Yearbook of Medical Informatics, Table of Contents Yearb Med Inform 2000; 09(01): 71-78DOI: 10.1055/s-0038-1637944 Review Paper Georg Thieme Verlag KG Stuttgart Patient-Computer Dialogue: A Review[1],[2] W.V. Slack 1 Division of Clinical Computing, Departments of Medicine and Psychiatry, Harvard Medical School and Beth Israel Deaconess Medical Center and Center for Clinical Computing, Boston, MA, USA › Author Affiliations Recommend Article Abstract Abstract Since the first study of communication between patient and computer was performed at the University of Wisconsin in 1965, programs for patient-computer dialogue have been developed, implemented, and studied in numerous settings in the United States and abroad, and the results have been encouraging. This review presents a brief history of patient-computer dialogue together with suggested guidelines for programs in the future. Keywords Keywordscybermedicine - patient-computer dialogue - computers - interviews - medical history taking - user-computer interface - self-care - patient power - patient satisfaction Full Text References References 1 Slack WV. The computer and the doctorpatient relationship. MD Comput 1989; 274: 320-1. 2 Slack WV, Hicks GP, Reed CE, Van Cura LJ. A computer-based medical-history system. N Engl J Med 1966; 274: 194-8. 3 Slack WV. Cybermedicine: How Computing Empowers Doctors and Patients for Better Health Care . San Francisco: Jossey-Bass; 1997 4 Machiavelli N. The Prince. (G. Bull, trans.). Harmondsworth, England: Penguin Books; 1981 5 Spock B. Dr. Spack’s Baby and Child Care: Sixth edition fully revised and updated for the 1990s . New York: NAU Dutton; 1992 6 Brodman K, Erdmann Jr AJ., Lorge I, Wolff HG. Cornell Medical Index: adjunct to medical interview. JAMA 1949; 140: 530-4. 7 Brodman K, Van Woerkom AJ, Erdmann Jr AJ., Goldstein LS. Interpretation of symptoms with data-processing machine. Arch Intern Med 1959; 103: 776-82. 8 Collen MF, Rubin L, Neyman J, Dantzig GB, Baer RM, Siegelaub AB. Automated multiphasic screening and diagnosis. Am J Public Health 1964; 54: 741-50. 9 Slack WV. Brave new interviewer. Harvard Med Alumni Bull 1966; 69: 44-9. 10 Slack WV. Patient-computer dialogue and the patient’s right to decide. In Brennan PF, Schneider SJ, Tornquist E. eds Information Networks for Community Health . New York: Springer-Verlag; 1997: 55-69. 11 Slack WV. Cybermedicine: how computing empowers patients for better health care. In Cesnik B, McCray AT, Scherrer J-R. eds Proceedings Medinfo 1998 . Amsterdam: IOS Press; 1998: 3-5. 12 Clark WA, Molnar CE. The LINC: a description of the laboratory instrument computer. Ann NY Acad Sci 1964; 115: 653-68. 13 Peckham BM, Slack WV, Carr WF, Van Cura LJ, Schultz AE. Computerized data collection in the management of uterine cancer. Clin Obstet Gynecol 1967; 10: 1003-15. 14 Slack WV, Van Cura LJ. Computer-based patient interviewing. Postgrad Med 1968; 43: 68-74. 15 Slack WV, Van Cura LJ. Computer-based patient interviewing. Postgrad Med 1968; 43: 115-20. 16 Slack WV. Medical interviewing by computer. South Med Bul 1969; 57: 39-44. 17 Slack WV, Van Cura LJ, Greist JH. Computers and doctors: use and consequences. Comput Biomed Res 1970; 3: 521-7. 18 Maultsby MC, Slack WV. A computerbased psychiatry history system. Arch Gen Psychiatry 1971; 25: 570-2. 19 Chun RWM, Van Cura LJ, Spencer M. Slack WV. Computer interviewing of patients with epilepsy. Epilepsia 1976; 17: 371-5. 20 Bana DS, Leviton A, Swidler C, Slack WV. Graham JR. A computer-based headache interview: acceptance by patients and physicians. Headache 1980; 20: 85-9. 21 Bana DS, Leviton A, Slack WV, Geer DE, Graham JR. Use of a computerized database in a headache clinic. Headache 1981; 21: 72-4. 22 Bennett SE, Lawrence RS, Fleischmann AB. Gifford CS, Slack WV. Profile of women practicing breast self-examination. JAMA 1983; 249: 488-91. 