Dick RS, Steen EB, Detmer DE eds. The Computer-Based Patient Record: An Essential Technology for Health Care. National Academies Press, 1991.  Home/Search   Document Not in Database   Summary   Related Articles   Check

....overshadowed by massive centralization efforts: solutions that fetch all the data from multiple systems to one site and build an integrated copy of the databases there. In document retrieval on the web, this is achieved by web crawlers [5] and in relational databases by data warehousing tools [1]. It has seemed, to date, that the technical and political ability to centralize data into traditional IT architectures has outweighed the promise and capabilities of decentralized query solutions. One reason for this is that the distributed query tools have been relatively evolutionary: they ....

.... System 11 Structured Data Entry in a Workflow enabled Electronic Patient Record Charles Webster, MD, MSIE, MSIS John Copenhaver, MD Direct data entry by the physician is key to a successful electronic patient record (EPR) as noted in a well known Institute of Medicine study [1]. Approaches to direct data entry include typing, speech recognition, and structured data entry (SDE) Typing is not an efficient use of physician time since most physicians are not fast typists; speech recognition has not yet been perfected to the point that speakers do not have to proof ....

Dick, R.S., Steen, E.B., Detmer, D.E., eds. The computer-based patient record: an essential technology for health care. Revised Edition. Institute of Medicine, National Academy Press, 1997

....Mathematical Research Institute. 6 Description of the Proposed Research 6. 1 Problem description As soon as Computer based Patient Record systems (CPRs ) are introduced into clinical practice, huge amounts of biomedical data will be collected and thus become available for exploitation [20, 24, 54]. The main goal of introducing the CPR is to improve the quality, e#ciency and coste #ectiveness of the care process. However, it is hard to imagine how this can be brought about without o#ering CPR integrated facilities for computer based medical decision support at the same time. Given the ....

R.S. Dick, et al. The Computer-Based Patient Record: An essential technology for health care. National Academy Press, Washington, DC, 1991

....to optimize coordinated healthcare. Discussion What role does the health record play in Medical Work The health record is often described as a repository of information ; as a log representing the work performed and often it is suggested that the current paper record fulfills this role poorly [1, 3]. The health record is a tool, and a crucial one at that, aiding memory, communication, and so forth but it is not a mirror of that work. It dies not represent the work, but it feeds into it, it structures and transforms it in complex ways: it structures the communication between healthcare ....

Dick R, Steen E. (1991): The Computer-Based Patient Record: An Essential Technology for health Care, (Washington, D. C.: National Academy Press).

....competitive environment. In the past, administrative and financial data were the major elements required for such planning, but this is no longer the case. Furthermore, the inefficiencies and frustrations associated with the use of paper based medical records have become increasingly clear [1], especially when inadequate access to clinical information is one of the principal barriers that clinicians encounter when trying to increase their efficiency in order to meet productivity goals for their practices. Electronic Health Records: Anticipating the Future Many health care ....

....organization as an off the shelf product. Joint development is crucial. The Medical Record and Clinical Trials The arguments for automating medical records are well known to the Medinfo audience and are nicely summarized in the Institute of Medicine s report on computer based patient records [1]. One argument that warrants emphasis is the importance of the electronic record in supporting clinical trials. We are constrained today by a terribly clumsy method for acquiring the data needed for clinical trials, generally relying on manual capture of information onto datasheets that are later ....

Dick R, Steen E, eds. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, D.C.: Institute of Medicine, National Academy Press, 1991.

....patient record that Chapter Eight Glossary CPRI Toolkit 8 8 Revision: October 2, 1999 resides in a system specifically designed to support users through availability of complete and accurate data, alerts, reminders, clinical decision support systems, links to medical knowledge, and other aids. [Dick and Steen, 1991] Electronically maintained information from all sources about an individual s lifetime health status and health care, replacing the paper medical record as the primary record of care, meeting all clinical, legal, and administrative requirements and providing added value in supporting decisions ....

....computer and system security. National Research Council, 1991] Key: An input that controls the transformation of data by an encryption algorithm. National Research Council, 1991] Longitudinal lifetime patient record: The concept of access to health information across an individual s lifetime. [Dick and Steen, 1991] A permanent, coordinated record of significant information, in chronological sequence. It may include all historical data collected or be retrieved as a user designated synopsis of significant demographic, genetic, clinical, and environmental facts and events maintained within an automated ....

Dick RS, Steen EB (Eds.), 1991. The Computer-based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press.

.... It has been referred to as disorganized and inaccurate heaps of information where seeking an answer to a particular problem is slow work [8] The 1989 US Academy of Medicine Committee on the medical record did not find any strengths of the paper based medical record reported in the literature [9]. The committees review listed a few strengths and many weaknesses of the paper based medical record. A Dutch study compared these results with the opinions of clinical physicians as measured by a questionnaire [10] In this study there was strong agreement on the strengths of the paper based ....

