TY - JOUR
T1 - Has general practitioner computing made a difference to patient care? A systematic review of published reports
AU - Sullivan, Frank
AU - Mitchell, Elizabeth
PY - 1995/9/30
Y1 - 1995/9/30
N2 - Objective: To review findings from studies of the influence of desktop computers on primary care consultations. Design: Systematic review of world reports from 1984 to 1994. Setting: The computerised catalogues of Medline, BIDS, and GPlit were searched, as well as conference proceedings, books, bibliographies, and references in books and journal articles. Subjects: 30 papers met the inclusion criteria and were included for detailed review. Interventions: A validated scheme for assessing methodological adequacy was used to score each paper. Main outcome measures: Papers were rated on sample formation, baseline differences, unit of allocation, outcome measures, and follow up. Differences in outcomes were also recorded. Results: Four of the six papers dealing with the consultation process showed that consultations took longer. Doctor initiated and “medical” content of consultations increased at the expense of a reduction in patient initiated and “social” content. Each of the 21 studies which looked at clinician performance showed an improvement when a computer was used (from 8% to 50%, with better results for single preventive measures). Only one of the three studies looking at patient outcomes showed an improvement (diastolic blood pressure control 5 mm Hg better after one year, with fewer doctor-patient consultations). Conclusions: Using a computer in the consultation may help improve clinician performance but may increase the length of the consultation. More studies are needed to assess the effects on patient outcomes of using a computer in consultations.
AB - Objective: To review findings from studies of the influence of desktop computers on primary care consultations. Design: Systematic review of world reports from 1984 to 1994. Setting: The computerised catalogues of Medline, BIDS, and GPlit were searched, as well as conference proceedings, books, bibliographies, and references in books and journal articles. Subjects: 30 papers met the inclusion criteria and were included for detailed review. Interventions: A validated scheme for assessing methodological adequacy was used to score each paper. Main outcome measures: Papers were rated on sample formation, baseline differences, unit of allocation, outcome measures, and follow up. Differences in outcomes were also recorded. Results: Four of the six papers dealing with the consultation process showed that consultations took longer. Doctor initiated and “medical” content of consultations increased at the expense of a reduction in patient initiated and “social” content. Each of the 21 studies which looked at clinician performance showed an improvement when a computer was used (from 8% to 50%, with better results for single preventive measures). Only one of the three studies looking at patient outcomes showed an improvement (diastolic blood pressure control 5 mm Hg better after one year, with fewer doctor-patient consultations). Conclusions: Using a computer in the consultation may help improve clinician performance but may increase the length of the consultation. More studies are needed to assess the effects on patient outcomes of using a computer in consultations.
UR - http://www.scopus.com/inward/record.url?scp=0029125655&partnerID=8YFLogxK
U2 - 10.1136/bmj.311.7009.848
DO - 10.1136/bmj.311.7009.848
M3 - Article
C2 - 7580494
AN - SCOPUS:0029125655
SN - 0959-8138
VL - 311
JO - BMJ
JF - BMJ
IS - 7009
ER -