek . Another conventional and similar digital journalling program is " al dente" , which are used by other app . 45% . " al dente" is obtainable from Dansk Nordenta A / S , Nydamsve j 8 , DK-8362 Horning .

[0054] Both systems are Windows-based and can be customised, e . g . by adding or changing macros .

[0055] A preferred touch screen is a 24 - 16 inch touch screen medical monitor . Such medical monitors are available from many sources , which are known to the skilled person .

[0056] A medical keyboard 22 , preferably a wireless medical keyboard, can conveniently be added to the computerised system, to be used in the start up procedure of the j ournalling system . The tip component 1 may also be used to tap the keys of the keyboard to open shortcuts to data input functions or to type text . As the tip covering component 1 is always clean even if the tool tip end part is soiled, the keyboard is never soiled, as it would be if touched by soiled gloves .

[0057] Fig . 6 shows a fragment of a third embodiment of a dental instrument 23 . Its elongate shaft 23a has a circumferential recess 24 that receives an interior annular bead 25 of a second embodiment of a tip component 26 for improved engagement and gripping .

[0058] The tip component 26 of the third embodiment of a dental instrument 23 seen in fig . 6 also has a vent hole 27 at its apex . The vent hole 27 is not mandatory but may be convenient for the tip component 26 to reassume its shape after having been compressed on the touch screen . The vent hole 27 can have other preferred positions .

Claims

Claims1. A computerised system (13) configured for the creation and updating of electronic clinical data records, which system comprises(a) an electronic computing device (12) with a touch screen (17) and a voice recognition software program,(b) a clinical journalling software program installed on the electronic computing device (12) , which clinical journalling software program is configured for inputting data into a plurality of electronic clinical data records via at least a voice recognition software program installed on the electronic computing device ( 12 ) , and(c) at least one further input device (1; 15; 14; 22) selected to communicate with the clinical journalling software program installed on the electronic computing device ( 12 ) , characterised in that the at least one further input device (1; 15; 14; 22) comprises one or both of a a clinical instrument (3; 4; 23) having an elongate shaft (3a; 4a) with a tool tip end part (7, 8; 10) and an opposite free end part (6) configured with a tip component (1;26) adapted for interacting with a touch user interface (18) via the touch screen (17) of the electronic computing device (12) , or a sterilized or sterilizable touch pen with a tip component adapted for interacting with the touch user interface (18) via the touch screen (17) of the electronic computing device (12) .

2. A computerised system (13) according to claim 1, characterised in that the at least one further input device further comprises one or more ofa headset (15) in electronic communication with the voice recognition software program to provide input to the clinical journalling software program via speech, and a switch (14; 22) to switch the headset (15) on and off, preferably the switch is a foot pedal (14) .

3. A computerised system (13) according to any of claims 1 or 2, characterised in one or more of that the sterilized or sterilizable touch pen is configured for sterilization by autoclave, the tip component (1;26) is non-detachable, and the touch pen is manufactured of materials that tolerate sterilization by autoclave.

4. A clinical instrument (3; ; 23) having an elongate shaft (3a; 4a) with a tool tip end part (7, 8; 10) and an opposite free end part (6) , characterised in that the opposite free end part (6) is configured with a tip component (1;26) adapted for interacting with a touch user interface (18) via a touch screen (17) of an electronic computing device (12) .

5. A clinical instrument (3;4;23) according to claim 4, characterised in that the tip component (1;26) is detachably fitted or non-detachably fitted at or on the opposite free end part (6' ; 6' ' ) .

6. A clinical instrument (3; 4; 23) according to any of claims 4 or 5, characterised in that the tip component (1;26) is substantially dome-shaped, substantially ball-shaped, substantially hemispherical, or any other shape with an opening (2) for passage of a free end 9' ; 9' ' of the opposite free end part (6' ; 6' ' ) .

1. A clinical instrument (3; 4; 23) according to any of the preceding claims 4 - 6, characterised in that the tipcomponent (1;26) ) is flexible, elastic and / or resilient, preferably the tip component (1;26) is made of rubber, optionally the tip component (1;26) is sterile or is adapted to be sterilized.

8. A clinical instrument (3; 4; 23) according to any of claims 4 - 7, characterised in that the tip component (1;26) has an opening (2) with an opening diameter (d) that is smaller than the diameter (D' ;D' ' ) of the opposite free end part (6' ; 6' ' ) of the elongate shaft (3a; 4a) , optionally the tip component (1;26) has one or more of an interior circumferential bead (25) at or close to the opening (2) for engaging a circumferential recess (24) at the opposite free end part (6' ; 6' ' ) of the elongate shaft (3a;4a;23a) , and a vent hole (27 ) .

9. A clinical instrument (3; 4; 23) according to any of the preceding claims 4 - 8, characterised in that the clinical instrument (3; 4; 23) is a dental instrument (3; 4; 23) , optionally the dental instrument (3; 4; 23) is selected from the group comprising a dental mirror (4) , an explorer, a single-ended poche meter or a single-ended periodontal probe (3; 23) .

10. A method of creation and updating of electronic clinical data records simultaneous with treating a patient (19) , characterised in that the method comprises the steps of(a) providing the computerised system (13) according to any of the preceding claims 1 - 3,(b) opening the patient's personal journal amongst stored electronic clinical data records representing personal journals if the patient (19) is known to the computerised system (13) , or creating a new electronic clinical data record if the patient (19) is unknown to the computerised system (13) ,(c) during the clinical procedure providing input to the journalling system by switching between at least the electronic data input procedures selected from voice recognition speech input enabled by the voice recognition software program, preferably by providing speech to the voice recognition software program using a headset (15) , or touch screen (17) input using the clinical instrument (3; 4; 23) according to any of the preceding claims 4 - 9, and(d) during the clinical procedure providing real-time electronic data input to the patient's personal journal using one or both of the electronic data input procedures of step (c) to continuously update the patient's personal journal with real-time data reflecting the ongoing clinical procedure and the result of the clinical procedure.

11. A method according to claim 10, characterised in further comprising during performing steps (c) and (d) switching the voice recognition software program on or off by means of a foot pedal (14) or by inputting speech instructions to the voice recognition software program.

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