title: Use of a computer to detect and respond to clinical events: its effect on clinician behavior.
abstract: A computer was used to prospectively detect and suggest responses to simple, medication-related events as reflected in a computerized record in a prospective, randomized study of a diabetes clinic with primary-care responsibility. There were two categories of event/suggestions: when the last observation of a test required for medication control was too old, the computer suggested a repeat; and when an abnormality with therapeutic implications was detected, the computer suggested a specific change in therapeutics. Clinicians responded to 36% of events in the first category with computer reminders and 11% without (P less than 0.0001); they responded to 28% of events in the second category with computer assistance and 13% without (P less than 0.026). For the most clinically significant of these second category events, the difference was even greater: 47% with and 4% without computer assistance (P less than 0.0004). I believe that computer detection and response (in the form of reminders) to simple clinical events will change clinician behavior.
mesh_terms: D002983:Clinical Competence; D003201:Computers; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008499:Medical Records; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin