The computer and screening techniques in general practice.

SCREENING procedures in general practice have as their object the early detection of disease and subsequent treatment. The disease may be presymptomatic, or the patient may be aware of the presence of some disorder. For the primary physician as distinct from the Public Health Service there is a focussing down on the family as seen against a background of community health. It is logical to include in a screening programme, measures to review regularly the immunization state of children and certain adult groups, and also such special groups as the handicapped child and the elderly. To carry out this work, which necessitates a change from therapeutic medicine to preventive medicine, new tools are needed in general practice. To set up this project the computer was considered a fundamental tool. The first step was to construct an age-sex register on a computer file. This was done in conjunction with the executive council, and each patient on the practice list was entered on this file. A suite of programs maintains this file up to date and prints lists and analysis of the patients' details on request. The updating is carried out at approximately monthly intervals. Identification of the patient is by National Health Service number and the date of birth. Input data are processed in three forms: 1. An 'A' document (figure 1) is used to initiate a record for a new patient or to amend the record of an existing patient over the following field-