Author:
S Zdanuk,Family Practice Vol. 18, No. 6, 602-604
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Date Posted: Sat, January 19 2002, 12:55:35 PST
In reply to:
Anna Lok, MD Thomas Shehab MD Mauricio Orrego, M.D. UMich
's message, "Doctors/Patients Not Following Through on Hepatitis C Screening" on Mon, July 30 2001, 8:16:52 PDT
The impact of medical informatics on the confidence of rural physicians caring for patients with chronic hepatitis C viral infections
S Zdanuk, J Gimpel, J Uhanova, KDE Kaita and GY Minuk
Liver Diseases Unit, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Correspondence to: Dr GY Minuk, Liver Diseases Unit, John Buhler Research Centre, 803F-715 McDermot Avenue, Winnipeg, Manitoba R3E 3P4, Canada.
Objective. The purpose of the present study was to determine whether CD-based medical informatics enhances rural physicians' confidence in the management of patients with chronic hepatitis C viral infections.
Methods. A total of 385 Canadian rural physicians were mailed a CD-based medical software programme that outlines all aspects of HCV care including diagnosis, counselling, treatment and follow-up. Accompanying the CD was a brief questionnaire that addressed physicians' confidence in the following areas: (i) identifying HCV patients in their practice; (ii) laboratory use and interpretation; (iii) patient counselling; (iv) selection of candidates for treatment; (v) sharing treatment delivery; and (vi) providing follow-up. Three months thereafter, the same questionnaire was repeated.
Results. Of the 385 mailings, 59 (15%) physicians returned the initial questionnaire and 57 (15%) the follow-up questionnaire. Twenty-five (44%) respondents indicated they had used the CD. Baseline physician confidence was low in three of the six areas addressed. At follow-up, in addition to now being confident in all areas, CD users were significantly more confident than those who had not used the CD. Increases in physician confidence for CD users were ~150–300% in the six areas addressed. The value assigned the CD programme was 8/10.
Conclusion. The results of this study indicate that: (i) rural physicians are uncomfortable in dealing with many aspects of HCV management; (ii) CD-ROM-based medical informatics can significantly enhance rural physicians' confidence in these areas; (iii) ~50% of physicians will employ CD-ROM-based medical informatics in their offices; and (iv) physician level of satisfaction with such programmes is high.
Keywords. CD-ROMs, health care, hepatitis C, medical education, medical informatics, rural medicine.
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