Computer-assisted history-taking systems (CAHTS) in health care:
benefits, risks and potential for further development

Pappas, Yannis; Anandan, Chantelle; Liu, Joseph K.; Car, Josip; Sheikh, Aziz; Majeed, Azeem

doi:10.14236/jhi.v19i3.808

Cited by 29 publications

(38 citation statements)

References 31 publications

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“…Our findings are consistent with other reviews on the use of computer-assisted history taking systems (CAHTS) for diabetes such as Pappas et al (2011) which found that CAHTS can save professionals' time, improve delivery of care to those with special needs and also facilitate the collection of information, especially potentially sensitive information (e.g. sexual history, alcohol consumption).…”

Section: Cahts For Cvd Managementsupporting

confidence: 91%

Computer-Assisted versus Oral-and-Written History Taking for the Prevention and Management of Cardiovascular Disease: a Systematic Review of the Literature

Pappas

Všetečková

Poduval

et al. 2017

Acta Med. (Hradec Kralove, Czech Repub.)

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A B ST R AC T Background and objectives: CVD is an important global healthcare issue; it is the leading cause of global mortality, with an increasing incidence identified in both developed and developing countries. It is also an extremely costly disease for healthcare systems unless managed effectively. In this review we aimed to: -Assess the effect of computer-assisted versus oral-and-written history taking on the quality of collected information for the prevention and management of CVD.-Assess the effect of computer-assisted versus oral-and-written history taking on the prevention and management of CVD. Methods: A systematic review of randomised controlled trials that included participants of 16 years or older at the beginning of the study, who were at risk of CVD (prevention) or were either previously diagnosed with CVD (management). We searched all major databases. We assessed risk of bias using the Cochrane Collaboration tool. Results: Two studies met the inclusion criteria. One comparing the two methods of history-taking for the prevention of cardiovascular disease n = 75. The study shows that generally the patients in the experimental group underwent more laboratory procedures, had more biomarker readings recorded and/or were given (or had reviewed), more dietary changes than the control group. The other study compares the two methods of history-taking for the management of cardiovascular disease (n = 479). The study showed that the computerized decision aid appears to increase the proportion of patients who responded to invitations to discuss CVD prevention with their doctor. The ComputerAssisted History Taking Systems (CAHTS) increased the proportion of patients who discussed CHD risk reduction with their doctor from 24% to 40% and increased the proportion who had a specific plan to reduce their risk from 24% to 37%. Discussion: With only one study meeting the inclusion criteria, for prevention of CVD and one study for management of CVD we did not gather sufficient evidence to address all of the objectives of the review. We were unable to report on most of the secondary patient outcomes in our protocol. Conclusions: We tentatively conclude that CAHTS can provide individually-tailored information about CVD prevention. However, further primary studies are needed to confirm these findings. We cannot draw any conclusions in relation to any other clinical outcomes at this stage. There is a need to develop an evidence base to support the effective development and use of CAHTS in this area of practice. In the absence of evidence on effectiveness, the implementation of computer-assisted history taking may only rely on the clinicians' tacit knowledge, published monographs and viewpoint articles.

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Section: Cahts For Cvd Managementsupporting

confidence: 91%

Computer-Assisted versus Oral-and-Written History Taking for the Prevention and Management of Cardiovascular Disease: a Systematic Review of the Literature

Pappas

Všetečková

Poduval

et al. 2017

Acta Med. (Hradec Kralove, Czech Repub.)

