Computer Support of Medical Decisions in Ambulatory Care

Decision makers in health care systems are giving greater emphasis to ambulatory care because of its recognized magnitude (in terms of volume of services rendered) and its potential cost-effectiveness. A challenge to computer scientists is to develop and evaluate computer support systems for ambulatory care professionals at each one of several critical decision points of the care process. These decision points may be at the level of interaction between patient and physician at the time of each encounter, or at the institutional level where the effect is on the setting in which ambulatory care is delivered.

Early experiences of computer applications in ambulatory medicine are helping to delineate areas where there is promise of widespread implementation. One of these areas is the computerization of summary ambulatory medical records such as the health-illness profile. This document serves the dual purpose of facilitating medical decisions at the time of each patient encounter, and administrative decisions made by the clinic directors to meet the health needs of the community.

Die für Entscheidungen in Gesundheitsversorgungssystemen Verantwortlichen messen der ambulanten Versorgung aufgrund ihrer anerkannten Größe (Ausmaß der geleisteten Dienste) und ihres potentiellen Kosten-Nutzen-Verhältnisses immer mehr Bedeutung bei. Die Computer-Wissenschaftler sind aufge-fordert, Computer-Unterstützungssysteme für die ambulante Patientenversorgung in jedem kritischen Entscheidungspunkt des Versorgungsprozesses zu entwickeln und zu bewerten. Diese Entscheidungspunkte können auf der Ebene des Kontaktes zwischen Arzt und Patient bei jeder Konsultation liegen oder auf institutioneller Ebene dort, wo die Wirkung auf das Milieu erfolgt, in dem die ambulante Versorgung erteilt wird.

Früher gesammelte Erfahrungen beim Einsatz des Computers in der ambulanten Medizin können helfen, die Gebiete für eine erfolgversprechende, weitgespannte Anwendimg abzustecken. Ein solches Anwendungsgebiet ist die computergerechte Verarbeitung von ambulanten Krankenpapieren, wie z.B. des Gesundheits-Krankheits-Profils. Dieses Schriftstück dient sowohl der Erleichterung ärztlicher Entscheidungen bei jeder Konsultation als auch der Erleichterung administrativer Entscheidungen der Klinikdirektoren bezüglich erforderlicher Maßnahmen zur Gesunderhaltung der Bevölkerung.

Keywords

Data Bases - Computer Systems - Ambulatory Record - Decision Algorithms - Health-Illness-Profile

Schlüsselwörter

Dateien - Computer-Systeme - ambulante Krankenpapiere - Entscheidungsalgorithmen - Gesundheits-Krankheits-Profil

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