Skip to main content
SpringerLink
Log in

Clinical Support Information Systems (CSISs)

  • Chapter
The History of Medical Informatics in the United States

Part of the book series: Health Informatics ((HI))

Abstract

Operating within a larger medical information system (MIS), clinical support information systems (CSISs) process the specialized subsystem information used in support of the direct care of patients. Most of these CSISs were developed as stand-alone systems. This chapter highlights the early efforts to combine data from disparate departmental data systems into more “integrated ones” that support the full spectrum of data management needs of multi-hospital and ambulatory health systems. In the 1960s and 1970s, institutions incorporated clinical laboratory and medication subsystems into their MISs; more subsystems were added (pathology, imaging, etc.); and systems with integrated CSIS were developed for ambulatory care settings. Despite all the progress made over the past 40 years, two key challenges remain unsolved: first is the lack of data interoperability among myriad systems; second is the lack of a useful point of care system. Both threaten to make the clinician’s work harder; overcoming them is key to transforming the health care system.

Author Collen was deceased at the time of publication.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. AHRQ. A robust health data infrastructure. Report prepared by JASON for the AHRQ National Resource Center; Health Information Technology: best practices transforming quality, safety, and efficiency. 2014.

    Google Scholar 

  2. Ash JS, Berg M, Coiera E. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med Inform Assoc. 2004;11:104–12.

    Article  PubMed Central  PubMed  Google Scholar 

  3. ASTM 1988. Standard guide for description of reservation/registration-admission, discharge, transfer (R-ADT) systems for automated patient care information systems. Philadelphia: American Society for Testing Materials; 1988. E-1239-88.

    Google Scholar 

  4. ASTM 1988. Standard specifications for transferring clinical laboratory data messages between independent computer systems. Philadelphia: American Society for Testing Materials; 1988. E-1238-88.

    Google Scholar 

  5. ASTM 1989. Standard specifications for transferring clinical observations between independent computer systems. Philadelphia: American Society for Testing Materials; 1989. E-1238-88.

    Google Scholar 

  6. Balintfy JL. Computer assisted menu planning and food service management. In: Spector W, editor. Handbook of biomedical information systems. Chicago: Encyclopedia Britannica; 1971. p. 85.

    Google Scholar 

  7. Balintfy JL, Nebel E. Experiments with computer-assisted menu planning. Hospitals. 1966;40:88–97.

    CAS  PubMed  Google Scholar 

  8. Ball MJ, Silva JS, Bierstock S, Douglas JV, Norcio AF, Chakraborty J, et al. Failure to provide clinicians useful IT systems: opportunities to leapfrog current technologies. Methods Inf Med. 2008;47:4–7.

    CAS  PubMed  Google Scholar 

  9. Barnett GO. The application of computer-based medical record systems in ambulatory practice. In: Orthner HF, Blum BI, editors. Implementing health care information systems. New York: Springer; 1989. p. 85–99.

    Chapter  Google Scholar 

  10. Barnett GO. Computers in patient care. N Engl J Med. 1968;279:1321–7.

    Article  CAS  PubMed  Google Scholar 

  11. Barnett GO. Computer-stored ambulatory record (COSTAT). NCHSR Research Digest Series. DHEW Pub No. (HRA) 76–3145, 1976.

    Google Scholar 

  12. Barnett GO, Castleman PA. A time-sharing computer system for patient-care activities. Comput Biomed Res. 1967;1:41–51.

    Article  CAS  PubMed  Google Scholar 

  13. Barnett GO, Souder D, Beaman P, Hupp J. MUMPS: an evolutionary commentary. Comput Biomed Res. 1981;14:112–8.

    Article  CAS  PubMed  Google Scholar 

  14. Barnett GO. Massachusetts general hospital computer system. In: Collen MF, editor. Hospital computer systems. New York: Wiley; 1974.

    Google Scholar 

  15. Barnett GO, Greenes RA, Grossman JH. Computer processing of medical text information. Methods Inf Med. 1969;8:177–82.

    CAS  PubMed  Google Scholar 

  16. Barnett GO, Justice NS, Somand ME, et al. COSTAR – a computer-based medical information system for ambulatory care. Proc SCAMC. 1978;483–7.

    Google Scholar 

  17. Barret JP, Hersch PL, Cashwell RJ. Evaluation of the impact of the Technicon medical information system at El Camino Hospital. Part II. Columbus: Battelle Columbus Labs; 1979.

