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- Title
Reminders to physicians from an introspective computer medical record. A two-year randomized trial.
- Authors
McDonald, Clement J.; Hui, Sui L.; Smith, David M.; Tierney, William M.; Cohen, Stuart J.; Weinberger, Morris; McCabe, George P.; McDonald, C J; Hui, S L; Smith, D M; Tierney, W M; Cohen, S J; Weinberger, M; McCabe, G P
- Abstract
We developed a computer-stored medical record system containing a limited set of the total clinical data base--primarily diagnostic studies and treatments. This system responds to its own content according to physician-authored reminder rules. To determine the effect of the reminder messages generated by 1490 rules on physician behavior, we randomly assigned practitioners in a general medicine clinic to study or control groups. The computer found indications for six different actions per patient in 12 467 patients during a 2-year study: 61 study group residents who received computer reminders responded to 49% of these indications; 54 control group residents, to only 29% (p less than 0.0001). Preventive care (occult blood testing, mammographic screening, weight reduction diets, influenza and pneumococcal vaccines) was affected. The intentions of the study group to use a given action for an indication predicted their response to the indications (p less than 0.03, r2 = 0.33). The intentions of the control residents did not.
- Subjects
MEDICAL records; DATABASES
- Publication
Annals of Internal Medicine, 1984, Vol 100, Issue 1, p130
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-100-1-130