Moulene Maigaelle V, de Lusignan Simon, Freeman George, van Vlymen Jeremy, Sheeler Ian, Singleton Andrew, Kumarapeli Pushpa
Primary Care Informatics, Division of Community Health Sciences, St. George'-University of London, United Kingdom.
Stud Health Technol Inform. 2007;129(Pt 2):1132-6.
In the UK routinely collected computerized clinical data is used to assess progress towards financially incentivised quality targets for chronic disease management including hypertension.
To develop a method for assessing the impact of recording quality target data in the clinical consultation.
Raters were trained how to rate a multi-channel video of a simulated clinical consultation for interaction between actors, computer use, non-verbal communication.
25% of consultation time is computer use and a median of 4 to 5 items were coded per consultation mainly items related to the hypertension quality target. Intraclass correlation coefficient showed good inter-rater reliability (>0.9; p<0.001).
We have successfully piloted a novel technique for observing the influence of the computer on the consultation. Despite increasing computer use to record quality target data the overwhelming proportion of the consultation remains doctor patient interaction.
