The doctors installed software called "InfoRetriever" on the Hewlett Packard Jornada, a palm-sized unit that weighs about one pound. The software manages and retrieves a range of medical information including summaries of the latest published papers, drug reports and treatment guidelines. The computers, which have been used with InfoRetriever software for only two months, can even tell a doctor which medications are covered by local insurance companies.

The InfoRetriever software was developed by Dr. Mark Ebell, an associate professor of family practice at Michigan State University, along with several colleagues around the country. "When doctors are caring for patients, they have a lot of questions," Ebell says. "All too often we don't have time for the necessary research. We're trying to bring the best information to the point of care."

The new software includes practice guidelines developed by groups of physicians who have carefully reviewed the medical literature to develop a suggested approach to common medical problems. These guidelines help physicians quickly identify the appropriate tests and treatments for a given malady.

For example, if a patient comes in with a sore throat, the doctor has to determine whether the patient has a streptococcus infection. Administering a throat culture takes three days, and the strep tests are inappropriate for patients with a very low or very high risk of strep. The physician can feed all of the pertinent information into the computer and quickly get a determination of the patient's risk level.

Ebell calls that kind of information POEM -- Patient Oriented Evidence that Matters. "The idea is to help doctors answer questions more quickly and with better evidence," he says. "We tried to focus on high-quality research," so doctors don't have to wade through an ocean of unhelpful information to find pertinent data.

Using a grant from the state of Michigan funneled through MSU's Institute for Managed Care, the university has purchased 100 of the computers. In addition to using them in clinical practice, Ebell and colleagues will use the computers as teaching tools and conduct a research project to determine the feasibility of using similar technologies in the future.

When a doctor is responding to a patient, Ebell says, "Not all answers are good answers. Many rely on opinion or anecdote. But if doctors have access to recent studies, they're better equipped to answer questions and provide better health care."

Ebell and his colleagues are hoping to make the software package available for mass release sometime this summer.
salon.com | June 15, 1999

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