Timer: a new objective measure of consultation content and its application to computer assisted consultations

• HIT Description: Computer-generated preventive care reminders. More info...
  
• Purpose of Study: Compare consultations with a computer and reminder to consultations without computer using ÒTime Interval Medical Event RecorderÓ (Timer).
  
• Years of study: Not Available
  
• Study Design: Case study w/concurrent control
  
• Outcomes: Impact on health care effectivness/quality, Impact on efficiency, utilization, costs, Impact on health care access
  

• Settings: Clinics staffed by 3 physicians at a health center in Collingham, UK.
• Intervention: Consultations with a computer with preventive care reminders were compared to control consultations.
• Evaluation Method: Measures of length of consultation, the problems being dealt with, the physical activity, the verbal activity, and the secondary tasks being attempted using ÒTimerÓ.
• Healthcare Utilization: ÒTimerÓ showed that control consultations lasted an average of 6 minutes 58 seconds. The doctors spent 35% of their time on administration, and patients and doctors were both conversational for just 33% of the consultation. Giving information was the most common verbal activity (48% of the duration of the consultation) with silence accounting for 21% of the time. When the computer was used the average consultation was longer, at 7 minutes and 46 seconds. The doctor's contribution to the consultation appeared to have increased. Patient centered speech fell from 36% in controls to 28% of the duration of the consultation when the computer was used, while doctor centered speech rose from 30% to 34.5%.
• Quality of Care and Patient Safety Outcome: Exploring patient concepts, education, management sharing, and prevention were attempted during 28% of the control consultations and 40% of the computer consultations. This was accounted for by the increase in prevention (p 0.001).