Clinic Function and Computerized Ambulatory Records: A Concurrent Study with Conventional Records

Controlled studies of computerized ambulatory information systems are rare. As part of an evaluation of the effects of COSTAR on clinic function, we divided our resident teaching clinic into a study group with access to COSTAR and a control group allowed access only to conventional medical records. We sampled staff attitudes toward use of the computer and did detailed time studies of clinic patient flow. Staff attitudes reflected a high degree of acceptance, favoring COSTAR over conventional records. This was primarily related to improvement in telephone management and demand care. House staff never became facile users of COSTAR because of infrequent clinic sessions. Clinics assigned to COSTAR experienced somewhat longer waiting times due to an increased workload and training effects. Installation of computerized records should prompt a careful evaluation of expected benefits.