Consultation use of a computer by general practitioners

• HIT Description: An ambulatory computer information system More info...
  
• Purpose of Study: To assess how computer use during a visit is viewed by physiciansthe effect of two different types of guideline based decision support aimed at primary care physicians for depression care.
  
• Years of study: Not Available
  
• Study Design: A cross-sectional study with mixed data sources and a before and after comparison of practice patterns..
  
• Outcomes: Time physicians spent using the computer during an encounter, physiciansÕ attitudes, extent of computer use.
  

• Settings: A primary care practice in the United Kingdoms National Health Service. The practice had six physicians.
• Intervention: A rudimentary computer information system was implemented. The system allowed for patient scheduling, documentation, and an electronic protocol for hypertension. Paper was still the primary means of documenting encounters.
• Evaluation Method: A cross sectional design was used to assess physician attitudes towards use of computer during a patient encounter. Structured interviews were performed to assess physician views. Log of computer use were reviewed to assess degree of use. Video recordings were made of patient encounters a two different periods (before computer implementation and after) in order to assess how long physicians were using the system.
• HIT System: As described above in the intervention.
• Implementation: Installation of the system began in 1981 and was done through a large information technology vendor. The system was implemented over a two year period. Handwritten notes were still the primary source of documentation.
• Benefits: Physicians were found to use the computer for a total of 99 seconds per visit (vists were scheduled for 5 minute slots). Physicians used the computer for around 33 seconds with the patient in the room. Physicians were noted to be more likely to stop directly interacting with the patient while they were using the computer. Physician views on how computer use impacted the Patient Ð Doctor relationship were mixed.