Instant medical history.

We introduce a knowledge-based patient driven screening expert system used in an outpatient family practice for 10,000 consecutive visits. The nurse hands the patient a laptop computer. Using knowledge-based questioning, subjective complaints are collected directly from the patient. The questions are response driven. Simultaneous analysis of the pattern of answering also determines the direction of the questioning. If indicated by the patient's answers, standardized published self-rating and self-assessment scales from the medical literature are administered totally unseen by the patient. The patient's complaints are succinctly presented to the physician as he enters the exam room. The physician can usually glance at the positive answers and graphically depicted scales and arrive at a working clinical impression in a few seconds before he begins his interview. Both he and the patient are totally focused on the problem at hand. Limitless potential for enhancing physician productivity is evoked.