Yearb Med Inform 1995; 04(01): 55-60
DOI: 10.1055/s-0038-1638020
Review Paper
Georg Thieme Verlag KG Stuttgart

Countdown to 2001: The Computer-based Patient Record After the Institute of Medicine Report

D. E. Detmer
1   University of Virginia, Health Sciences Center, Charlottesville VA, USA
,
E. B. Steen
1   University of Virginia, Health Sciences Center, Charlottesville VA, USA
› Author Affiliations
Further Information

Address of the authors:

D. E. Detmer, E.B. Steen
University of Virginia
Health Sciences Center
Health Sciences Center Box 179
Charlottesville, Virginia 22908
USA

Publication History

Publication Date:
05 March 2018 (online)

 

Abstract:

A 1991 Institute of Medicine report called computer-based patient records (CPRs) an essential technology for health care and recommended widespread implementation of CPRs within a decade. Although a broader understanding of CPRs has been achieved and more leadership for CPR development exists today, substantial work remains to be accomplished. Critical tasks include developing a detailed specification of the CPR concept, strengthening standards development efforts through greater federal funding and involvement, developing national policy on key issues, and identifying funding sources for CPR system implementation. This article reviews the major views and issues of the 1991 IOM report and relates them to subsequent developments.


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  • References

  • 1 Institute of Medicine. Dick RS, Steen EB. eds. The Computer-based Patient Record: An Essential Technology for Health Care . Washington, DC: National Academy Press; 1991
  • 2 Institute of Medicine. Field MJ, Lohr KN, Yordy KD. eds. Assessing Health Care Reform . Washington, DC: National Academy Press; 1993
  • 3 U.S. House of Representatives. HR 1200: American Health Security Act. 1993
  • 4 Shortliffe EH. Health care professional workstations: Where are we now? ... Where should we be tomorrow?. Int J Biomed Comp 1994; 34: 45-55.
  • 5 Bergman R. Where there’s a will ... Computer-based patient records require commitment, time and money. Hospitals and Health Networks 1994. May 36-42.
  • 6 Levesque G. 1994 HIMSS/Hewlett Packard leadership survey results. Healthcare Informatics 1994. July 44-8.
  • 7 U.S. General Accounting Office. Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care . Washington, DC: General Accounting Office; 1991
  • 8 Rind DM, Safran C. Real and imagined barriers to an electronic medical record. In: Safran C. ed. Proceedings of the Seventeenth Annual Symposium on Computer Applications in Medical Care. . New York: McGraw-Hill; 1993: 74-8.
  • 9 Work Group on Computerization of Patient Records. Report to the Secretary, U.S. Department of Health and Human Services. Toward a national health information infrastructure. 1993
  • 10 Bakker A, Hammond WE, Ball MJ. Summary Report of Observations, Conclusions, and Recommendations: IMIA Working Group 10 Hospital Information Systems . 1994
  • 11 Hammond WE. Hospital information systems: a review in perspective. In: Van Bemmel JH, McCray AT. eds. Yearbook of Medical Informatics: Advanced Communications in Health Care. Stuttgart: Schattauer Verlag; 1994: 95-102.
  • 12 Institute of Medicine. Donaldson MS, Lohr KN. eds. Health Data in the Information Age: Use, Disclosure, and Privacy . Washington, DC: National Academy Press; 1994
  • 13 Institute of Medicine. America’s Health in Transition: Protecting and Improving Quality . Washington, DC: National Academy Press; 1994
  • 14 Rector AL, Nowlan WA, Kay S. Foundations for an electronic medical record. Meth Inform Med 1991; 30: 179-86.