23 Leviton A, Slack WV, Bana D, Graham JR. Age-related headache characteristics. Arch Neurol 1984; 41: 762-4. 24 Slack WV. A history of computerized medical interviews. MD Comput 1984; 1: 52-9. 25 Mayne JG, Weksel W, Sholtz PN. Toward automating the medical history. Mayo Clin Proc 1968; 43: 1-25. 26 Mayne JG, Martin MJ. Computer-aided history acquisition. Med Clin North Am 1970; 54: 825-33. 27 Coombs GJ, Murray WR, Krahn DW. Automated medical histories: factors determining patient performance. Comput Biomed Res 1970; 3: 178-81. 28 Grossman JH, Barnett GO, Mcguire MT, Swedlow DB. Evaluation of computeracquired patient histories. JAMA 1971; 215: 1286-91. 29 Warner HR, Rutherford BD, Houtchens BA. A sequential Bayesian approach to history taking and diagnosis. Comput Biomed Res 1972; 5: 256-62. 30 Stead WW, Heyman A, Thompson HK, Hammond WE. Computer assisted interview of patients with functional headaches. Arch Intern Med 1972; 129: 1-12. 31 Simborg DW, Rikli AE, Hall P. Experimentation in medical history-taldng. JAMA 1969; 210: 1443-5. 32 Coddington RD, King TL. Automated, history taking in child psychiatry. Am J Psychiatry 1972; 129: 176-82. 33 Gottlieb GL, Beers RF, Bernecker C, Samter M. An approach to automation of medical interviews. Comput Biomed Res 1972; 5: 99-107. 34 Greist JH, Gustafson DH, Stauss FF, Rowse GL, Laughren TP, Chiles JA. A computer interview for suicide-risk prediction. Am J Psychiatry 1973; 130: 1327-32. 35 Rockhart JF, McLean ER, Hershberg PI. et al. An automated medical history system. Arch Intern Med 1973; 132: 348-58. 36 Schuman SH, Curry HB, Braunstein ML, Schneeweiss R, Jebaily GC, Glazer HM, Cahn JR, Crigler WH. A computer-administeredinterview on life events: improving patient-doctor communication. J Fam Pract 1975; 2: 263-9. 37 Pauker SG, Gorry GA, Kassirer JP, Schwartz WB. Towards the simulation of clinical cognition: taking a present illness by computer. Am J Med 1976; 60: 981-96. 38 Lucas RW, Card WI, Knill-Jones RP, Watkinson G, Crean GP. Computer interrogation of patients. Br Med J 1976; 2: 623-5. 39 Lucas RW, Mullin PJ, Luna CB, Mclnroy DC. Psychiatrists and a computer as interrogators of patients with alcohol-related illnesses: a comparison. Br J Psychiatry 1977; 131: 160-7. 40 Lucas RW. A study of patients’ attitudes to computer interrogation. Int J Man-Machine Studies 1977; 9: 69-86. 41 Greist JH, Klein MH. Computer programs for patients, clinicians, and researchers in psychiatry. In Sidowski JB, Johnson JH, Williams TA. eds Technology in Mental Health Care Delivery Systems . Norwood, Conn: Ablex; 1980: 161-82. 42 Carr AC, Ghosh A, Ancill RJ. Can a computer take a psychiatric history?. Psychol Med 1983; 13: 151-8. 43 Carr AC, Ghosh A. Response of phobic patients to direct computer assessment. Brit J Psych 1983; 142: 60-5. 44 Skinner HA, Allen BA. Does the computer make a difference? Computerized versus face-to-face versus self-report assessment of alcohol, drug, and tobacco use. J Consulting Clin Psych 1983; 51: 267-73. 45 Millstein SG, Irwin Jr CE.. Acceptability of computer-acquired sexual histories in adolescent girls. J Pediatr 1983; 103: 815-9. 46 Tanser AR, Davies A. Archie: the use of a microcomputer in an allergy clinic. Br J Dis Chest 1984; 78: 135-9. 47 Quaak MJ.. Westerman RF, Schout JA, Hasman A, van Bemmel JH. Patient appreciations of computerized medical interviews. Med Info 1986; 11: 339-50. 48 Houziaux MO, Lefebve PJ. Historical and methodological aspects of computer-assisted medical history taking. Med Info 1986; 11: 129-43. 49 Lindberg G, Seensalu R, Nilsson LH, Forsell P, Kagar L, Knill-Jones RP. Transferability of a computer system for medical history taking and decision support in dyspepsia. A comparison of indicants for peptic ulcer disease. Scand J Gastroenterol Suppl 1987; 128: 190-6. 50 Haug PJ, Warner HR, Clayton PD. et al. A decision-driven system to collect the patient history. Comput Biomed Res 1987; 20: 193-207. 