The development and implementation of a computerized on‐line obstetric record

Gonzalez, Frederick A.; Fox, H.

doi:10.1111/j.1471-0528.1989.tb03231.x

Cited by 12 publications

(4 citation statements)

References 9 publications

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“…(21, 22) However, only recently have there been calls for increased uptake of EMRs within obstetrics. In fact, many features of obstetric care, including standardized protocols, make it particularly appropriate for EMR adoption.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Study of Gestational Weight Gain Counseling and Tracking

Oken

Switkowski

Price

et al. 2012

Matern Child Health J

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Objectives Excessive gestational weight gain (GWG) predicts adverse pregnancy outcomes and later obesity risk for both mother and child. Women who receive GWG advice from their obstetric clinicians are more likely to gain the recommended amount, but many clinicians do not counsel their patients on GWG, pointing to the need for new strategies. Electronic medical records (EMRs) are a useful tool for tracking weight and supporting guideline-concordant care, but their use for care related to GWG has not been evaluated. Methods We performed in-depth interviews with 16 obstetric clinicians from a multi-site group practice in Massachusetts that uses an EMR. We recorded, transcribed, coded, and analyzed the interviews using immersion-crystallization. Results Many respondents believed that GWG had “a lot” of influence on pregnancy and child health outcomes but that their patients did not consider it important. Most indicated that excessive GWG was a big or moderate problem in their practice, and that inadequate GWG was rarely a problem. All used an EMR feature that calculates total GWG at each visit. Many were enthusiastic about additional EMR-based supports, such as a reference for recommended GWG for each patient based on pre-pregnancy body mass index, a “growth chart” to plot actual and recommended GWG, and an alert to identify out-of-range gains, features which many felt would remind them to counsel patients about excessive weight gain. Conclusion Additional decision support tools within EMRs would be well received by many clinicians and may help improve the frequency and accuracy of GWG tracking and counseling.

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Section: Discussionmentioning

confidence: 99%

A Qualitative Study of Gestational Weight Gain Counseling and Tracking

Oken

Switkowski

Price

et al. 2012

Matern Child Health J

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“…In 1986 Gonzalez and Fox [ 67 ] at the Columbia University College of Physicians and Surgeons implemented a complete computer-based obstetrics record. All patient encounters were recorded directly into the system by the health care providers; all of the information was stored in the computer and was available in real time.…”

Section: Obstetrics and Gynecologymentioning

confidence: 99%

Information Systems for Clinical Subspecialties

Collen¹,

Lorenzi

2015

Health Informatics

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Some of the earliest applications of computers in clinical medicine were in the clinical subspecialties, including cardiology, pulmonary, nephrology, gastroenterology, pediatrics, and the surgical sciences. But health professionals found these prototypes diffi cult to use; data entry devices were awkward and ineffi cient, and order entry functions were often not integrated. Each information system for a clinical subspecialty (ISCS) evolved differently, with its own specialized functional and technical requirements. In the 1960s mainframe computers were limited in their ability to meet all the processing requirements of all the ICSCs in a large hospital. By the 1970s each ISCS could have its own minicomputer-based system linked directly to the central mainframe. Health care professionals used terminals connected to the central computer to enter orders and to receive test results; the central computer transferred the orders to the appropriate ISCS subsystems and integrated the data coming back from the ISCSs into the patients' records stored in the mainframe computer. In the 1980s local area networks linked multiple lower-cost minicomputers; with distributed minicomputers and interactive visual display terminals, clinicians could begin to benefi t from the ISCSs in direct patient care and each ISCS could develop its own system to meet its own requirements. In the 1990s distributed information systems allowed physicians to enter orders and retrieve test results using clinical workstations connected to client-server minicomputers in the local area network that linked the entire hospital, and patient data from all of the distributed ISCS databases were integrated in a computer-based patient record.

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“…Computerization of clinical data can provide important benefits (Gonzalez & Fox 1989) but there are several significant problems (Table 1).…”

Section: Benefits and Difficulties In The Computerization Of Clinicalmentioning

confidence: 99%

Computerization of a colposcopy clinic

Soutter

1991

BJOG

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Summary. The first phase of a paperless computer record has been developed at Hammersmith Hospital. The system was designed around the work practices of the clinic staff. In this phase the data are collected on forms which replace the normal case notes. This information is entered onto an IBM compatible computer by the secretary using a quick, user‐friendly program written in a dBASE dialect and compiled with Quicksilver. The program produces letters to patients and their doctors and a printed record of the clinic findings for the case sheet to replace the handwritten form. When funding for hardware becomes available the data will be entered directly into the system by the medical staff in the clinic. Clinic appointment lists are maintained and patients ‘lost to follow‐up’ can be identified. Ad hoc enquiries can be made using dBASE III Plus or any similar program. This approach has integrated the computerized recording of data in a colposcopy clinic with the normal work of the staffinvolved so that no extra effort is required from medical or secretarial staff. The immediate accessibility of patient data and the ability to audit the work of the clinic have been particularly useful.

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The development and implementation of a computerized on‐line obstetric record

Cited by 12 publications

References 9 publications

A Qualitative Study of Gestational Weight Gain Counseling and Tracking

A Qualitative Study of Gestational Weight Gain Counseling and Tracking

Information Systems for Clinical Subspecialties

Computerization of a colposcopy clinic

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