Getting computerized: practical advice
By Edward Doyle
Whether it was how to surf the Internet or what features to demand in medical software, internists at this year's Annual Session got answers to their questions about computers and medicine.
More than 40 courses at this year's meeting covered everything from what to look for in a new computer to how to implement sophisticated electronic records systems. And for physicians who wanted a close-up look at technology, more than 30 products including palmtop computers and online services for physicians were available for hands-on use at the Learning Center's Computer Resource Room.
When it came to tips on how to improve clinical practice through computing, some of the most practical advice came during a two-day pre-Session course, where more than 250 internists gathered to hear about the technologies they should consider using in their practice.
One of the hottest topics during the pre-Session course was how to choose the right electronic medical records program. Jerome H. Carter, FACP, assistant professor of medicine at the University of Alabama at Birmingham, advised physicians to carefully examine medical records programs before buying. Just a few years ago, he said, most physicians viewed this kind of software as a way to produce cleaner-looking, more organized records. With the growing presence of managed care, however, many physicians today need electronic records software to do more: provide information critical to their managed care contracts, such as how many preventive tests and general services they use.
Before proceeding with any purchase, Dr. Carter said, physicians should realize that vendors often sell software that is not yet finished. Worse, he said, vendors often finish developing the product in the physician's office, disrupting the practice—and charging the physician up to $125 an hour.
Panel members advised physicians to use caution—and a bit of skepticism—when working with consultants. Because consultants often push their clients to purchase products that they directly represent or have a financial interest in, panelists urged physicians to ask about any financial interests consultants may have in various products.
Using the Internet in a clinical setting was another popular topic. Daniel R. Masys, FACP, director of biomedical informatics at the University of California, San Diego School of Medicine and a pioneer in creating Internet tools for physicians, pointed to several online databases like Medline from the National Library of Medicine. Dr. Masys predicted the Internet will become even more useful for physicians in the next year as journal publishers make full text of articles available online for a small fee.
But many internists wanted even more basic advice: how to get on the Internet. While many commercial services such as CompuServe and America Online provide links to the Internet, Dr. Masys suggested shopping for an Internet serve provider—a firm that provides access to all of the Internet and not just to a single service. To find the best Internet provider, he said, ask the firm how many users it can handle at one time and how many total users it currently has; you don't want to sign up with a service that is taking on more users than it can handle. Additionally, he said, ask for a trial period of a day or two to see how fast the provider's system really is. Finally, he said, don't sign up for any long-term agreements—as large phone companies and other vendors jump into the Internet, market prices will continue to fall.
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