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of surgery.
"It's really transformed the way we initially review and get to know our patients," says Dr. Lennon. "If you can obtain detailed information about your patients in advance of their coming in for surgery, it allows time for follow-up if necessary. It lets us know as much as we can about the patient so that we can make proper patient selection. We want to know more about that patient before we anesthetize them in a surgery center."
Ms. Pochman says online histories tend to be much more detailed, revealing information and raising red flags you might not have gleaned over the phone. "If a patient has a latex allergy or diabetes," says Ms. Pochman, "you can schedule him as the first patient of the day."
Another example of how computerized pre-screening enhances patient safety? Dr. Lennon advises patients who indicate on their online health histories that they're on antihypertensives not to take their medication the day of surgery. "We found that their vital signs under anesthesia are more stable if they don't take it on the morning of surgery," he says.
Dr. Eckert warns that online medical histories are only as thorough as patients are willing to make them. "Don't assume that it's going to be 100% accurate," he says. "Confirm the important details. In the ambulatory surgery business, often the reason you have bad outcomes is because the caregivers didn't know enough about the patient that he needed to know."
Dr. Eckert worked with his vendor to customize the forms and the questions patients are asked. He's also working to add a risk evaluation form that would replace a manual screen for deep vein thrombosis, which he calls "a bit painstaking." Not only does he hope to incorporate the DVT screening questions he asks into his center's online questionnaire, but also a weighted value to the replies. "We'd apply each of the positive risk factors to a DVT risk-assessment score," says Dr. Eckert. "This will let us customize what prophylaxis might be needed for that patient."
