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We just came back from an appointment at a very busy pediatric spine clinic. Our 13-year old daughter has developed a very bad case of scoliosis. While we were there, we must have filled out 20 pages worth of questions. In today's world of advanced technology, isn't there some way medical offices could use computers to cut down on paper use and speed up the process?

You may be referring to the use of an electronic medical record (EMR). The EMR has already been introduced in many places. Hospitals, clinics, and other health care organizations are heading in that direction and going green.

Saving time, paper, and money are important goals. Doctors and other health care professionals are also under additional pressures to prove that the treatment provided is beneficial and cost effective.

That means more time is taken to assess the before and after effects of any treatment. Surveys, questionnaires, and various parent- or patient-reports of results are needed to document clinical outcomes.

Finding one evaluation tool that meets the wide range of ages, physical conditions, and diagnoses of patients is very challenging. Researchers have developed a Computerized Adaptive Test (CAT) that will help. This program has the ability to ask a series of questions based on the age, gender, and condition of the patient. Each subsequent question is selected by the computer based on answers to the last question.

For example, questions about children with very low skills will be different than questions presented for older, more independent children. An interactive program of this type helps cut down on unnecessary or repeated questions.

Such tools will also help keep track of changes in patients' progress. With such a record at his or her disposal, physicians may be able to identify the need to make changes in the treatment program sooner than later. And everyone (patient, family, physician, and insurance company) will recognize smaller increments of improvement sooner.

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