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Results for “Medical Records Systems, Computerized”

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PubMed1985

A computerized summary medical record system can provide more information than the standard medical record.

We assessed the ability of a computerized outpatient medical record (MR) system, the Summary Time-Oriented Record (STOR), to communicate information to clinicians in two randomized single-blind studies. In the first study, physicians were better able to predict their patients' future symptom changes and laboratory test results from outpatient visits to an arthritis clinic when STOR was added to the standard MR than when the standard MR was used alone. In a separate study, the removal of the standard MR did not result in important decrease in the physicians' ability to predict their patients' symptoms and laboratory test results if they had the option of using the full paper record when they thought they needed it. In 134 (26%) of 514 visits, the physicians exercised this option. We conclude that for outpatient visits, the computerized record system STOR operationally added information to that supplied by the full paper MR. This improved flow of information could improve the clinical decision process.

Arthritis↗
PubMed2003

An inventory of publications on computer-based medical records: an update.

OBJECTIVES: In 1998, we reported a steady increase in the number of publications indexed in MedLine with the MeSH term 'Medical Records Systems, Computerized'. No signs indicating an increasing interest of high-impact medical journals to publish on the computer-based patient record could be determined. In this review we provide an update. METHODS: We retrieved and analyzed all English publications indexed before Feb 22, 2002 in PubMed with the MeSH term 'Medical Records Systems, Computerized'. RESULTS: We retrieved a total of 5856 publications, of which 1824 (31%) appeared in a journal with an impact factor in the year of publication. The total impact-score shows an upward trend. CONCLUSIONS: The results show that the earlier observed increase in number of publications did not persist in the second half of the nineteen-nineties. Since the mid-nineties, there has been a steady yearly production of publications indexed with the MeSH term, reflecting a sustained interest in the domain. However, the volume of publications appearing in journals with higher impact factors is increasing. Furthermore, high-impact journals, such as the "British Medical Journal", the "Lancet" and "Annals of Internal Medicine" regularly publish on the subject, reflecting an interest well beyond the medical informatics community.

Abstracting and Indexing↗
PubMedDate not supplied

Implementing information technology in a behavioral health setting.

The art and practice of nursing in today's health care arena is becoming increasingly complex. One of the newest challenges in the field of behavioral health is the integration of quality health care with information technology. The authors of this paper examine four emerging aspects of information technology: the electronic medical record, automated medication distribution systems, computerized charting, and hand-held computers. The benefits, costs, uses of these technologies, and the potential problems they can provide in the field of behavioral health are discussed. Implications for nursing practice also are explored.

Behavioral Medicine↗
PubMed1995

On content of practice. The advantage of computerized information systems in family practice.

BACKGROUND: Computerized medical records have been widely used in family practice in Iceland for several years. Extensive data have been accumulated; however, how best to use and implement these data has been debated. OBJECTIVES: The main objectives of this study was to determine the advantage of computerized information systems in family practice. MAIN RESULTS: The results provided broad epidemiological information on the content of family practice in Iceland. The study population consisted of 50,865 Icelanders and their 257,188 contacts with 17 community health centres over one whole year, 1988. Services were provided by 50 doctors, 43 nurses and nurses' assistants, and 7 midwives. Almost 90% of the rural population made at least one contact over the year of study; the mean rate of contacts per individual was 5.1, office visit 2.8-3.3, phone calls 1.1-1.6, and home-visits 0.4, females (40%) more often than males, increasing in number with increasing age. Disease symptoms were the reason for contact in 35-39% of cases, the initiative of the health care provider in 44-50%, and administration in 9-12%. The mean number of health problems recorded were 2.3 per individual per year. Extensive prevalence numbers are provided by age and sex. The largest categories were respiratory, injuries and musculoskeletal with a prevalence of over 200/1000 individuals per year. The most frequent contacts were made by persons with cancer and mental problems. The actions taken (processes) as a result of these contacts were numerous, an average of 1.6 per contact; 648 medications/1000 contacts, 141 laboratory tests, 126 surgical procedures, 15-24 referrals, and 15-26 hospital admissions. Prescriptions were most frequently for central nervous system medication (93-117/1000 contacts), for anti-infectives (100-106), and for cardiovascular (58-99). The cost of x-rays was shown to be $866 per 1000 contacts, and the odds for having an x-ray decreased by 18% for every 1000 individuals added to a practice. A quality study showed 16% of x-ray requests and 13% of office prescriptions were lacking. CONCLUSION: The information obtained reflects health problems of the population as observed by family doctors. The information is useful for observing and influencing the health of a nation, the practices of health care providers, the generation of cost in the health system, and the use of appropriate health services. It is also useful to health care planners and researchers, as well as educators of health care providers. This study serves as a baseline for these tasks.

