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Measuring the impact of different brands of computer systems on the clinical consultation: a pilot study

Lookup NU author(s): Dr Richard DoddsORCiD



This is the final published version of an article that has been published in its final definitive form by BCS, The Chartered Institute for IT, 2008.

For re-use rights please refer to the publisher's terms and conditions.


BACKGROUND:UK general practitioners largely conduct computer-mediated consultations. Although historically there were many small general practice (GP) computer suppliers there are now around five widely used electronic patient record (EPR) systems. A new method has been developed for assessing the impact of the computer on doctor-patient interaction through detailed observation of the consultation and computer use.OBJECTIVE:To pilot the latest version of a method to measure the difference in coding and prescribing times on two different brands of general practice EPR system.METHOD:We compared two GP EPR systems by observing use in real life consultations. Three video cameras recorded the consultation and screen capture software recorded computer activity. We piloted semi-automated user action recording (UAR) software to record mouse and keyboard use, to overcome limitations in manual measurement. Six trained raters analysed the videos using data capture software to measure the doctor-patient-computer interactions; we used interclass correlation coefficients (ICC) to measure reliability.RESULTS:Raters demonstrated high inter-rater reliability for verbal interactions and prescribing (ICC 0.74 to 0.99), but for measures of computer use they were not reliable. We used UAR to capture computer use and found it more reliable. Coded data entry time varied between the systems: 6.8 compared with 11.5 seconds (P = 0.006). However, the EPR with the shortest coding time had a longer prescribing time: 27.5 compared with 23.7 seconds (P = 0.64).CONCLUSION:This methodological development improves the reliability of our method for measuring the impact of different computer systems on the GP consultation. UAR added more objectivity to the observation of doctor-computer interactions. If larger studies were to reproduce the differences between computer systems demonstrated in this pilot it might be possible to make objective comparisons between systems.

Publication metadata

Author(s): Refsum C, Kumarapeli P, Gunaratne A, Dodds R, Hasan A, de Lusignan S

Publication type: Article

Publication status: Published

Journal: Journal of Innovation in Health Informatics

Year: 2008

Volume: 16

Issue: 2

Pages: 119-127

Print publication date: 01/03/2008

Online publication date: 01/03/2008

Date deposited: 27/03/2018

ISSN (print): 2058-4555

ISSN (electronic): 2058-4563

Publisher: BCS, The Chartered Institute for IT


DOI: 10.14236/jhi.v16i2.683

PubMed id: 18713528


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