A Computer-Assisted Preanesthesia Interview

A computer-assisted preanesthesia historical interview and a computer-generated summary have been developed as an aid for preanesthesia rounds. Using a video monitor and a keyboard computer terminal, patients were questioned regarding previous medical, surgical, and anesthetic history, medications, allergies, and other items of particular interest to the anesthesiologist. Computer-generated data were compared to those derived from personal interviewing of patients by anesthesiologists. The computer interview was more accurate (96%, p < 0.0005) and less variable than the anesthesiologists in listing correct positive and negative historical information. When the computer interview summary was used in the preanesthesia visit (study 2) the anesthesiologists' assimilation of historical information was greater (82.18%, p < 0.005) than when the summary was not used during the preanesthesia visit (73.75%) (study 1). When only positive symptoms and conditions were compared, however, the difference between the computer and the anesthesiologists became more obvious, with more positive findings listed by the computer than by the anesthesiologists. Items missed by anesthesiologists included angina, myocardial infarction, recent upper respiratory infection, asthma, and low back pain. There was stronger agreement between the computer summary and the anesthesiologists in study 2 than in study 1. Items showing improved agreement (p < 0.05) from study 1 to 2 were a history of having had a local anesthetic, including adverse reactions, level of physical activity, alcohol use, and smoking. The computer was more correct (p < 0.05) than the anesthesiologists in more items in study 1 than in study 2. These findings suggest that a computer-generated summary of the preanesthesia history can enhance the anesthesiologists' assimilation of pertinent information. The computer interview was seen by the physicians as an effective aid, and it was accepted well by patients.