BOX 5-1
SUMMARY OF THE RECOMMENDATIONS OF THE INSTITUTE OF MEDICINE COMMITTEE ON IMPROVING THE PATIENT RECORD

The committee recommends the following:

  1. Health care professionals and organizations should adopt the computer-based patient record (CPR) as the standard for medical and all other records related to patient care.
  2. To accomplish Recommendation 1, the public and private sectors should join in establishing a Computer-based Patient Record Institute (CPRI) to promote and facilitate development, implementation, and dissemination of the CPR.
  3. Both the public and private sectors should expand support for the CPR and CPR system implementation through research, development, and demonstration projects. Specifically, the committee recommends that Congress authorize and appropriate funds to implement the research and development agenda outlined herein. The committee further recommends that private foundations and vendors fund programs that support and facilitate this research and development agenda.
  4. The CPRI should promulgate uniform national standards for data and security to facilitate implementation of the CPR and its secondary databases.
  5. The CPRI should review federal and state laws and regulations for the purpose of proposing and promulgating model legislation and regulations to facilitate the implementation and dissemination of the CPR and its secondary databases and to streamline the CPR and CPR systems.
  6. The costs of CPR systems should be shared by those who benefit from the value of the CPR. Specifically, the full costs of implementing and operating CPRs and CPR systems should be factored into reimbursement levels or payment schedules of both public and private sector third-party payers. In addition, users of secondary databases should support the costs of creating such databases.
  7. Health care professional schools and organizations should enhance educational programs for students and practitioners in the use of computers, CPRs, and CPR systems for patient care, education, and research.

This chapter summarizes the committee's principal conclusions and presents recommendations for improving patient records (see Box 5-1). These recommendations, to which committee members gave unanimous approval, outline a course to facilitate the transition of health care away from the current paper patient record and toward routine use of the CPR and its



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