Principals of design and evaluation of an information system for a department of respiratory medicine.
OBJECTIVE
To evaluate a departmental computer system.


METHODS
a. Direct comparison of the time taken to use a manual system with the time taken to use a computer system for lung function evaluation, loan of equipment and production of correspondence. b. Analysis of the accuracy of data capture before and after the introduction of the computer system. c. Analysis of the comparative running costs of the manual and computer systems.


METHODS
Within a department of respiratory medicine serving a hospital of 1323 beds.


METHODS
a. Time taken to perform functions with the assistance of computerised methods, in comparison to the manual method used alone. b. Accuracy of data capture. c. Relative running costs.


RESULTS
a. The computer system (CS) was significantly faster than the manual system (MS) for lung function evaluation (CS = 7.63 min/test, MS = 12.25 min/test), loan of equipment (CS = 0.40 min/loan, MS = 2.07 min/loan), and checking for overdue equipment (CS = 0.49 s/record, MS = 9 s/record). The production of correspondence was slightly slower with the computer (CS = 9.30 min/letter, MS = 8.54 min/letter). b. All outpatient episodes, but only 43 of 65 (66%) of in-patient episodes, were captured. Lung function and managerial report data were accurate using both manual and computerised methods. The manual system for equipment loans was inefficient, and use of the computer resulted in the recovery of 221 nebulisers. c. Development costs for 1988-1990 were high (72,178 pounds). Only 1200 pounds to 1845 pounds per year was recovered directly from staff time saved by the computer but larger savings resulted from changes in work practice (4049-4765 pounds). After 10 years the projected deficit is 10,000 pounds per annum in running costs.


CONCLUSIONS
In comparison with the manual methods, the computer system has shown significant advantages which provide accurate information, with significant favourable effects on working practices. In evaluating computer systems used in clinical practice it is essential to ensure that the projected work practice benefits are achieved without unacceptable costs in staff time, inaccurate data and high financial outlay.
Baldwin
D R
DR
Nottingham City Hospital, UK.
Beech
C A
CA
Evans
A H
AH
Prescott
J
J
Bradbury
S P
SP
Pantin
C F
CF
D003199:Computer Systems / Q000191:economics*; D005069:Evaluation Studies as Topic; D005568:Forms and Records Control / Q000191:economics*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006751:Hospital Information Systems / Q000191:economics*; D006801:Humans; D016247:Information Storage and Retrieval; D012129:Respiratory Function Tests / Q000191:economics / Q000379:methods; D012139:Respiratory Therapy Department, Hospital / Q000191:economics / Q000458:organization & administration*; D013222:State Medicine; D013996:Time and Motion Studies; D006113:United Kingdom