should be collected so that they can produce quality secondary records; subject to appropriate controls, these records can be added to institutional, local, regional, national, or international databases as needed for clinical, administrative, or research purposes.
In summary, the committee believes that the computer-based patient record can play an increasingly important role in the health care environment. This role begins in the care process by providing patient information when needed and by supporting clinical decision making. It extends to the management of care by establishing a mechanism by which quality assurance procedures and clinical practice guidelines (including the most recent warnings on contraindications and adverse reactions to therapies) can be brought to health care professionals at the time and site of patient care. It also includes providing opportunities for reducing administrative costs associated with health care financing and collecting administrative data for internal and external review. It encompasses enhancing health care professional education by supporting independent, lifelong learning. Finally, it extends to capturing relevant, accurate data necessary for technology assessment, health services research, and related studies concerning the appropriateness, effectiveness, and outcomes of care.
Aranda, J. M. 1974. The problem-oriented medical records: Experiences in a community hospital. Journal of the American Medical Association 229:549–551.
Association of American Medical Colleges. 1986. Medical Education in the Information Age: Proceedings of the Symposium on Medical Informatics . Washington, D.C.
Barnett, O. G., R. Winickoff, J. L. Dorsey, M. M. Morgan, and R. S. Lurie. 1978. Quality assurance through automated monitoring and concurrent feedback using a computer-based medical information system. Medical Care 16:962–970.
Barton, M. B., and S. C. Schoenbaum. 1990. Improving influenza vaccination performance in an HMO setting: The use of computer-generated reminders and peer comparison feedback. American Journal of Public Health 80:534–536.
Batalden, P. B., and E. D. Buchanan. 1989. Industrial models of quality improvement. Pp. 133–159 in Providing Quality Care: The Challenge to Clinicians, ed. N. Goldfield and D. B. Nash, D.B. Philadelphia, Pa.: American College of Physicians.
Berwick, D. M. 1989. Sounding board: Continuous improvement as an ideal in health care . New England Journal of Medicine 320:53–56.
Bikson, T. K., B. A. Gutek, and D. A. Mankin. 1987. Implementing Computerized Procedures in Office Settings: Influence and Outcomes . Santa Monica, Calif.: The RAND Corporation.
Donabedian, A. 1966. Evaluating the quality of medical care. Milbank Memorial Fund Quarterly 44(pt. 2):166–203.