Abstract

This study examines the attitudes of care recipients toward their use of computers to improve quality of services offered by primary care providers. Care recipients indicated support for computerized point-of-care prompts for preventive services, behaviour counselling, and chronic disease management. Background: This study examines care recipient attitudes toward their use of computerized prompts to improve health service delivery.

Method: Four patient focus groups were conducted to identify important issues in design and implementation of a patient-centred computer system. These data were used to develop a patient survey that asked "Overall, would you support answering questions using a computer before each visit in order to prompt your doctor to: (a) perform a health screening test (b) counsel you about your health behaviour, and (c) change your treatments for conditions like high blood pressure and diabetes?" Patients were also asked about their concerns regarding data security using a 5-point likert scale coded, "definitely no" to "definitely yes". One hundred and twenty-four patients from 10 physician practices were surveyed.

Findings: Participants were 42.8 years on average (almost 75% female). 49.2% reported weekly use of computers; only 12.7% reported never using a computer. Patients supported using computers (definitely or probably yes) to prompt their doctor to: (a) do health-screening tests (92.2%) (b) do health behaviour counselling (92.2%), and (c) change medical treatments if necessary (85.5%). Men, frequent computer users, and those who indicated comfort using a computer reported greater support for computerized point-of-care prompts to improve quality of care. Age, education level, minority status, presence of chronic illnesses, and concerns over data security were not associated with acceptance of computerized prompts.

Conclusions: Care recipients supported using computers to improve quality of care (i.e., preventive services, health behaviour counselling, chronic disease management).

If home and community care clients were to hold similar attitudes to those reported in this study, there may be an opportunity to use computers to guide resource use within home care settings (e.g., timing and number of appointments). However, challenges to the diffusion of technology in a community setting must be addressed (i.e. finance, access, training, maintenance). Screening questions may need to be used to identify those most likely to use or respond to computerized point-of-care prompts.

Patient acceptability must be clearly defined. What may be acceptable to patients while in a physician's office may not be deemed acceptable while receiving care in the community or home. Overall, patients may be open to greater use of computers to enhance care delivery. Implications of patients' acceptance of computer-based applications are potentially far reaching. Current computer-based applications like telehealth or remote collection and transmission of vital sign data may prove acceptable and effective means of care delivery within home and community care settings.

Reference: Sciamanna CN, Diaz J, Myne P. Patient attitudes toward using computers to improve health services delivery. BMC Health Services Research 2002; 2(1):19.