Prevent Disease.com - Kids' Care Better if Doctor Uses Computer in Visit



		Kids' Care Better if Doctor Uses Computer in Visit Excerpt by Keith Mulvihill, Reuters Health NEW YORK (Reuters Health) - Children may get better care if their doctors use a computer to record medical information during a visit rather than taking notes the traditional way, new study findings suggest. When using computers to log health information, doctors were more likely to discuss a variety of issues with parents, including the child's sleep patterns, exposure to smoking, possible access to guns and behavioral milestones. While nearly all doctors offices have computerized billing systems, very few--about 5 percent to 10 percent--generate electronic medical records while seeing patients, said lead study author Dr. William G. Adams of Boston University School of Medicine in Massachusetts. "The major findings from our study are that computers can be successfully used while seeing patients and doctors welcome them--although for some, about 40 percent--it slowed them down somewhat," Adams told Reuters Health. But all the doctors in the study said they wanted to continue to use the system, despite a few drawbacks. According to Adams, the doctors in the study reported that that the newer method improved the quality of care overall. "For example, in a sample of paper-based records, only a few notes even mentioned the presence of smoking in the home, an important issue for passive smokers--kids--and their parents. People who need to be reminded to quit," said Adams. The findings are published in the March issue of the journal Pediatrics. In the study, Adams and colleagues gave 10 doctors and nurse practitioners computers equipped with software, developed by the study's authors, that offered extensive electronic medical forms for gathering information. The study included a total of 235 paper-based visits (before the system was introduced) and 986 computer-based visits for children under five. Three doctors were excluded from the study because they left the practice or did not use the system often enough. Doctors using the electronic system were much more likely to discuss a number of issues, including exposure to domestic or community violence, guns in the home, behavioral milestones, infant sleep position, poison control, child safety and sleep in general. Still, four of the seven doctors using computer-based systems reported that office visits were longer (about 9.3 minutes) and five of the seven said the system decreased eye-to-eye contact with patients. "When...designed to fit into the busy workflow of a pediatric practice, the computer can help doctors be much more complete, give doctors information that would otherwise be hard to find, and give patients their own personal health information as well as information on a wide variety of topics," said Adams. "Doctors who take care of children--all doctors actually--need to begin thinking about getting a computer system to provide at least some, if not all, the features in this (report). Doctors don't mind using it if it is well designed, quality will improve, and patients will like and benefit from it," concluded Adams. The study was funded by the Robert Wood Johnson Foundation, David and Lucille Packard Foundation and the National Library of Medicine. SOURCE: Pediatrics 2003;111:626-632. Reference Source 89 For more information on how to prevent other diseases, use PreventDisease.com's "Quick Prevention Resources".