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Toward Electronic Medical Records That Improve Care
- William M. Tierney, MD;
- J. Marc Overhage, MD; and
- Clement J. McDonald, MD
- Regenstrief Institute for Health Care, Indianapolis, IN 46202 Requests for Reprints: William M. Tierney, MD, Regenstrief Institute for Health Care, RHC, Fifth Floor, 1001 West Tenth Street, Indianapolis, IN 46202 Grant Support: In part by HS07632, HS07763, and HS07719 from the Agency for Health Care Policy and Research; PHB93-S1 from the Indiana State Department of Health; and contract N01-LM-4-3510 from the National Library of Medicine. The opinions expressed are solely those of the authors.
Computers and other machinery of the Information Age have been touted as bringing a revolution to medical care that would improve its quality and lower its costs [1]. However, accomplishing these tasks requires electronic medical record systems that are not merely electronic renditions of paper charts. For maximum effect, electronic medical record systems should actively participate in improving patient outcomes.
The first attempts to improve care with electronic medical records began more than 20 years ago with the computerizing of guidelines for simple preventive care and for identifying abnormal test results and potential drug interactions [2, 3]. Over the ensuing two decades, computers have become much faster (by orders of magnitude) and much less expensive. Meanwhile, partly in response to increasing health care costs and research showing that medical practice varied greatly among geographic locations and practices [4], professional organizations and federal agencies began developing more sophisticated clinical practice guidelines [5]. The automation of early guidelines through computers improved health care delivery [6-8] and, occasionally, patient outcomes [9, 10]. Electronic medical records thus offer a way to efficiently improve and monitor the processes and outcomes of care.
The ability to implement practice guidelines using electronic …
