E-drug: Decision support on computers (2)
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Peter,
Lots (tons) of literature on this - lots of discouraging reports as well.
Nonetheless as the technology improves and physicians become more
computer literate, looks increasingly hopeful.
A few names to look for (experts in this field) in search:
Jeremy Wyatt
CJ McDonald and WM Tierney
EH Shortliffe
Mary Johnston wrote a nice review of computer-based decision support
impact on practice in Annals Int Med 1994;120:135-42.
The Salt Lake City reports on their HELP system and impact on antibiotic
utilization are also worth looking at - one of authors is Classen, i think...
We are in the midst of setting up an electronic medical record network of
family docs in our region to study prescribing with comparison of
academic detailing and computer-based, patient-specific intervention - in
3 years we might have data. Seem to be major concerns world-wide re:
confidentiality and security of data with EMRs. Other major issues are
efficiency of practice - has to not slow practice down to be widely
acceptable; concern re: office staff getting up to speed; etc. Major
training and support needs.
I hope this helps.
Regards,
Anne Holbrook,MD,PharmD,MSc,FRCPC
Centre for Evaluation of Medicines, St Joseph's Hospital, and
Department of Medicine, McMaster University, Rm 4X1
Phone: (905) 522-1155 ext 5269 (SJH) or 521-2100 ext 3371 (MUMC)
FAX: 521-6136 (SJH) or 521-4971 (MUMC)
E-mail: holbrook@fhs.csu.mcmaster.ca
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