III. the Physicians Office and Group Practice—Ambulatory Medical Record Systems: F. Practice Review and Quality of Care: Experience with a COSTAR Quality Assurance Program in Private Practice

摘要

A pre-programmed Quality Assurance Module was installed in a private practice where the paper chart had been eliminated by using COSTAR (COmputer STored Ambulatory Record) with CRT terminals built into each physician's desk. Automatic notices were generated of those patients for whom elevated diastolic blood pressures but no diagnosis of hypertension were recorded. There was an apparent improvement (by a factor of two) in the recognition of hypertension as compared with a six week control period. Physicians subsequently requested more timely and sophisticated feedback regarding hypertension investigation and management. This COSTAR module is transportable and acceptable to non-academic physicians who respond to computer feedback by altering practice behaviour.