    Google Scholar 

  18. Beggs S, Vallbona C, Spencer WA, Jacobs FM, Baker RL. Evaluation of a system for on-line computer scheduling of patient care activities. Comput Biomed Res. 1971;4:634–54.

    Article  CAS  PubMed  Google Scholar 

  19. Bleich HL, Safran C, Slack WV. Departmental and laboratory computing in two hospitals. MD Comput. 1988;6:149–55.

    Google Scholar 

  20. Blose WF, Vallbona C, Spencer WA. System for processing clinical research data. System design. Proc 6th IBM Symposium. 1964. pp. 463–85.

    Google Scholar 

  21. Blum BI, Lenhard Jr RE, McColligan EE. An integrated data model for patient care. IEEE Trans Biomed Eng. 1985;32:277–88.

    Article  CAS  PubMed  Google Scholar 

  22. Blum B, Lenhard Jr R. A clinical information display system. Proc SCAMC. 1977;131–8.

    Google Scholar 

  23. Blum BI. Design methods for clinical systems. Proc SCAMC. 1986;309.

    Google Scholar 

  24. Booker E. Can IoT slash healthcare costs? InformationWeek 2014 (Nov 22).

    Google Scholar 

  25. Buchanan NS. Evolution of a hospital information system. Proc SCAMC. 1980;1:34.

    Google Scholar 

  26. Campbell CM. Information system for a short-term hospital. Hosp JAHA. 1964;38:71–80.

    CAS  Google Scholar 

  27. Collen MF. Data processing techniques for multitest screening and hospital facilities. In: Bekey GA, Schwartz MD, editors. Hospital information systems. New York: Marcel Dekker; 1972. p. 149–87.

    Google Scholar 

  28. Collen MF. General requirements of a medical information system (MIS). Comput Biomed Res. 1970;3:393–406.

    Article  CAS  PubMed  Google Scholar 

  29. Collen MF. Computers in preventive health services research. 7th IBM Medical Symposium. 1965.

    Google Scholar 

  30. Collen MF. Multiphasic health testing services. New York: Wiley; 1978.

    Google Scholar 

  31. Collen MF. Patient data acquisition. Med Instrum. 1977;12:222–5.

    Google Scholar 

  32. Ellis L, Huang P, Buzzard IM. Touchscreen versus keyboard for menu-based food coding. Proc MEDINFO. 1986. pp. 999–1003.

    Google Scholar 

  33. Emmel GR, Greenhalgh RC. Hospital information system study (part I). Proc 4th IBM Med Symposium. 1962. pp. 443–58.

    Google Scholar 

  34. Esterhay Jr R, Foy JL, Lewis TL. Hospital information systems: approaches to screen definition: comparative anatomy of the PROMIS, NIH and Duke systems. Proc SCAMC. 1982;903–11.

    Google Scholar 

  35. Fetter RR, Mills RE. A micro computer based medical information system. Proc 2nd Annual WAMI Meeting. 1979. pp. 388–91.

    Google Scholar 

  36. FHIR Overview. Fast healthcare interoperability resources (FHIR) v0.0.82. Health Level Seven. 2015.

    Google Scholar 

  37. Frey R, Girardi S, Wiederhold G. A filing system for medical research. Int J Biomed Comput. 1971;2:1–26.

    Article  CAS  PubMed  Google Scholar 

  38. Gabrieli ER. Standardization of medical informatics (special issue). J Clin Comput. 1985;14:62–104.

    CAS  PubMed  Google Scholar 

  39. Gall J. Computerized hospital information system cost-effectiveness: a case study. In: van Egmond J, de Vries Robbe PF, Levy AH, editors. Information systems for patient care. Amsterdam: North Holland; 1976. p. 281–93.

    Google Scholar 

  40. Gall J. Cost-benefit analysis: total hospital informatics. In: Koza RC, editor. Health information system evaluation. Boulder: Colorado Associated University Press; 1974. p. 299–327.

    Google Scholar 

  41. Gardner RM, Pryor TA, Warner HR. The HELP hospital information system: update 1998. Int J Med Inform. 1999;54:169–82.

    Article  CAS  PubMed  Google Scholar 

  42. Giebink GA, Hurst LL. Computer projects in health care. Ann Arbor: Health Administration Press; 1975.

    Google Scholar 

  43. Gotcher SB, Carrick J, Vallbona C, Spencer WA, Carter RE, Cornell S. Daily treatment planning with an on-line shared computer system. Methods Inf Med. 1969;8:200.