Dick RS , Steen EB. The computer-based patient record - An essential technology for health care. National Academy Press, Washington DC, 1991.

....One suggested remedy would be better user education. Alternatively, resistance is explained in system centered theories by factors inherent in a system itself, such as slow response time, poor screen design, and other factors. For example, what the Institute of Medicine in the United States (Dick and Steen 1991) classified as technological barriers to the adoption of computer based patient records would fit in this category. Remedies include changing the system. Finally, according to interactional theories, resistance is due to interrelationships and interactions between users, a system, and the ....

.... a fourth thread was added to this literature, and managerial issues joined these three other areas of concern (Kaplan 1987b) Interactional factors were not addressed in much depth in these analyses of barriers to using computers in clinical practice, even recently by the Institute of Medicine (Dick and Steen 1991). On the individual level, clinical values are one important example of interactional factors. On the organizational level, communication and control within an organizational unit could be crucial. Instead, the Institute of Medicine divided barriers into two categories: technological and ....

Dick, R. S., and Steen, E. B. (eds.). The Computer-Based Patient Record: An Essential Technology for Health Care, Institute of Medicine, National Academy Press, Washington, DC, 1991.

....of cancer. Over the last few decades, many types of medical information have been computerized, including bibliographic data (e.g. MEDLINE and its search interface, Grateful Med) treatment, prevention, and screening information, etc. Most recently, even medical records have begun to be automated (Dick and Steen, 1991). Two particularly important information resources in the cancer treatment field are CANCERLIT, an indexed bibliographic database of cancerrelated citations and PDQ (Physicians Data Query) which contains a range of textual information on classification, diagnosis and treatment of cancer including ....

Dick, R. S., & Steen, E. B. (Eds.). (1991). The computerbased patient record: An essential technology for health care. Washington: National Academy Press.

....instruments employed in the delivery of health care, including patient history forms, personality inventories, psychiatric symptom questionnaires, and patient satisfaction surveys. World Wide Web could thereby become a key enabling technology in the development of the computer based patient record [16]. The use of Web technology to administer patient surveys could dramatically lower the cost of performing both randomized clinical investigations and routine outcomes monitoring. As a result, the World Wide Web may play an important role in advancing health services research and outcomes based ....

Dick RS, Steen EB, ed. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press, 1991.

....reports, and creates datasets for analysis of aggregate results. DRML allows knowledge engineers to design a wide variety of clinical reports and survey instruments. INTRODUCTION The realization of the computer based patient record (CPR) has become an important goal for providers of health care [1]. The success of CPR systems depends in large part on the mechanisms for capturing clinical information. Physicians typically record their clinical observations as handwritten notes. Although quick and convenient, this form of documentation suffers from illegibility, poor formatting, missing ....

Dick RS, Steen EB, ed. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press, 1991.

....and education. The computer based patient record now recognized as an important goal for health care will foster widespread clinical computing, and will provide a platform for integration of clinical information, images, laboratory data, medical literature, and decision support technology [46]. Decision support systems can add value to clinical information systems and to radiology consultations. Through integration with the computer based patient record, radiology decision support systems are poised to improve the quality of medical care. 13 ....

Dick RS, Steen EB, ed. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press, 1991. 16

....and may reduce the time and expense of dictating and transcribing reports. Standardized observational data acquired directly from the clinician may lower the cost and increase the certainty of data summaries needed for outcomes research. Another important goal for the emerging CPR is portability [5]. Ideally, the information within a patient s record should be comprehensible to authorized users regardless of the specifics of their local computer system. Open, platform independent systems should adhere to national and international standards for exchange of medical information. Standard ....

Dick RS, Steen EB, ed. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press, 1991.

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Dick RS, Steen EB, Detmer DE eds. The Computer-Based Patient Record: An Essential Technology for Health Care. National Academies Press, 1991.

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R. S. Dick, E. B. Steen, and D. E. Detmer, The computer-based patient record: An essential technology for health care. Washington, DC: National Academy Press, 1997.

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Dick R , Steen E , Detmer D, (eds). The Computer-Based Patient Record: An Essential Technology for Health Care. Revised ed. Washington, DC: Institute of Medicine National Academy Press; 1997.

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Dick RS, Steen EB, Detmer DE, eds. The ComputerBased Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: National Academy Press; 1997.

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Dick RS, Steen EB, eds. The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press; 1991.

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Richard S. Dick and Elaine B. Steen, editors. The Computer-Based Patient Record: An Essential Technology For Health Care, Washington, DC, 1991. Institute of Medicine, National Academy of Science, National Academy Press.

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Dick RS, Steen EB, eds. The computer-based patient record: an essential technology for health care. Washington, DC: National Academy Press, 1991.

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Dick RS, Steen EB (eds): The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC, National Academy Press, 1991

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. Dick, R.S., Steen, E.B. The Computer-Based Patient Record: An Essential Technology for Health Care, Institute of Medicine, 1991.

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