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The EVS: a computerized decision support system for GPs in the Netherlands.
Wolters, I., Hoogen, H. van den, Bakker, D. de. The EVS: a computerized decision support system for GPs in the Netherlands. European Journal of Public Health: 2003, 13(4 sup), 68
Background: In 1998 a project was started to introduce nationally a decision support system in general practice in the Netherlands, called EVS (electronic prescription support system). The system contains national guidelines developed by the Dutch Council of GPs (NHG) for approximately 80 diagnoses. GP-organizations, ministry of Health and National Insurers Board participated. Between April 1999 up to April 2002 the EVS was implemented in the six main computerized medical record systems for GPs in the Netherlands. Consultation of the EVS is expected to shift GPs’ prescribing behaviour towards evidence based therapies: According to the participating organisations this should lead to more rational drug therapy and cost containment. Aim: Study the effects of the introduction of a computerized decision support system (EVS) on prescribing behaviour of GPs. Specific goals are to: - identify conditions and barriers for GPs to be able to consult the EVS; - explain whether or not GPs use the EVS; determine whether prescribing behaviour of GPs changed as a result of the introduction of the EVS. Methods: Data are derived from postal questionnaires sent to 800 GPs in 1999 and 2001 (response = 72%/67%) and prescription data were extracted from the medical records from approximately 150 GPs over a four year period, using software from the national GP information network (LINH) (n=12 million prescription records). Results: 56% of the GPs who have the EVS installed consult it daily. Proper technical features seem to be important conditions, regarding the variation in daily use among GP’s using different medical record systems: 42% to 86%. This contrast increases when looking at frequent use (over ten times a day): 0% to 56%. GPs who use the EVS over 10 times a day show an overall prescribing behaviour slightly more conform the national guidelines than other GPs (67% vs. 62%, p=0,03). This does not lead to detectable financial savings. Specific drug and diagnosis related prescribing behaviour will be addressed as well. Conclusion: The EVS can be considered a relatively cheap quality enhancing instrument, compared to e.g. educational outreach. Use of EVS can be increased by improving technical features in some computerized medical record systems. (aut. ref.)
Background: In 1998 a project was started to introduce nationally a decision support system in general practice in the Netherlands, called EVS (electronic prescription support system). The system contains national guidelines developed by the Dutch Council of GPs (NHG) for approximately 80 diagnoses. GP-organizations, ministry of Health and National Insurers Board participated. Between April 1999 up to April 2002 the EVS was implemented in the six main computerized medical record systems for GPs in the Netherlands. Consultation of the EVS is expected to shift GPs’ prescribing behaviour towards evidence based therapies: According to the participating organisations this should lead to more rational drug therapy and cost containment. Aim: Study the effects of the introduction of a computerized decision support system (EVS) on prescribing behaviour of GPs. Specific goals are to: - identify conditions and barriers for GPs to be able to consult the EVS; - explain whether or not GPs use the EVS; determine whether prescribing behaviour of GPs changed as a result of the introduction of the EVS. Methods: Data are derived from postal questionnaires sent to 800 GPs in 1999 and 2001 (response = 72%/67%) and prescription data were extracted from the medical records from approximately 150 GPs over a four year period, using software from the national GP information network (LINH) (n=12 million prescription records). Results: 56% of the GPs who have the EVS installed consult it daily. Proper technical features seem to be important conditions, regarding the variation in daily use among GP’s using different medical record systems: 42% to 86%. This contrast increases when looking at frequent use (over ten times a day): 0% to 56%. GPs who use the EVS over 10 times a day show an overall prescribing behaviour slightly more conform the national guidelines than other GPs (67% vs. 62%, p=0,03). This does not lead to detectable financial savings. Specific drug and diagnosis related prescribing behaviour will be addressed as well. Conclusion: The EVS can be considered a relatively cheap quality enhancing instrument, compared to e.g. educational outreach. Use of EVS can be increased by improving technical features in some computerized medical record systems. (aut. ref.)
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