Automation of the patient history--evaluation of ergonomic aspects.

In this study it was investigated in quantitative terms how patient reactions were on automated history-taking. The study is part of a comprehensive project, in which also physicians participated in the validation of such computerized medical records. In total 99 patients, visiting the outpatient clinic of Internal Medicine for the first time, took part in this in-depth study, in which they could express themselves via an interactive and modified terminal and keyboard. The questionnaire that was used in the system contains 28 different screens. Patient complaints are entered together with data on frequency, severity, onset, and duration. The patient may indicate his physical complaints on a stylized picture of the human body. Of the 99 patients, 67 answered the full questionnaire, and another 16 the main part. On the average, 66 min were needed. Younger patients do complete the history in a significantly shorter time than older patients, resulting in relatively more completed histories for the younger group. Quick patients answered on the average 3.5 questions per minute, the slow patients only 2.5. This was strongly correlated with patient familiarization, that has also been investigated: patients who had a quick familiarization were able to finish within 50 min. Patients who needed no help at all in using the system had even answering rates of 3.9/min.

AIDA for the automation of the patient history.

This article describes the application of a fourth-generation programming package (AIDA) for the construction of an interactive system for history-taking. It is shown that this system has been made very flexible and user-friendly, and that patients can easily answer all questions themselves. Parts of the system, that are supported by AIDA, are an interactive terminal with special, illuminated function keys, a screen driver for the generation and maintenance of 28 different screens, extensive help texts (with 260 help messages), and a report generator. The screens contain altogether 402 questions, through which 434 different answers can be given on 179 different items. The system has been evaluated extensively.