Once prompted, the assistant executes the appropriate steps. Within minutes, the printer kicks in, printing out a computer-generated letter detailing the patient's CD4 status and requesting that the patient schedule an appointment. This is a typical interaction between clinicians at Beth Israel Hospital and a newly developed computer program integrated into the hospital's Online Medical Record system. This allows the computer to be a partner in the care process. One innovation of this program is the system of alerts and reminders that prompt caregivers on a range of medical concerns.
Alerts are more visible, coming up whenever the clinician logs onto the computer.
Designed to analyze data for specific indicators, alerts issue electronic messages whenever a potentially important or harmful event is recognized. For example, the computer may point out the falling white blood cell count of a patient on AZT and suggest certain actions be taken, such as adjusting the AZT dose or stopping treatment. Unlike alerts, reminders come up only when a clinician is looking at a patient's record. The program also informs clinicians of their patients' eligibility for AIDS clinical trials using HIV ProtoCall, a built-in, interactive program that itemizes protocols available through the AIDS Clinical Trials Group. Beth Israel Hospital boasts the highest clinical trial enrollment in Boston, a success Safran attributes in part to ProtoCall.