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“…The use of CAHTS has the potential to improve quality and comprehensiveness of information captured, reduce data entry errors, save time and facilitate acquisition of sensitive patient information [24]. It can be used from the convenience of home, while travelling, or while in the waiting room.…”

Section: The Patient’s Medicines Management Journeymentioning

confidence: 99%

eHealth in the future of medications management: personalisation, monitoring and adherence

Car

Tan

Huang

et al. 2017

BMC Med

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145

105

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BackgroundGlobally, healthcare systems face major challenges with medicines management and medication adherence. Medication adherence determines medication effectiveness and can be the single most effective intervention for improving health outcomes. In anticipation of growth in eHealth interventions worldwide, we explore the role of eHealth in the patients’ medicines management journey in primary care, focusing on personalisation and intelligent monitoring for greater adherence.DiscussioneHealth offers opportunities to transform every step of the patient’s medicines management journey. From booking appointments, consultation with a healthcare professional, decision-making, medication dispensing, carer support, information acquisition and monitoring, to learning about medicines and their management in daily life. It has the potential to support personalisation and monitoring and thus lead to better adherence. For some of these dimensions, such as supporting decision-making and providing reminders and prompts, evidence is stronger, but for many others more rigorous research is urgently needed.ConclusionsGiven the potential benefits and barriers to eHealth in medicines management, a fine balance needs to be established between evidence-based integration of technologies and constructive experimentation that could lead to a game-changing breakthrough. A concerted, transdisciplinary approach adapted to different contexts, including low- and middle-income contries is required to realise the benefits of eHealth at scale.

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“…This patient-administered sexual history taking can be computer or paper-based [75–78]. The use of a computerised tool to elicit patients’ sexual histories has the advantages of saving physicians’ time, of being acceptable to both patients and physicians, of improving care for patients’ specific needs by patient screening and routing, and of improving information collection, especially sensitive information [74, 79, 80]. While high literacy rates [96.1% among males and 92% among females] and a rapid increase in computer/Internet usage in Vietnam [0.3% in 2000 to 34% in 2012] [81] may suggest that ACASI could be feasible for sexual history taking in Vietnam, further research in this area is necessary to evaluate the practicality of using this approach in a country like Vietnam, and whether patients and health professionals would access information on sexual health via e-technology.…”

Section: Discussionmentioning

confidence: 99%

Physicians’ perceived barriers to management of sexually transmitted infections in Vietnam

Minichiello

Hussain

et al. 2014

BMC Public Health

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BackgroundSexually transmitted infections (STIs) are a public health problem in Vietnam with sub-optimal care in medical practice. Identifying practitioners’ perceived barriers to STI care is important to improve care for patients with STIs.MethodsA cross-sectional survey was conducted among 451 physicians. These physicians were dermatology and venereology (D&V) doctors, obstetrical/gynaecological (Ob/Gyn) doctors, general practitioners, and assistant doctors working in health facilities at provincial, district and communal levels in three provinces in Vietnam.ResultsAlmost all (99%) respondents mentioned at least one barrier to STI care. The barriers were “lack of STI training” (57%), “lack of professional resources” (41%), “lack of time” (38%), “lack of reimbursement” (21%), “lack of privacy/confidentiality” (17%), “lack of counselling” (15%), and “not the role of primary care provider” (7%). Multivariable logistic regression analysis showed that “lack of professional resources” was associated with respondents being in medical practice for ten years or under (vs. 11–20 years), and working at district or communal health facilities (vs. provincial facilities); “lack of time” were associated with respondents being female, seeing more than 30 patients a week (vs. <15 patients/week); and “lack of privacy/confidentiality” was associated with physicians’ seeing more than 30 patients a week (vs. <15 patients/week).ConclusionThe study has identified several barriers to STI care in medical practice in Vietnam. Results of the study can be used to improve areas in STI care including policy and practice implications.

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Computer-assisted history-taking systems (CAHTS) in health care: benefits, risks and potential for further development

Cited by 29 publications

References 31 publications

Computer-Assisted versus Oral-and-Written History Taking for the Prevention and Management of Cardiovascular Disease: a Systematic Review of the Literature

Computer-Assisted versus Oral-and-Written History Taking for the Prevention and Management of Cardiovascular Disease: a Systematic Review of the Literature

eHealth in the future of medications management: personalisation, monitoring and adherence

Physicians’ perceived barriers to management of sexually transmitted infections in Vietnam

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