Giving Doctors The Complete Picture

Photo: Paper files systematically sorted

The computer system could render
lots of paper work unnecessary;

During the course of a hospitalisation, patients are seen by a variety of specialists in addition to the physician who has primary responsibility for their care. However, faulty communication, inappropriate timing, inadequate details, illegibility, lost paperwork or other problems may keep the specialists' recommendations from being evaluated and implemented.

A study by Martin Were and colleagues reports on the success of a physician decision-support tool they developed to overcome these barriers and to complement physician-to-physician communication processes already in place. The computer tool facilitated convenient flow of information, providing both the specialists and the patient's primary-care physician with detailed information on the patient and the advice sought at the right time and place. They found that when using the new computer tool, medical recommendations from geriatrics consultants were implemented 30 percent more frequently than when it was not used.

"Consulted specialists might not have the full clinical or most current picture of the patient. For example, they might not know all medications the patient is taking, the patient's allergies, or the most current results of tests ordered by others. The decision-support system provided by our computer tool eliminated these problems,” explained Were.

“We alerted the specialist when a drug he was contemplating prescribing conflicted with another medication the patient was taking. Automatic electronic notification of the exact specialist recommendations eliminated the need for the patient's primary doctor to leaf through a thick medical file to see the specialist's recommendations and the details of these recommendations. The tool also lets the specialists know if their recommendations have been implemented by the patient's primary doctor. All these benefits can be very important for patient safety," said Were who is an internist.

According to the researchers, use of the new clinical support tool may save health-care dollars by decreasing delays in care, improving patient safety, and prioritising specialty treatment. The next step is to see how big a difference implementation of the system makes in patients' outcomes, duration of hospitalisation and costs of care.; Source: Indiana University