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Table 1 Significant problems reported by computer histories but not physician histories for 45 hospitalized patients

From: Underutilization of information and knowledge in everyday medical practice: Evaluation of a computer-based solution

Organ
System/Issue
Problem Reported by Computer History but not Hospital Chart Patients with Problem
Heart Symptoms heart failure (dyspnea on exertion, paroxysmal nocturnal dyspnea, marked fatigue, pitting edema) with no prior diagnosis 10
  Symptoms decompensated heart failure in patients with prior diagnosis 2
  "Cardiac asthma" versus reactive airway disease 4
  Prior diagnosis angina with chest pain 1
  Symptoms effort-induced angina versus reactive airway disease manifest as chest tightness 1
  Effort induced chest pain, no prior diagnosis angina 3
  Prior MI no invasive treatment 2
  Prior MI and angioplasty in last year 1
  Syncope 1
  Hypertension 8
  Uncontrolled hypertension by self-reported BP 3
  Arrhythmia 12
Peripheral Symptoms compatible with intermittent claudication 5
Vascular Symptoms intermittent claudication versus spinal stenosis 1
System TIAs in patients with prior CVA 2
  TIAs in patient with no prior CVA 2
  History carotid artery surgery 1
  History peripheral arterial surgery 1
  Symptomatic asthma in patients with prior diagnosis but no rescue or control meds 5
  History treated TB 1
  Symptoms obstructive sleep apnea 1
  Symptoms sleep apnea 1
Pulmonary 34 old woman with daily cough and sputum throughout year. Onset as child. (Computer and physician history reported new onset fever and dyspnea with history pneumonia 4 months prior to admission) 1
GI GERD, AM cough and hoarseness in patient with asthma 1
  Symptoms active ulcer disease in patient with prior upper GI bleed 1
  Daily aspirin use in patient with prior upper GI bleed 1
  Dysphagia in patient with scleroderma 1
  Erectile dysfunction 5
GU/GYN Symptoms urinary obstruction in elderly men 7
  Stress incontinence (women) 2
  Symptoms estrogen deficiency in patients taking HRT 1
  Symptoms recurrent cystitis and back pain in woman 1
  Urinary incontinence since prostate surgery 1 year PTA plus 6 months dysuria, back pain and polyuria/polydypsia. 1
Endocrine/Metabolic Uncertain thyroid status in patients treated previously for hyperthyroidism 3
  Polyuria/dyspsia, recent onset blurred vision 1
  Gout; no symptoms in last 1 year 1
  Polyphagia with no weight gain 1
  Diabetics with symptoms hypoglycemia 13
  Diabetics not monitoring or inadequately monitoring blood glucose 5
  Diabetics unaware of treatment regime for blood sugar 5
  Glaucoma 2
  Tunnel vision in patient with no prior diagnosis glaucoma 1
  Symptoms CNS vasculitis in patient with diagnosis SLE 1
  Episodic diplopia 1
  Tinnitus, hearing loss but no vertigo 1
  Current evidence major depression. No treatment. 2
  Major depression in setting of bereavement. No treatment. 1
  Current evidence moderate depression. No treatment 1
  Past history depression; not currently depressed; no meds 1
  Past history mania 1
  Prior diagnosis bipolar disorder not currently depressed 1
  Symptoms migraine; no prior diagnosis; positive FH migraine 1
Neurology Multiple hospitalizations for falls; negative AUDIT score 3
  High risk for falling because of motor weakness, unsteady gait, past history falls not requiring hospitalization 10
  Episodic dizziness and abnormal gait in patient with positive AUDIT score 1
  Hodgkin's treated with XRT 3 years prior to admission. Now on chemo for 2nd recurrence. 1
  Renal cell cancer treated with surgery and radiation 20 years prior to admission. No recurrence. 1
Oncology Rheumatology Active rheumatoid arthritis on steroids 1
Life Style Active smokers seeking help to stop smoking 2
  Positive AUDIT score 5
  Multiple 1st and 2nd degree relative with breast cancer 1
Family History Multiple 1st degree relatives with diabetes in patient with history gestational diabetes and recent onset chest pain provoked by emotional upset. 1
Vegetative Night sweats 1
Symptoms Weight loss > 10 pounds in non-dieting patient 1
  1. The physician history was acquired prior to the computer history, which was obtained within the first 2 days of hospitalization.