  • 15 Computer-based Patient Record Institute, CPR Systems Evaluation Work Group. Draft CPR Project Evaluation Criteria (version 1.0): The Nicholas E. Davies Recognition Program. Schaumburg, IL: Computer-based Patient Record Institute; 1994
  • 16 Tang PC, Fafchamps D, Shortliffe EH. Traditional medical records as source of clinical data in the outpatient setting. In: Ozbolt JG. ed. Proceedings of the Eighteenth Annual Symposium on Computer Applications in Medical Care. . Philadelphia: Hanley & Belfus; 1994: 575-9.
  • 17 Tierney WM, Miller ME, Overhage JM, McDonald CJ. Physician inpatient . order writing on microcomputer workstations: effects on resource utilization. JAMA 1993; 269: 379-83.
  • 18 Evans RS, Pestotnik SL, Classen DC, Horn SD, Bass SD, Burke JP. Preventing adverse drug events in hospitalized patients. Ann Pharmacother 1994; 28: 523-7.
  • 19 Borowitz SM. Using a computerized patient record to reengineer an outpatient clinic. In: Ozbolt JG. ed. Proceedings of the Eighteenth Annual Symposium on Computer Applications in Health Care. . Philadelphia: Hanley & Belfus; 1994: 286-90.
  • 20 Borzo G. Physicians who computerize save on liability premiums. American Medical News February 1995
  • 21 Carpenter PC. The electronic medical record: perspective from Mayo Clinic. Int J Biomed Comp 1994; 34: 159-71.
  • 22 Wykes A. Automating health care. Economist 1994; 330: 885-887.
  • 23 Churgin PG. Introduction of an automated medical record at an HMO clinic. MD Comput 1994; 11: 293-300.
  • 24 vander Lei J, Duisterhour JS, Westerhof HP, van der Does E, Cromme PVM, Boon WM, van Bemmel JH. The introduction of computer-based patient records in the Netherlands. Ann Intern Med 1993; 19: 1036-41.
  • 25 Miller G, Britt H. Data collection and changing health care systems. Med J Australia 1993; 159: 471-6.
  • 26 Duncan K. Health Information and Health Reform: Understanding the Need for a National Health Information System . San Francisco: Jossey-Bass Publishers; 1994
  • 27 Berwick OM. Eleven worthy aims for clinical leadership of health system reform. JAMA 1994; 272: 797-802.
  • 28 Weed LL. New premises and new tools for medical care and medical education. Meth Inform Med 1989; 28: 207-14.
  • 29 Essin DJ. Intelligent processing of loosely structured documents as a strategy for organizing electronic health care records. Meth Inform Med 1993; 32: 265-8.
  • 30 Collen MF. The use of documents for computer-based patient records. Meth Inform Med 1993; 32: 269
  • 31 Rector AL. Marking Up is not enough. Meth Inform Med 1993; 32: 272-3.
  • 32 Barnett GO, Jenders RA, Chueh HC. The computer-based clinical record – where do we stand? Editorial comment. Ann Int Med 1993; 119: 1046-8.
  • 33 Silva JS and Ball MJ. The professional workstation as enabler: conference recommendations. Int J Biomed Comp 1994; 34: 3-10.
  • 34 Heller E. What is HOST and how does it relate to CPRI?. CPRI-MAIL 1994; 3: 2-3.
  • 35 Lindberg DAB. Global information infrastructure. Int J Biomed Comp 1994; 34: 13-9.
  • 36 Gaus C. Remarks of address at CPRI fall meeting. CPRI-MAIL 1994; 3: 9-11.
  • 37 Hudson T. Military maneuvers: DoD moves ahead with integrated clinical records. Hospitals 1993; 67: 28-9.
  • 38 Hubbell PJ. The pharmacy as part of an integrated hospital information system: a focus on benefits. Hosp Pharm 1994; 29: 440-1. 445-6, 468
  • 39 Tang PC, Patel VL. Major issues in user interface design for health professional workstations: summary and recommendations. Int J Biomed Comp 1994; 34: 139-48.
  • 40 U.S. General Accounting Office. Automated Medical Records: Leadership Needed to Expedite Standards Development. Washington, DC: General Accounting Office; 1993
  • 41 van Bemmel JH. A model for the assessment of medical workstations for health care support. Int J Biomed Comp 1994; 34: 365-71.

