This study will evaluate a touch screen patient-initiated computer system designed to integrate cancerand other adult preventive services into the primary care environment. The computer system, named HealthTouch, was previously developed by a working group operating from the Department of Family Practice at the Medical College of Virginia. A number of preliminary evaluation studies have been conducted to support the current proposal. Two validation studies have been conducted to assess the accuracy of the patient information collected by Health Touch in comparison to patient information collected by primary health care professionals. Three focus groups have been conducted, using substantially different patient audiences, to assess patients'understanding and acceptance of the system. Expert review has been provided by a computer user interface expert. A baseline study of the rate of conduct of various preventive procedures has been completed at the Phase I evaluation site. Ascertaining primary health care provider's (physicians and nurses) and staffers (receptionists) acceptance of, and willingness to use, HealthTouch is the next step in the evaluation and refinement of the system. The activities will include: (1) introducing HealthTouch into a busy family practice (which serves 12,000 patients) in order to evaluate its use by patients, receptionists, nurses and physicians; (2) identifying the barriers and facilitating factors experienced by care providers and office staff, and (3) measuring the impact of the system on the delivery of cancer prevention activities, including mammogram, BSE, physician breast examination, PAP smears, flexible sigmoidoscopy, fecal occult blood tests, digital rectal exams, and oral examinations. HealthTouch will be introduced into the practice for three months. A survey and interview of care providers and office staff will be conducted approximately six weeks into the intervention to provide formative information. Interviews and staff survey, chart audit, and log laboratory audits will be performed post-intervention to provide sununative information. Statistical tests will be conducted on the chart audit and log laboratory audit data to make two comparisons: (1) patients seen at baseline versus patients seen during the intervention period, and (2) patients who choose to use HealthTouch during the intervention period versus patients who choose not to use HealthTouch.Awardee's statement of the potential commercial applications of the research:The foremost commercial application of the HealthTouch system will be its adoption by primary care practitioners who will purchase the software, its support system and ongoing updated scientific content to help accomplish cancer prevention goals for their practice populations. Such a computer system can be used as a stand-alone system, yet has the potential to link with office billing database programs and emerging "paper-less" medical chart and office systems. In addition, simple modifications allow for use in non-practice settings.National Cancer Institute (NCI)
