Annals of Family Medicine -- Comments for Main et al., 2 (5) 421-424

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Methodology From PBRNS:
Deborah S. Main, Javan Quintela, Rodrigo Araya-Guerra, Sherry Holcomb, and Wilson D. Pace
Exploring Patient Reactions to Pen-Tablet Computers: A Report from CaReNet
Ann Fam Med 2004; 2: 421-424 [Abstract] [Full text] [PDF]

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Context of Study in Current Environment: John W Bachman (21 November 2004)

Context of Study in Current Environment 21 November 2004

John W Bachman,
Rochester Minn
Physician
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Re: Context of Study in Current Environment

This article has several innovations that are worthy of comment. In my research I have not found any studies that use Pocket PCs as interviewing tools. It also is the first to have patients record information by voice for later use by typist. The satisfaction with the technique was shown to be 70%. This is lower then most studies using conventional computers (85-95% patient acceptance). It will be interesting to note in the future who will make the connection between voice recognition software and patient voiced in answers. At the present time voice recognition in patient computer entry has been done only for simple commands. In reviewing the comparison with written questionnaires and patient computer generated information there is the implication that they are comparable. The data on studies comparing written questionnaires with computer-generated questions shows a clear advantage to computer-generated questions. In patient computer generated dialogue the questions are more likely to be more accurate, completely done, and more inclined to have better success in detecting socially sensitive issues such as abuse or alcoholism. Patients also favor the computer over the questionnaires. An obvious point is that there are numerous questionnaires and the logistics of administering them to the given patient with the specific problem has proven difficult. Less then ½ of the doctors in Chicago surveyed used questionnaires in their practice. Computer generated histories on the hand have been created that have over one hundred specific questionnaires that can be administered as part of an interview if the patient requires them. One certainly can ask why we would wish to do research on paper when the specialty has set as its goal to be computerized. One of the difficulties in computer patient dialogue over the past forty years has been the diffusion into medical practice of software. This study shows that the program used was done in house. Most studies are done this way. This limits the application of the concepts in the mainstream of medicine. Before those researchers that are wishing to study patient computer dialogue begin; they may wish to review the market for software that will function in the office. The following is a summary Instant Medical History has been available for over 15 years and now has 75 000 available questions. It is now interfaced to 45 electronic medical records and several virtual office portals. It remains relatively inexpensive at 50 dollars a month www.medicalhistory.com Medisolve is a product from Canada that allows dialogue in several languages. It furnishes kiosks for waiting rooms and has Internet access. It allows clinicians to enter their own questions www.medisolve.ca Cleos is a product that is currently in beta testing with over 45000 questions available. Primarily adults use it and has some coupling do prevention. http://www.zmedix.com/Cleos.html Medical Net Systems is also available on the Internet and as a stand alone system https://www.medicalnetsystems.com/history_ad/index.html The advantage of having our researchers use software that clinicians on the front line could use seems obvious. Electronic medical records are disseminating and require data to be entered. To have doctors and nurses enter yes and no questions is time consuming and very expensive. The patient has a vested interest in ensuring an accurate collection of data and the literature supports the improved quality of history provided to the clinician. This is an area which primary care needs to develop into a practical everyday use. For further reading and references Bachman, John. The Patient-Computer Interview: A Neglected Tool That Can Aid the Clinician. Mayo Clin Proc. 2003;78:67-78. .
Competing interests: None declared