In theory big improvements in patient care and their health can occur if electronic patient management systems are utilised properly. The Cochrane Review has been looking at studies involving electronic patient management systems.
This review looked at the use of “recalls” or computer reminders. 28 studies were identified. These showed an overall improvement in ‘process adherence’ of 4.2%. The medication ordering improved by 6.2%. Patient health improved by 3% (what figure is the tipping point for a patient to start ‘feeling’ much better?).
A 6.2% increase in medication may seem small but an improvement of this amount I suggest would lead to dramatically streamlined ordering and logistical processes with a reduction of urgent last minute orders in remote health services. This ensures the more timely deliveries and supply of medications out bush as well as reducing costs and freeing up staff time for other tasks such as patient care. I know because we do it.
These studies did not look at an organisation similar to a remote health service where mainly nurses (but a range of health professionals) providing care independently, by protocol and delivering specific care requested by doctors. This care is provided by different staff over a number of clinics over a large geographical area (where it is impossible to transfer paper notes) for a largely itinerant population.
I wonder how much improvement there would be in those situations? I suspect a similar review would show better more consistent care and follow-up being provided.
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4% sounds like a fairly modest improvement. It would be fascinating to look at a cost benefit analysis of this result – ie the cost of implementing such systems vs the overall patient benefit to determine whether from a public health point of view they should be supported/subsidised by Government.
On the flip side does that mean without the systems doctors get it right using their own memory/experience nearly 96% of the time. That’s not bad in my book.
G’day Ben,
4% does sound modest. But I think the gains are substantially greater where it is not the doctor seeing the patients the majority of the time, where there are several doctors seeing the patient or being seen over a wide geographic area where phone calls would have to be made to determine where the follow up was at,for recent info on both general review or on acute emergency presentations. Out bush all delays are magnified.