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Patient Care Improved with Instant Medical History

May 12, 2002

Mr. John Gould of Columbia, South Carolina, became a medical pioneer by saving his own life. With software he operated himself, Mr. Gould reminded his physician he was overdue for a flexible sigmoidoscopy. When the procedure revealed a pre-cancerous polyp, Dr. Allen Wenner was able to remove it just in time.

The story began simply enough, when Mr. Gould stopped by the office to pay the bill for his wife’s visit the week before. Since the receptionist was busy on the telephone, Mr. Gould sat down at a computer kiosk running Instant Medical History, a software program for the patient. Prior to seeing the doctor or nurse, the patient sits down and enters information into a kiosk computer in the waiting room.

No instruction is given to the patient by the staff about the self-administered software. It asks the patient questions on screen. Each question changes as the patient responds. Since no physician can be expected to remember the thousands of recommended interventions for each patient, the software remembers the preventive guidelines of the U.S. Preventive Services Task Force and queries the patient for the appropriate items based on gender, age and risk factors. The software prints the information for the physician to review. In Mr. Gould’s case, the key question was that it had been more than a year since his last flexible sigmoidoscopy.

After the questionnaire is completed, the physician reviews the information. In the case of Mr. Gould, a flexible sigmoidoscopy was scheduled and a resectable severely dysplasic polyp was removed easily from his colon. Mr. Gould knew the importance of his decision to take the interview after his physician Dr. Allen Wenner explained, “there is no way I would have done this test on you unless the computer had reminded us.” Mr. Gould was totally unaware of his risk for other conditions until he took the preventive interview.

Patient interview systems save lives while reducing overall health care costs by helping physicians to recognize early warning symptoms of disease. Every physician wants to do prevention, but nobody has time. The patient operated system, Instant Medical History, saves time for busy clinicians. The health care system saved more than $100,000 on Mr. Gould for cancer surgery, cancer chemotherapy, and follow-up, and Mr. Gould was spared the complications and suffering. And there’s no value to those extra years with his wife and children.

As told by Mr. John Gould at the Opening Session of the Towards an Electronic Patient Record Conference.