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DOCTOR WRITES COMPUTER PROGRAM TO HELP PATIENTS TAKE ADVICE HOME

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An emergency room physician at Orem Community Hospital has found a way to improve on doctors' advice.

Bruce Argyle, chairman of the Department of Emergency Medicine at Orem Community, has written a software program that allows emergency room personnel to provide patients with written, comprehensive and customized discharge instruction sheets about ailments and follow-up care. Argyle wrote the program, known as the Patient Instruction Generator System, because of his own frustration in providing patients with complete information.By law, emergency room doctors are required to provide appropriate written after-care instructions to every patient upon discharge. Many emergency rooms meet that requirement through the use of pre-printed ailment forms that list a problem and generalized instructions for follow-up care.

Unfortunately, most emergency rooms only stock preprinted forms on the 20 most common ailments. And because the instructions are so general, doctors are required to "fill in the blanks, then cross off the wrong parts, then explain what doesn't quite apply," Argyle says.

"The Patient Instruction Generator makes sure the patient receives only the instructions that apply to him," Argyle said. "The system allows the doctor to get as specific as he wants to be. It doesn't replace a doctor's advice; it reinforces it."

The program can be used in two ways. One method of use provides prelinked groups of problem information, treatment description and follow-up care instructions. An emergency room nurse usually creates a form after hearing instructions from a doctor; the form is then reviewed by the doctor.

The information is printed out in duplicate and is signed by the patient and the physician. The hospital retains one copy while the patient retains the other. Argyle points out that the instruction sheets also can be used as school releases.

If a patient's problem doesn't fit a prelinked group of instructions, the doctor - or other personnel - can select instructions from separate problem, treatment and follow-up categories. The program also works as a word processor, allowing a user to type in specific instructions, to edit existing categories and to add new ones.

Argyle wrote the program a year and a half ago, and has been testing it since then at Alta View and Cottonwood hospitals, where he also works. He said the program, which now has 1,200 instructions, is in its final form, although it will have to be updated as new drugs and methods of treatment are developed. Orem Community Hospital began using the system several weeks ago, and it is now being marketed nationwide.

There are other similar programs, but Argyle believes his is more complete and easier to use.

"All I have to do to get nurses up and running is to show them how to find their way in the program," Argyle said. "Other than that it takes time."

"At Cottonwood they swear they can't live without it," Argyle said. "The patients are more likely to come back when they are told to. They go to the physicians they've been referred to and their questions are more educated."

Argyle has written four other computer programs for medical personnel.

The most well-known is "Cardiac Arrest!," an advanced cardiac life-support simulation program for medical personnel.

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Just what the doctor ordered

Bruce Argyle's software program provides detailed follow-up information for patients discharged from the emergency room. Calling up information on a "fractured radius," for example, provides information about the body part, how the injury occurred, why a cast or splint was applied, how long healing will take, signs the injury is not healing properly, what precautions should be taken with the cast, what the patient should do over the next several days to facilitate healing and when the patient should return to the doctor for follow-up care. References to specialists can also be included, complete with a doctor's name, address and telephone number.