In 2000–2001, investigators at the Centers for Behavioral and Preventive Medicine at Miriam Hospital, in Providence, R.I., conducted a study to test the feasibility of using a point-of-care computer system to assess patient risk of smoking or physical inactivity and assist physicians with appropriate counseling.

Under this grant, researchers:

• Developed content on smoking and physical activity for a 10-minute computer program.
• Met with physicians and office staff to integrate use of the computerized system into the office routine.
• Installed a laptop and a printer for a one-month trial in 10 practices.
• Recruited 15 patients at each site to pretest the intervention system.
• Subsequently monitored patients' unprompted use of the computer system. A total of 150 patients used the program and completed exit interviews during routine care.
• Conducted exit meetings with each practice to discuss problems.

Key Findings

The researchers reported the following findings to the Robert Wood Johnson Foundation (RWJF):

• The computer program was underutilized in routine care.
• Physicians and office staff reported four main barriers to incorporating the computer program into routine care.
  • Overall, the program was viewed as inconsistent with the practice workflow.
  • Staff were inexperienced with the program.
  • Technical problems emerged with the computer and/or printer.
  • The program placed an additional time burden on already overworked staff.
• Physicians and office staff made four recommendations to improve the program and its utilization.
  • Shorten the program.
  • Orient the program to a target patient population (e.g., those with hypertension).
  • Include other conditions pertinent to primary care (e.g., screen for depression).
  • Select patients to use the system rather than ask all patients to use it.

Funding

RWJF supported the study with a $197,013 grant from January 2000 to December 2001.