MERET Solutions traces its heritage to the first patient-computer interview conducted by Warner Slack at the University of Wisconsin in 1965.¹
“The LINC (Laboratory Instrument Computer) has been used in this research. This is a small, general-purpose high speed digital computer especially designed for on-line collection (that is, collection directly by the computer) and real-time (that is, processing data at least as fast as they are generated) of experimental data in the biomedical laboratory…A typewriter keyboard provides direct access to the processing unit of the computer. Two magnetic-tape units provide both storage and retrieval functions, and a cathode ray oscilloscope, resembling a television screen and capable of displaying easily readable statements is an integral part of the LINC.”
Fifty years ago, we reported the advantages of a computer interview for suicide risk assessment.² The computer had grown to a LINC – 8 that combined a LINC computer with a PDP-8 permitting programs written for either architecture. But the process was the same: tapes spun and whirred, lights blinked and questions and information appeared on the tiny cathode ray oscilloscope, blinking more with each added word – favoring terse phrasing. Patients responded using the keyboard and reports were printed on the 10 character per second teletype. It worked well, never tiring, going at the patient’s pace, presenting procedurally invariant questions and branching contingent on each response. Patients rapidly overcame any anxiety and read and pecked through the assessment, often commenting aloud as well.
“Patients preferred the computer interview to talking to a physician…the computer was more accurate than clinicians in predicting suicide attempts.”
Dr. Slack’s advocacy of patient-centered medicine remains persuasive: "It can be argued that the largest yet most neglected healthcare resource, worldwide, is the patient or the prospective patient."³
From this beginning, the field has grown to provide myriad direct patient-computer interviews and other applications, including therapies. Today's computer-based assessments continue to offer the advantages early innovators identified including a direct connection between patients and the computer; candor in both directions; presentation of subsequent questions contingent on patients’ answers; and consistent, invariant questioning by the computer that is impossible with clinicians.
Meret principals have advanced computerized assessment research and development at the University of Wisconsin, the Dean Foundation, and Healthcare Technology Systems (HTS). Over the years, we have developed, studied, and provided in clinical and research settings more than 50 computer interviews. These include computerized versions of primary efficacy measures and the electronic version of the Columbia-Suicide Severity Rating Scale (eC-SSRS) used in clinical trials that led to FDA approval of new medications.⁴-5
MERET Solutions was founded in 2016 to extend the benefits of more than 50 years of excellence in computer interviewing to clinical and educational settings where it would be most beneficial.
eC-SSRS offers the clearest signal regarding initial and ongoing suicide risk assessment: an essential element in reducing suicides.