An interactive computerized protocol for the management of hypertension: effects on the general practitioner's clinical behaviour

• HIT Description: Decision support system using a computerized care protocol with alerts. More info...
  
• Purpose of Study: Assess the effect of the computerized care protocol with alerts on physicianÕs system usage and delivery of care during consultations.
  
• Years of study: Not Available
  
• Study Design: Pre-Post
  
• Outcomes: Impact on health care effectivness/quality, Other outcome
  

• Settings: Two general practices in Sheffield, UK participated in the study. One had 4 physicians with 8,000 registered patients, and the other had 7 physicians with 20,000 patients
• Intervention: A computerized care protocol with alerts for the management of hypertension was compared to a paper protocol and non-protocol periods.
• Evaluation Method: Measures of the physician's delivery of care, and the usage of the system.
• Description: The computerized protocol displayed prompts for specific investigations or decisions to be made by physicians during consultations with patients with chronic hypertension. It was designed by 2 of the investigators in the study and a hospital hypertension specialist.
• Healthcare Utilization: The mean number of physical examinations by physicians during the non-protocol period ranged from 1.42 to 3.31 compared to 5.78 during the paper protocol period and 6.93 during the computer protocol period.
• Quality of Care and Patient Safety Outcome: Verbal examinations (regarding new clinical events since last appointment, e.g. myocardial infarction, angina/chest pains) of patients by physicians during the non-protocol period was lower than during the protocol periods. Physicians asking general health questions was not affected by the protocol.