Functional Characteristics of a Computerized Medical Record

Research-based clinical information systems are presently being developed. This paper discusses some characteristics which such systems must have to be successful and affordable outside the research world. Problems of data entry, verification, and correction must be dealt with. Programs must be bug-free, and provisions must be made for data protection and integrity, for growth of record files, and for the ultimate purging of those files.

Functional characteristics of a computerized medical record — TMR — developed at Duke University are presented, based on three health care facilities : the University Health Services Clinic with an active file of 33,000 patients; the Renal Dialysis Unit of the Durham Veterans Hospital with an active file of 300 patients; and the Department of Obstetrics and Gynecology with an active file of 7,000 patients. These functional characteristics include the rate of growth of files, the length of various components of the record, the type and length of program modules, and various system function response times.

Gegenwärtig werden auf Forschung gegründete klinische Informationssysteme entwickelt. In dieser Arbeit werden einige Charakteristika erörtert, die derartige Systeme haben müssen, um außerhalb der Welt der Forschung erfolgreich und erschwinglich zu sein. Probleme der Dateneingabe, Verifizierung und Verbesserung müssen behandelt werden. Die Programme müssen fehlerfrei sein, und es müssen Vorkehrungen für den Schutz und die Integrität der Daten, für das Anwachsen des Krankenblatt-bestandes und letztlich für dessen Bereinigung getroffen werden.

Funktionale Charakteristika eines automatisierten Krankenblattes — TMR —, entwickelt an der Duke University, werden dargestellt, und zwar auf der Grundlage von drei medizinischen Einrichtungen: der University Health Services Clinic mit einem aktiven Bestand von 33.000 Patienten, dem Renal Dialysis Unit des Durham Veterans Hospital mit einem aktiven Bestand von 300 Patienten und dem Department of Obstetrics and Gynecology mit einem aktiven Bestand von 7.000 Patientinnen. Zu diesen funktionalen Charakteristika gehören die Wachstumsrate des Bestandes, die Länge der verschiedenen Komponenten des Krankenblattes, die Art und Länge der Programm-Moduln und die verschiedenen Antwortzeiten des Systems.

Key-Words:

Medical Database - Computerized Medical Record - GEMISCH - Clinical Information System

Schlüssel-Wörter:

Medizinische Datenbank - Automatisiertes Krankenblatt - GEMISCH - Klinisches Informationssystem

• References

• 1 Beaman P. D, Justice N. S, Barnett G. O. A Medical Information System and Data Language for Ambulatory Practices. Computer 1979; 12: 9-17.
• 2 Pries J. P, Mcshane D. ARAMIS : A National Chronic Disease Data Bank System. Proc. Third Annual Symposium on Computer Application in Medical Care, Washington, D.C., October 1979. New York: IEEE; 1979: 798-801.
• 3 Gleser M, Young G, Woods D. A Database Built upon the Medical Event Vector. Meth. Inform. Med 1979; 18: 131-137.
• 4 Hammond W. E, Brantley B. A, Feagin S. J, Lloyd S. C, Stead W. W, Walter E. L. GEMISCH — a Minicomputer Information Support System. Proc. IEEE 1973; 61: 1575-1583.
• 5 Hammond W. E, Stead W. W, Feagin S. J, Brantley B. A, Straube M. J. Database Management System for Ambulatory Care. Proc. First Annual Symposium on Computer Application in Medical Care, Washington, D.C., October 1977. 173-188. New York: IEEE; 1977
• 6 Hammond W. E, Stead W. W, Straube M. J, Collins J. D. Experiences in the Development of an Ambulatory Care Medical Information System. Third USA—Japan Computer Conference, San Francisco, October 1978. Baltimore, Md.: AFIPS; 1978: 452-456.
• 7 Hammond W. E, Walter E. L, Brantley B. A, Feagin S. J, Stead W. W. Evolution of a Minicomputer Information System. COMPCON 75 Spring. Computer Technology to Reach the People. Digest of Papers New York: IEEE; 1975: 237-239.
• 8 Mcdonald C. J. et al. The Regenstrief Medical Record System. Proc. First Annual Symposium on Computer Application in Medical Care, Washington, D.C., October 1977. New York: IEEE; 1977: 168-172.
• 9 Thompson H. K, Mabry J. C. et al. User Experience with a Prototype Data Management and Analysis System for Clinical Investigators (CLINPO). Proc. Third Illinois Conference on Medical Information Systems. 1977: 21-28.
• 10 Vallbona O, Spencer W. A. et al. The Patient Care Centered Information System of the Texas Institute for Rehabilitation and Research. In Collen M. F. (Edit.): Proc. Int. Conf. on Technology and Health Care Systems in the 1980’s Springfield, Va.: Nat. Techn. Inform. Serv; 1973
• 11 Walton P. L, Holland R. R, Wolf L. I. Medical Guidance and PROMIS. Computer 1979; 12: 19-27.
• 12 Wirtschafter D. D, Scalise M. et al. Clinical Algorithms in a Co-operative Multi-institutional Clinical Trial. Proc. Fourth Illinois Conference on Medical Information Systems. 1978: 62-74.