Computers And Clinical Care
In todays Australia it is highly unusual to find a workplace that does not avail itself of information technology. General practice is no different, with less than 1 in 15 general practitioners working in a non-computerised practice1. However, information as to exactly how GPs and general practice staff use computers is relatively unmapped.
A recent Medical Journal of Australia article explored clinical uptake of computers and found it was reasonably high. Computers were used by 98% of the sample for prescribing and 85% to order laboratory tests. However, gaps remain where the use of computers is still only at low to moderate levels: recording reasons for prescribing (65%), recording progress notes (64%) and accessing patient material (63%) among them. BEACH data confirms these figures, noting that computers are predominantly used for prescribing purposes, with administrative functions such as billing also quite common.
So how do we plug the gaps? What can you do with a computer to provide clinical care? Actually the question should be: what cant you do? Health summaries, past medical histories, prescribing, progress notes, recording investigations, immunisation information, chronic disease management, letters, audits, recalls and a number of other functions are contained within clinical software packages. It is simply a matter of learning to appreciate the advantages of electronic health records over your paper based system. If you are concerned your computer abilities arent up to scratch it is important to start small once you have gained familiarity with one task, you can then opt to tackle another.
Therefore whilst the trusty computer is playing a part in the doctor-patient relationship there still exists the opportunity for further development of this tool. Behavioural adaptations are required by both GPs and practice staff. Relevant training and knowledge of software packages is also required. Given that general practice has only increased its IT focus over the last 10 years, this computer know-how could be a knowledge gap that needs to be bridged before behavioural adaptation can be properly tackled. Your local Division of General Practice may be able to provide you with IT training.
So what can busy GPs do to take charge of their clinical IT systems? : Do not try to take on too many new functions at once. If you currently use your system for a number of tasks, add one more until you have successfully incorporated it into your consultation.
Be comfortable with your level of skill, rather than embarrassed your patients know that you are a doctor, not an IT expert!
Also, find a routine that works for you. Every doctor will have a different level of knowledge that they need to obtain, and therefore a different rate of uptake.
Talk to your practice colleagues and collectively agree on which functions you will adopt.
The GPCG Computers And Clinical Care Module
This education module is designed to guide GPs and practice staff through some of the tasks a clinical software package can perform. It is non-specific, so regardless of what kind of software package you have this module is relevant. It has clear learning objectives at the outset, begins with more basic concepts and contains a number of practical exercises to guide you. It is all about using the computer on your desk to improve the care of patients.
Should you wish to know any more details or get your hands on a copy of the module, you can contact Jane London at the Royal Australian College of General Practitioners. It is also available on the GPCG website.
General Practice Computing Group (GPCG)
Posted in Australian eHealth