To The Editor

In his opinion statement on obsolete equipment (APSF Newsletter, Summer 1996), Dr. Gravenstein dismisses the automated anesthesia record keeper as an expensive product that has not achieved sufficient acceptance to be a commercial success or routine of care. This may describe the current frequency of use of automated record keepers, but probably understates their future roles. Our business, professional, and personal worlds are becoming more automated and information driven. Few people who have mastered the technologies of automation and computers would return to their former (lower-tech) state. Two years ago, our hospital lived through the conversion to automated record keepers, and even the thought of returning to (semi-readable, time-consuming) handwritten records is upsetting.

I agree that financial and human barriers to record keeping systems exist. They cost approximately $20,000 per operating room in an era when reducing costs is important and seems paramount and, in addition, they require learning new skills. However, automated systems are becoming more powerful, easier to use, and less expensive. I think the future will evolve toward more automated records combined with real-time information. The accuracy and analytic capabilities of automated systems may promote safety and efficiency to such an extent that operating room managers will demand them. Large stores of clinical information which these devices easily accumulate certainly will make many studies easier or, even, possible for the first time. At least, we should not discourage automated record keepers until their capabilities for enhancing safety and productivity are fully explored.

Robert E. Johnstone, M.D. Professor and Chair Department of Anesthesiology West Virginia University Morgantown, WV