Address of the authors:

D. E. Detmer, E.B. Steen
University of Virginia
Health Sciences Center
Health Sciences Center Box 179
Charlottesville, Virginia 22908
USA

  • References

  • 1 Institute of Medicine. Dick RS, Steen EB. eds. The Computer-based Patient Record: An Essential Technology for Health Care . Washington, DC: National Academy Press; 1991
  • 2 Institute of Medicine. Field MJ, Lohr KN, Yordy KD. eds. Assessing Health Care Reform . Washington, DC: National Academy Press; 1993
  • 3 U.S. House of Representatives. HR 1200: American Health Security Act. 1993
  • 4 Shortliffe EH. Health care professional workstations: Where are we now? ... Where should we be tomorrow?. Int J Biomed Comp 1994; 34: 45-55.
  • 5 Bergman R. Where there’s a will ... Computer-based patient records require commitment, time and money. Hospitals and Health Networks 1994. May 36-42.
  • 6 Levesque G. 1994 HIMSS/Hewlett Packard leadership survey results. Healthcare Informatics 1994. July 44-8.
  • 7 U.S. General Accounting Office. Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care . Washington, DC: General Accounting Office; 1991
  • 8 Rind DM, Safran C. Real and imagined barriers to an electronic medical record. In: Safran C. ed. Proceedings of the Seventeenth Annual Symposium on Computer Applications in Medical Care. . New York: McGraw-Hill; 1993: 74-8.
  • 9 Work Group on Computerization of Patient Records. Report to the Secretary, U.S. Department of Health and Human Services. Toward a national health information infrastructure. 1993
  • 10 Bakker A, Hammond WE, Ball MJ. Summary Report of Observations, Conclusions, and Recommendations: IMIA Working Group 10 Hospital Information Systems . 1994
  • 11 Hammond WE. Hospital information systems: a review in perspective. In: Van Bemmel JH, McCray AT. eds. Yearbook of Medical Informatics: Advanced Communications in Health Care. Stuttgart: Schattauer Verlag; 1994: 95-102.
  • 12 Institute of Medicine. Donaldson MS, Lohr KN. eds. Health Data in the Information Age: Use, Disclosure, and Privacy . Washington, DC: National Academy Press; 1994
  • 13 Institute of Medicine. America’s Health in Transition: Protecting and Improving Quality . Washington, DC: National Academy Press; 1994
  • 14 Rector AL, Nowlan WA, Kay S. Foundations for an electronic medical record. Meth Inform Med 1991; 30: 179-86.
  • 15 Computer-based Patient Record Institute, CPR Systems Evaluation Work Group. Draft CPR Project Evaluation Criteria (version 1.0): The Nicholas E. Davies Recognition Program. Schaumburg, IL: Computer-based Patient Record Institute; 1994
  • 16 Tang PC, Fafchamps D, Shortliffe EH. Traditional medical records as source of clinical data in the outpatient setting. In: Ozbolt JG. ed. Proceedings of the Eighteenth Annual Symposium on Computer Applications in Medical Care. . Philadelphia: Hanley & Belfus; 1994: 575-9.
  • 17 Tierney WM, Miller ME, Overhage JM, McDonald CJ. Physician inpatient . order writing on microcomputer workstations: effects on resource utilization. JAMA 1993; 269: 379-83.
  • 18 Evans RS, Pestotnik SL, Classen DC, Horn SD, Bass SD, Burke JP. Preventing adverse drug events in hospitalized patients. Ann Pharmacother 1994; 28: 523-7.
  • 19 Borowitz SM. Using a computerized patient record to reengineer an outpatient clinic. In: Ozbolt JG. ed. Proceedings of the Eighteenth Annual Symposium on Computer Applications in Health Care. . Philadelphia: Hanley & Belfus; 1994: 286-90.
  • 20 Borzo G. Physicians who computerize save on liability premiums. American Medical News February 1995
  • 21 Carpenter PC. The electronic medical record: perspective from Mayo Clinic. Int J Biomed Comp 1994; 34: 159-71.
  • 22 Wykes A. Automating health care. Economist 1994; 330: 885-887.
  • 23 Churgin PG. Introduction of an automated medical record at an HMO clinic. MD Comput 1994; 11: 293-300.
  • 24 vander Lei J, Duisterhour JS, Westerhof HP, van der Does E, Cromme PVM, Boon WM, van Bemmel JH. The introduction of computer-based patient records in the Netherlands. Ann Intern Med 1993; 19: 1036-41.
  • 25 Miller G, Britt H. Data collection and changing health care systems. Med J Australia 1993; 159: 471-6.
  • 26 Duncan K. Health Information and Health Reform: Understanding the Need for a National Health Information System . San Francisco: Jossey-Bass Publishers; 1994
  • 27 Berwick OM. Eleven worthy aims for clinical leadership of health system reform. JAMA 1994; 272: 797-802.
  • 28 Weed LL. New premises and new tools for medical care and medical education. Meth Inform Med 1989; 28: 207-14.
  • 29 Essin DJ. Intelligent processing of loosely structured documents as a strategy for organizing electronic health care records. Meth Inform Med 1993; 32: 265-8.
  • 30 Collen MF. The use of documents for computer-based patient records. Meth Inform Med 1993; 32: 269
  • 31 Rector AL. Marking Up is not enough. Meth Inform Med 1993; 32: 272-3.
  • 32 Barnett GO, Jenders RA, Chueh HC. The computer-based clinical record – where do we stand? Editorial comment. Ann Int Med 1993; 119: 1046-8.
  • 33 Silva JS and Ball MJ. The professional workstation as enabler: conference recommendations. Int J Biomed Comp 1994; 34: 3-10.
  • 34 Heller E. What is HOST and how does it relate to CPRI?. CPRI-MAIL 1994; 3: 2-3.
  • 35 Lindberg DAB. Global information infrastructure. Int J Biomed Comp 1994; 34: 13-9.
  • 36 Gaus C. Remarks of address at CPRI fall meeting. CPRI-MAIL 1994; 3: 9-11.
  • 37 Hudson T. Military maneuvers: DoD moves ahead with integrated clinical records. Hospitals 1993; 67: 28-9.
  • 38 Hubbell PJ. The pharmacy as part of an integrated hospital information system: a focus on benefits. Hosp Pharm 1994; 29: 440-1. 445-6, 468
  • 39 Tang PC, Patel VL. Major issues in user interface design for health professional workstations: summary and recommendations. Int J Biomed Comp 1994; 34: 139-48.
  • 40 U.S. General Accounting Office. Automated Medical Records: Leadership Needed to Expedite Standards Development. Washington, DC: General Accounting Office; 1993
  • 41 van Bemmel JH. A model for the assessment of medical workstations for health care support. Int J Biomed Comp 1994; 34: 365-71.