The Ambulatory Medical Record project at Group Health Cooperative

Payne, Thomas H.; Murphy, Gretchen; Wagner, Edward H.

doi:10.1097/00004479-199207000-00005

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Development efforts for an EMR for in‐patient as well as ambulatory settings have been underway in a few committed institutions for more than two decades [6,15,25–28]. The experience has thus far resulted in notable successes and failures [29–32]. Commercial attempts at implementing ICU “patient data management systems” began in the late 1970s, and approximately 250 systems were installed nationwide, but only 6 to 10% were routinely used to chart patient data [33].…”

Section: Goals For the Electronic Medical Record In The Intensive Cmentioning

confidence: 99%

“…Physicians are a troublesome source of data [80], and even techniques from the field of anthropology have been used to study use of information in physician decision‐making [81]. A few experienced computer system architects have found physician progress notes to have “insufficient structure” to be readily made part of an EMR [26,32]. One study showed that physicians used as many as 236 categories of information in evaluating ICU patients [34].…”

Section: Physician Progress Notes and Structured Reportsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Information Systems for Intensive Care, Pediatric Critical Care, and Neonatology

Jose

Adler

Keyes

et al. 1997

J Intensive Care Med

View full text Add to dashboard Cite

Computer information systems are expected to soon take the place of current paper charting practices, and they offer great promise to assist management of the considerable amounts of data encountered in the information‐rich environment of intensive care units (ICUs). Efforts to create an electronic medical record (EMR) have been underway for more than two decades, and major national organizations, such as the Institute of Medicine, have issued recommendations on standards. Benefits of an EMR include a legible patient record, enhanced communication, provision of timely reminders and alerts to clinicians, reduction of calculation errors, access to data bases for quality assurance and research, reduced healthcare costs, and improved patient outcomes. Despite these benefits, successful EMR implementations have been confined to a few committed institutions, and expensive failures have occurred. Practitioners of neonatology and pediatric intensive care are likely to have substantial difficulty implementing an EMR to fit their specialized needs because most experience in this area has been gained through care of adult patients, and systems being developed are oriented toward nonpediatric patients. It is therefore important to examine experience thus far with the functional components of an EMR so practitioners will be able to evaluate systems better as they become available. System components discussed include nursing charting facilities, lab reporting, physician order entry, physician progress notes, structured reports, decision support systems, and problem list management. Other concerns discussed include research and quality assurance functions, data access and confidentiality issues, and electronic mail. Maximizing the “structured data” content, as opposed to narrative content of an EMR, is an important priority, and progress on developing a uniform medical language is discussed. An approach to evaluating clinical information systems for use in the ICU is presented; it should assist practitioners of pediatric critical care and neonatology in identifying computer‐based charting solutions that are optimal for infants and children, while cooperating with medical center‐wide needs for compatibility and a common data base.

show abstract

Section: Goals For the Electronic Medical Record In The Intensive Cmentioning

confidence: 99%

Section: Physician Progress Notes and Structured Reportsmentioning

confidence: 99%