51 Pringle M. Using computers to take patient histories. Br Med J 1988; 297: 697-8. 52 Lutner RE, Roizen MF, Stocking CB. et al. The automated interview versus the personal interview. Do patient responses to preoperative health questions differ?. Anesthesiology 1991; 75: 394-400. 53 Locke SE, Kowaloff HB, Hoff RG. et al. Computer-based interview for screening blood donors for risk of HIV transmission. JAMA 1992; 268: 1301-5. 54 Sanders GD, Owens DK, Padian N, Cardinalli AB, Sullivan AN, Nease RF. A computer-based interview to identify HIV risk behaviors and to assess patient preferences for HIV-related health states. In Gardner RM.. Proceedings 19th Annual Symposium on Computer Applications in Medical Care . Philadelphia: Hanley & Belfus; 1994: 20-4. 55 Hasley S. A comparison of computerbased and personal interviews for the gynecologic history update. Obstet Gynecol 1995; 85: 494-8. 56 Vitkun SA, Gage JS, Anderson DH, Williams SA, Halpern-Lewis JG, Poppers PJ. Computerization of the preoperative anesthesia interview. Int J Clin Monit Comput 1995; 12: 71-6. 57 Kobak KA, Greist JH, Jefferson JW, Katzelnick DJ. Computer-administered clinical rating scales. Psychopharmacology (Berl) 1996; 127: 291-301. 58 Taenzer PA, Sauve L, Burgess ED, Milkavich L, Whitmore B. The health interview: automated assessment in a multidisciplinary outpatient hypertension treatment program. MD Comput 1996; 13: 423-6. 59 Kohlmeier L, Mendez M, McDuffie J, Miller M. Computer-assisted selfinterviewing: a multimedia approach to dietary assessment. Am J Clin Nutr 1997; 65 Suppl (Suppl. 04) 1275-81. 60 Bock B, Niaura R, Fontes A, Bock F. Acceptability of computer assessments among ethnically diverse, low-income smokers. Am J Health Promot 1999; 13: 299-304. 61 Slack WV, Van Cura LJ. Patientreactionto computer-based medical interviewing. Comput Biomed Res 1968; 1: 527-31. 62 Starkweather JA. Computest: a computer language for individual testing, instruction, and interviewing. Psychol Rep 1965; 17: 227-37. 63 Swedlow DB, Barnett GO, Grossman JH, Souder DE. A simple programming system ("DRIVER”) for the creation and execution of an automated medical history. Comput Biomed Res 1972; 5: 90-8. 64 Angle HV, Carroll JA. Computer interview language: prograrnming the on-line interactive computer. Behav Res Meth Instrumentation 1979; 11: 379-83. 65 Bloom SM, White RJ, Beckley RF, Slack WV. Converse: ameans to write, edit, administer, and summarize computer-based dialogue. Comput Biomed Res 1978; 11: 167-75. 66 Slack WV. Patient power: a patient-oriented value system. In Jacques JA. ed Computer Diagnosis and Diagnosis Methods: Proceedings of the Second Conference on Diagnostic Process held at the University of Michigan . Springfield, Ill: Charles C Thomas; 1972: 3-7. 67 Slack WV. The patient’s right to decide. Lancet 1977; 2 8031 240 68 Witschi J, Porter D, Vogel S, Buxbaum R, Stare FJ, Slack W. A computer-based dietary counseling system. J Am Diet Assoc 1976; 69: 385-90. 69 Slack W, Porter D, Witschi J, Sullivan M, Buxbaum R, Stare FJ. Dietary interviewing by computer. An experimental approach to counseling. J Am Diet Assoc 1976; 69: 514-7. 70 Fisher LA, Johnson TS, Porter D, Bleich HL, Slack WV. Collection of a clean voided urine specimen: a comparison among spoken, written, and computer-based instructions. Am J Public Health 1977; 67: 640-4. 71 Slack WV, Safran C, Kowaloff HB, Pearce JP, Delbanco TL. A computer-administered health screening interview for hospital personnel. MD Comput 1995; 12: 25-30. 72 Bleich HL, Beckley RF, Horowitz G. et al. Clinical computing in a teaching hospital. N Engl J Med 1985; 312: 756-64. 73 Slack WV, Bleich HL. The CCC systemin two teaching hospitals: a progress report. Int J Med Inform 1999; 54: 183-96. 74 Van Cura LJ, Jensen NM, Greist JH, Lewis WR, Frey SR. Venereal disease: interviewing and teaching by computer. Am J Public Health 1975; 65: 1159-64. 