sets goals for automating medical information, addresses individual and organizational concerns with automated records, and identifies incentives to induce health care organizations to increase their use of automation" (GAO, 1991:26).

Specific Steps for Change Agents

The challenges of developing affordable CPR systems that are acceptable to users and of achieving widespread use of such systems within a decade should not be underestimated or understated. Much of the progress toward these goals is likely to occur incrementally over time and across the country. The CPRI can play an important role in tracking progress and directing future efforts, but significant contributions to CPR development and implementation can and must be made by individuals and groups other than the CPRI. A great deal of work can be accomplished at the regional, local, and institutional levels in preparation for CPR implementation.

  • As discussed earlier in this chapter, health care professionals could support development and implementation by helping to plan and conduct research or demonstrations of CPR systems. Involvement of all kinds of CPR users is needed—especially practitioners as the primary source of data—to design systems that will meet their requirements.
  • Professional societies could implement formal education and awareness programs as part of their membership mailings and annual meetings. They could also support conferences at which CPR users could share experiences, report on useful experiments in various settings, and meet with other professional disciplines to discuss data and function needs.
  • Purchasers of CPR systems could actively seek systems that are able to meet basic data-exchange and security standards and offer sufficient capacity to evolve over time.
  • Insurers could offer incentives (e.g., faster payment of claims) for data that are provided in electronic form.
  • Health care business coalitions, chambers of commerce, and major employers could all support CPR development and implementation efforts by supporting research and pilot demonstrations as well as by developing relationships with insurers and health care provider institutions that use or support CPR systems.
  • Federal agencies could provide substantial funding for research and development and support standards development through funding or regulatory mandate.
  • States could serve as candidates for pilot regional studies or experimental prototypes.
  • Health care accreditation organizations could foster CPR development,

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