Computer usage high among physician executives.

The American College Physician Executives has long had a commitment to information technology and computers, both as an organization and as a representative of the medical management profession. Staff work depends to a large degree on computers that are updated on a regular basis to ensure that the College is getting maximum benefit from computer technology. The College began Inter NET, its information and communication network, more than seven years ago, and is currently exploring improvements that will make it more friendly to users. The Forum on Computers and Information Technology was one of the charter forums of the College.

The College, through the Forum, also is determined to provide education and training in computers and information technology to members. To aid the College in the planning and design of such programs, a random sample of the membership was selected earlier this year for a survey questionnaire. Questionnaire were mailed to 570 members, and 162 were returned, for a response rate of 28.4 percent.

On the issue of computer literacy, 59.3 percent said that they were literate, and 71.6 percent said that they regularly use computers. For those who use computers, 56.8 percent said they use them at home, 37.7 percent use them in their practice offices, and 51.2 percent use them in their management offices.

Personal finances were the most common application for hom computers; 46.3 percent of the respondents used computers for this purpose. Other applications on home computers were education (32.7 percent), medical databases (25.9 percent), games (24.7 percent), office/practice patient information (17.9 percent), and hospital patient information (9.3 percent).

In the practice office, the top applications were financial operations other than billing and access to medical databases, both with 31.5 percent of the respondents. Billing procedures were mentioned by 26.5 percent, patient care applications by 24.7 percent, forecasting by 21.6 percent, and access to hospital patient information by 17.3 percent.

The most common management application (27.8 percent) was looking up departmental data. Next were integrated patient care delivery (14.2 percent), medical records management (12.3 percent), access to outpatient records (8.6 percent), and physician order entry (4.3 percent). An indication that management applications are more varied than either practice office or home applications is contained in that fact that 29.6 percent of the respondents marked the other category for this question.

For those who indicated that they used personal computers, 62 percent said that they were proficient in the use of spreadsheets, 41 percent in the use of database managers, 82 percent of word processing programs, 26 percent in integrated information systems, and 46 percent in on-line access to external databases. The most common program for each of these areas, in the same order, is Lotus, Dbase, Word-Perfect, Enable, and CompuServe.

Finally, those surveyed were asked to rank 21 potential computer courses on a scale of 1 to 5, with 5 being very important and 1 being least important. The average scores for all 21 topics are shown in the accompanying table. The highest ranking went to "Using basic computer tools in health care," followed by "Systems for quality improvement," "Sources of data for problem solving (data for quality improvement, utilization management, and cost-benefit analysis)," "Future trends in information systems," and "Electronic medical records." The least popular topic was "Techniques and standards for procuring hospital patient care systems." Both the positive and the negative responses to this final question on the survey will guide the Forum and the College in the development of educational programming and information programs.

Physician Executive Identified Topics for Educational Programming

                                                      Average
Topic                                                  Scores
Using basic computer tools in health care                4.0
Systems for quality improvement                          3.9
Sources of data for problem solving                      3.8
Future trends in information systems                     3.5
Electronic medical records                               3.5
Outpatient automated record systems                      3.5
Physician executives as chief information officers
  and medical information officers                       3.4
Strategic information systems                            3.2
Integrated inpatient care management systems             3.1
Outpatient financial systems                             3.1
Use of database programs for managing
  personal size research databases                       3.0
Electronic imaging systems                               2.9
Telecommunications and telemedicine                      2.9
Use of spreadsheets                                      2.9
Computer "Nuts and Bolts"                                2.9
Use of word processors                                    2.8
General computer update (not specific to health care)    2.8
Human factors in system installation                     2.7
Inpatient financial systems                              2.6
Techniques and standards for procuring office systems    2.5
Techniques and standards for procuring hospital
  patient care systems                                   2.3

Kathleen Touchette Fern is Coordinator, Societies and Forums, American College of Physician Executives, Tampa, Fla.