Adolescent↗
PubMed1988

An unsuccessful experience with computerized medical records in an academic medical center.

Computerized medical records systems are used in only a small percentage of U.S. health care facilities, despite predictions that they would be widely used. The authors here report on their experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center. Although some equipment and computer resources were provided by the medical center, ongoing operations were financed by clinic revenues. After four months, use of the system was terminated because clinic revenues could not cover operating costs. The operating costs accounted for 17 percent of the average charge for an office visit. The major component of the operating costs was personnel expenses for data entry.

Academic Medical Centers↗
PubMed1996

Spreadsheet evaluation of computerized medical records: the impact on quality, time, and money.

Information and communication technologies are presumed to play a critical role in improving effectiveness and efficiency of clinical care. Although the most promising directions of technological development are microcomputer-generated computerized medical record systems, documenting their value has been a major challenge for health care providers. This paper proposes a 15-item spreadsheet instrument for evaluating computerized medical records, and demonstrates how it was experimentally applied to a 6-year long experience at three sites. In conclusion, preliminary implications and guidelines are drawn with regard to practice and research in this area.

Cost-Benefit Analysis↗
PubMedDate not supplied

Robo-Pill.

Explore the source record for details and available documents.

Computer User Training↗
PubMed1982

GENTIC: a computerized medical genetic case record system.

Gentic is a computerized system for the storage, recall, and analysis of data collected by the Medical Genetics Center in Marseille, France. It is based on a standard case report file that includes a full clinical description of all patients, results of cytogenetic investigations, and details of the genetic counseling provided. GENTIC has been used since 1975, and data on more than 5,000 families are accessible for study. This system has improved the quality of consultations, follow-up, and research. It provides data for epidemiological studies and for syndrome identification. This system is maintained at an annual cost of $3,000, salary costs not included, after an initial investment of $40,000.

Computers↗
PubMedDate not supplied

Design and implementation of an application and associated services to support interdisciplinary medication reconciliation efforts at an integrated healthcare delivery network.

Confusion about patients' medication regimens during the hospital admission and discharge process accounts for many preventable and serious medication errors. Many organizations have begun to redesign their clinical processes to address this patient safety concern. Partners HealthCare, an integrated delivery network in Boston, Massachusetts, has answered this interdisciplinary challenge by leveraging its multiple outpatient electronic medical records (EMR) and inpatient computerized provider order entry (CPOE) systems to facilitate the process of medication reconciliation. This manuscript describes the design of a novel application and the associated services that aggregate medication data from EMR and CPOE systems so that clinicians can efficiently generate an accurate pre-admission medication list. Information collected with the use of this application subsequently supports the writing of admission and discharge orders by physicians, performance of admission assessment by nurses, and reconciliation of inpatient orders by pharmacists. Results from early pilot testing suggest that this new medication reconciliation process is well accepted by clinicians and has significant potential to prevent medication errors during transitions of care.

Clinical Pharmacy Information Systems↗
PubMed1999

Perinatal computerized patient record and archiving systems: pitfalls and enhancements for implementing a successful computerized medical record.

Interest in purchasing and installing a perinatal computerized patient record (CPR) and archiving system is growing in the United States as a result of increased patient satisfaction demands, cost containment, and quality improvement. Perinatal nurses are commonly charged with researching available computer software and hardware, making purchasing decisions, developing menus and forms, orienting users, and maintaining and upgrading systems. The decision to chart and archive by computer as well as installation and maintenance issues mandate that nurses increase their computer-related knowledge. The article reviews information related to CPR capabilities and rationales for purchase decisions, implementation and staff development issues, ergonomic and maintenance considerations, and realistic expectations of a CPR to provide perinatal nurses who are involved in purchasing, implementing, and maintaining these systems with a timely understanding of important elements that they need to know to make this effort successful.

Archives↗
PubMed1995

Handling controlled substances: upgrading the system.

To provide safe patient care and to meet legal standards, an automated medstation replaced the manual controlled substances system. Using the medstation streamlines documentation, captures patient charges and reduces floor stock's inventory carrying charges.

Drug and Narcotic Control↗