Management of Clinical Problems by Physician-Computer Dialogue
In recent years hospitals have begun using a computer program designed to help physicians manage patients with electrolyte and acid—base disorders. The program directs a dialogue during which the physician supplies clinical and laboratory information. When requested data are unavailable, the program proceeds with incomplete information. On the basis of the abnormalities detected, it then asks further questions as needed to characterize the electrolyte and acid—base disturbances. Upon completion of the interchange, the program produces an evaluation note that resembles a remotely located consultant’s discussion of the problem presented. The note includes a list of diagnostic possibilities, an explanation of the pathophysiology, therapeutic recommendations, suggestions for additional laboratory studies, precautionary measures required by the illness or the treatment, and references to the medical literature. Since additional hospitals are scheduled to begin using the program shortly, and additional computer consultation programs are under various stages of development, it seems appropriate to compare computerized and human consultation, and to consider some of the implications of this adjunct to patient care.
KeywordsRenal Tubular Acidosis Metabolic Alkalosis ETHACRYNIC Acid Serum Sodium Concentration Evaluation Note
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