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Biomedical subjects

B H Starfield

Publications and source records attributed to B H Starfield.

23 records · Page 2Linked to original sources
PubMed1977

A minirecord: an aid to continuity of care.

A simple, low cost computerized minirecord system (minimal essential record) has been in full operation for two years in the Medical Clinic of The Johns Hopkins Hospital. The primary objective of the minirecord system is to permit rapid retrieval of current information concerning Medical Clinic patients. The system provides a computer-printed listing of problems and medications in the front of each chart and on-line display of this information at strategically located computer terminals. The information is generated via existing simple systems with minimal additional effort and with the use of any terminology deemed appropriate. Chart review revealed that minirecords were actually present in 92% of the charts and that significant improvement occurred in the recognition of a subsequent visit of clearly defined problems and therapies noted on the initial minirecord. Current modifications will replace the separate minirecord and encounter form (registration and visit note) with a single form that will facilitate completion an updating. The rapid availability of this information provides a mechanism for coordinating continuing care in a university hospital system that is otherwise inevitably fragmented and composed of multiple health care providers.

Comprehensive Health Care↗
PubMed1976

Continuity and coordination in primary care: their achievement and utility.

Coordination is a hallmark of primary care. Efforts to improve primary care services should involve assessment of the extent to which coordination is achieved. Our study in three adult and three pediatric clinics demonstrates that existing information concerning patients' problems, therapies, tests, and referrals is often not recognized by primary care practitioners. Recognition of these types of information is better when the practitioner who provides follow-up care is the same from one visit to the next. Information about visits which were anticipated by the practitioner, and particularly the content of these visits, is often neglected. The largest deficit, however, is in recognition of both the occurrence and content of visits unanticipated by the primary care practitioner. Greater efforts to achieve better coordination of care, by improving either continuity of practitioner, communication among practitioners, or the information system, are required before this essential element of primary care becomes a reality.

Adult↗
PubMed1976

Information factors affecting problem follow-up in ambulatory care.

The influence of information factors on the follow-up of patient problems was studied in six ambulatory clinics providing primary patient care. By means of chart review, the encounter notes were examined for two consecutive visits to the same clinic to determine problems identified at the first visit and detect evidence of follow-up of these problems at the second visit. In those clinics using a problem list, at the front of the chart, those problems on the problem list had a higher follow-up rate than those not on the list particularly at longer intervals between patient visits. An encounter note written in the problem-oriented format did not enhance follow-up. Since information factors as well as clinical factors affect the follow-up of patient problems these factors must be carefully considered when designing information systems to serve ambulatory care.

Adult↗