Computerized protocol for preventive medicine: a controlled self-audit in family practice

A protocol for adult health maintenance was designed for display on a desk-top microcomputer in the general practitioner's office. Two hundred and twenty-two patients were entered into a randomized study comparing the outcome of the computerized protocol with manual records. The doctor had the option of displaying the single-screen protocol for the experimental group and acting on its prompts in the course of his normal clinical consultations. At the end of 30 months, significantly more preventive medicine items--smoking, height, blood group, tetanus and rubella immunization status and family planning--had been recorded for patients in the computerized group. For other items, requiring more frequent measurements, computerization produced an advantage only for blood pressure and breast examination, but not for weight, occult blood and serum cholesterol. Recording rates increased significantly for patients in both the control and the computerized groups for all the items. Using the computer lengthened the average consultation time from 8.5 minutes to 10 minutes. Such systems are a valuable aid to encouraging doctors to increase the amount of preventive medicine they incorporate into their routine practice.