The use of a small computer to provide action suggestions in the booking clinic

The principal function of antenatal care is the identification of clinical features which require further action. Nevertheless, human vigilance is imperfect and medical staff fail to recognise 20% of risk factors. We describe here the use of microcomputers to supply action suggestions (clinical reminders) on the basis of the antenatal booking interview. Interactive programs obtain the history and provide a neatly formated hard-copy containing the action suggestions. A total of 82 suggestions are included in the programs and the average history generates 1.5 of these. These reminders are a form of quality control and they will become even more important as technological advances expand the range of possible investigations. This method is presented as an alternative to risk scoring. The suggestions are intended as reminders of items that may have passed unnoticed; they are not intended to limit or constrain individual judgement. Furthermore, they can easily be altered to suit the resources and preferences of individual hospitals. As a result of the low cost of newer microcomputers, this form of electronic reminder has now become a viable proposition on a large scale.