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Use of a Computer to Detect and Respond to Clinical Events: Its Effect on Clinician Behavior

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Some of the data presented in this paper appeared as an abstract in Clinical Research in April 1975.

▸Requests for reprints should be addressed to Clement J. McDonald, M.D., Regenstrief Institute, Wishard Memorial Hospital, 1001 W. 10th St., Indianapolis, IN 46202.

Indianapolis, Indiana

Ann Intern Med. 1976;84(2):162-167. doi:10.7326/0003-4819-84-2-162
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A computer was used to prospectively detect and suggest responses to simple, medication-related events as reflected in a computerized record in a prospective, randomized study of a diabetes clinic with primary-care responsibility. There were two categories of event/suggestions: when the last observation of a test required for medication control was too old, the computer suggested a repeat; and when an abnormality with therapeutic implications was detected, the computer suggested a specific change in therapeutics. Clinicians responded to 36% of events in the first category with computer reminders and 11% without (P < 0.0001); they responded to 28% of events in the second category with computer assistance and 13% without (P < 0.026). For the most clinically significant of these second category events, the difference was even greater: 47% with and 4% without computer assistance (P < 0.0004). I believe that computer detection and response (in the form of reminders) to simple clinical events will change clinician behavior.







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