75 Barry MJ, Mulley Jr AG., Fowler FJ, Wennberg JW. Watchful waiting vs immediate transurethral resection for symptomatic prostatism: the importance of patients’ preferences. JAMA 1988; 259: 3010-7. 76 Mulley AG. Supporting the patient’s role in decision making. J Occup Med 1990; 32: 1227-8. 77 Brennan PF, Ripich S, Moore SM. The use of home-based computers to support persons living with AIDS/ARC. J Community Health Nurs 1991; 8: 3-14. 78 Gustafson DH, Bosworth K, Hawkins RP, Boberg EW, Bricker E. CHESS: acomputer-based system for providing information, referrals, decision support and social support to people facing medical and other health-related crises. In Frisse ME. ed Proceedings 16th Annual Symposium on Computer Applicatins in Medical Care . New York: McGraw-Hill; 1992: 161-5. 79 Friedman RH, Kazis LE, Jette A. et al. A telecommunications system for monitoring and counseling patients with hypertension: impact on medication adherence and blood pressure control. Am J Hypertens 1996; 9: 285-92. 80 Gustafson DH, Hawkins R, Boberg E. et al. Impact of patient-centered, computerbased health information/support system. Am J Prev Med 1999; 16: 1-9. 81 Slack WV. Computer-based interviewing system dealing with nonverbal behavior as well as keyboard responses. Science 1971; 171: 84-8. 82 Lucas RW. Computer interrogation: investigation of patients’ response times. Int Res Commun Systems J Med Sci 1974; 2: 1176 83 Slack WV, Leviton A, Bennett SE, Fleischmann KH, Lawrence RS. Relation between age, education, and time to respond to questions in a computer-based medical interview. Comput Biomed Res 1988; 21: 78-84. 84 Weizenbaum JE. ELIZA: acomputerprogram for the study of natural language communication between man and machine. Commun Assoc Comput Mach 1966; 9: 36-45. 85 Colby KM, Watt JB, Gilbert JP. A computer method of psychotherapy: preliminary communication. J Nerv Ment Dis 1966; 142: 148-52. 86 Rogers CR. Client-centered therapy. Boston: Houghton Mifflin; 1965 87 Selmi PM, Klein MH, Greist JH, Sorrell SP, Erdman HP. Computer-administered cognitive-behavioral therapy for depression. Am J Psychiatry 1990; 147: 51-6. 88 Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression . New York: Guilford Press; 1979 89 Hoffmann M, Hock C, Muller-Spahn F. Computer-based cognitive training in Alzheimer’s disease patients. Ann New York A cad Sci 1996; 777: 249-54. 90 Blood GW. A behavioral-cognitive therapy program for adults who stutter: computers and counseling. J Commun Disord 1995; 28: 165-85. 91 Slack WV, Slack CW. Patient-computer dialogue. N Engl J Med 1972; 286: 1304-9. 92 Slack WV, Slack CW. Talking to a computer about emotional problems: a comparative study. Psychother Theory Res Pract 1977; 14: 156-64. 93 Slack WV, Porter D, Balkin P, Kowaloff HB, Slack CW. Computer-assisted soliloquy as an approach to psychotherapy. MD Comput 1990; 7: 37-42. 58 94 Spielberger CD. The measurement of state and trait anxiety: conceptual and methodological issues. In Levi L. ed Emotions: their Parameters and Measurement . New York: Raven Press; 1975: 713-25. 95 Freud SA. A General introduction to Psychoanalysis . New York: Pocket Books; 1921 96 Watson JB. Behaviorism . New York: Norton; 1924 97 Skinner BF. Science and Human Behavior . New York: Macmillan; 1953 98 Slack WV. The handheld calculator. MD Comput 1991; 8: 8-10. 99 Harris Pole 1999, reported in NUA Internet Surveys www.nua.ie/surveys 100 Ferguson T. Health Online: How to Find Health information, Support Groups, and Self Help Communities in. Cyberspace . Reading, Massachusetts: Addison Wesley; 1996 101 Horowitz GL, Bleich HL. Paper Chase: a computer program to search the medical literature. N Engl J Med 1981; 305: 924-30. 102 Scolamiero SJ. Support groups in cyberspace. MD Comput 1996; 14: 12-7. 103 Slack WV. The issue of privacy. MD Comput 1997; 14: 8-10. 104 Slack WV. Private information in the hands of strangers. MD Comput 1997; 14: 83-6.