Towards improving the accuracy of the clinical database: allowing outpatients to review their computerized data

We developed an application that allowed patients coming to the clinic to review on a paper form their computerized health maintenance, medication, and allergy data. The patient could edit the paper form and the physician then could enter the new data into the database. We implemented the system in 4 clinics (17 MDs) To evaluate the system, we reviewed 80 forms from one physician's patients to determine how often patients provided new data. We also sent questionnaires to the physicians asking for their estimates of how often there was new data and for their impression of the system. We interviewed secretaries in the clinics about logistical issues. Of the 80 forms, 29 (36%) had new data; 28% had new health maintenance data and 19% had new medication data. The 7 physicians who responded to the questionnaire estimated that new health maintenance data were present on 22% of the forms. The physicians who responded to the questionnaire felt the system was useful. The secretaries said that managing the paper flow in the clinic was often unwieldy and in some clinics, the system has been abandoned or is used intermittently. Having patients review their data is one avenue to improving the accuracy of computerized records.