Implementation of a microcomputer-based opportunistic health maintenance programme in a general practice teaching clinic.

The general practice teaching clinic at the Chinese University of Hong Kong uses a microcomputerbased medical record system. To implement a uniform and up-to-date health maintenance programme, a set of protocols has been written for a list of health maintenance items, and the computer has been programmed to identify the items which should be carried out at each patient encounter. Over a period of 16 months, after the start of this programme, 99% of the 1120 clinic patients had a minimum of two items performed. Of a selected sample of 203 patients 119 attended the clinic more than once in the same period and 47% of these patients had all of the health maintenance items recommended for their age and sex group completed. Abnormal screening results led to action by the general practice team. The process of implementing a health maintenance programme has helped the team to discuss current recommendations and to agree on standards. The programme has also helped with undergraduate teaching. The automated opportunistic health maintenance programme is a practical tool for improving patient care.