    CAS  PubMed  Google Scholar 

  44. Grams RR. Medical information systems: the laboratory module. Clifton: Humana Press; 1979.

    Book  Google Scholar 

  45. Grossman JH, Barnett GO, Koepsell TD, Nesson HR, Dorsey JL, Phillips RR. An automated medical record system. JAMA. 1973;224:1616–21.

    Article  CAS  PubMed  Google Scholar 

  46. Hammond WE. GEMISCH. A minicomputer information support system. Proc IEEE. 1973;61:1575–83.

    Article  Google Scholar 

  47. Hammond W, Stead W, Straube M, Kelly M, Winfree R. An interface between a hospital information system and a computerized medical record. Proc SCAMC. 1980;3:1537–40.

    Google Scholar 

  48. Hammond WE, Stead WW, Straube MJ, Jelovsek FR. Functional characteristics of a computerized medical record. Methods Inf Med. 1980;19:157–62.

    CAS  PubMed  Google Scholar 

  49. Hammond WE, Stead WW, Feagin SJ, Brantley BA, Straube MJ. Data base management system for ambulatory care. Proc SCAMC. 1977;173–87.

    Google Scholar 

  50. Hernandez T, Walker B. Innovations in microcomputer based dietary assessment. Proc MEDINFO. 1986. pp. 476–9.

    Google Scholar 

  51. Hodge MH. Medical information systems: a resource for hospitals. Germantown: Aspen Publishers; 1977.

    Google Scholar 

  52. Jelliffe RW, Schumitzky A, Rodman J, Crone J. A package of time-shared computer programs for patient care. Proc SCAMC. 1977;154.

    Google Scholar 

  53. Johns RJ, Blum BI. The use of clinical information systems to control cost as well as to improve care. Trans Am Clin Climatol Assoc. 1979;90:140.

    PubMed Central  CAS  PubMed  Google Scholar 

  54. Juenemann HJ. The design of a data processing center for biological data. Ann N Y Acad Sci. 1964;115:547–52.

    Article  CAS  PubMed  Google Scholar 

  55. Kuperman GJ. The pharmacy application of the HELP system. In: Kuperman GJ, Gardner RM, Pryor TA, editors. HELP: a dynamic hospital information system. New York: Springer; 1991. pp. 168–72.

    Google Scholar 

  56. Lacson R, Long W. Natural language processing of spoken diet records (SDRs). Proc AMIA Annu Symp. 2006. pp. 454–8.

    Google Scholar 

  57. Lamson BG. Mini-computers and large central processors from a medical record management point of view. International symposium on medical information systems. 1975. pp. 58–65.

    Google Scholar 

  58. Lindberg D. The computer and medical care. Springfield: CC Thomas; 1968.

    Google Scholar 

  59. Lindberg D. Electronic retrieval of clinical data. J Med Educ. 1965;40:753–9.

    CAS  PubMed  Google Scholar 

  60. Lindberg D. A computer in medicine. Mo Med. 1964;61:282–4.

    CAS  PubMed  Google Scholar 

  61. Lindberg D, Reese GR, Buck C. Computer generated hospital diagnosis file. Mo Med. 1964;61:581–2. passim.

    CAS  PubMed  Google Scholar 

  62. Lowder W, Medill C. Punch cards simplify selective menus. Mod Hosp. 1958;90:90–102. passim.

    Google Scholar 

  63. McColligan E, Blum B, Brunn C. An automated care medical record system for ambulatory care. In: Kaplan B, Jelovsek FR, editors. Proc SCM/SAMS joint conf on ambulatory med. Washington, DC: Society for Computer Medicine; 1981. pp. 72–6.

    Google Scholar 

  64. McDonald CJ. The medical gopher: a microcomputer based physician work station. Proc SCAMC. 1984;453–9.

    Google Scholar 

  65. McDonald C, Blevins L, Glazener T, Haas J, Lemmon L, Meeks-Johnson J. Data base management, feedback control, and the Regenstrief medical record. J Med Syst. 1983;7:111–25.

    Article  CAS  PubMed  Google Scholar 

  66. McDonald CJ, Hammond WE. Standard formats for electronic transfer of clinical data. Ann Intern Med. 1989;110:333–5.

    Article  CAS  PubMed  Google Scholar 

  67. McDonald CJ, Tierney WM. Computer-stored medical records: their future role in medical practice. JAMA. 1988;259:3433–40.

    Article  CAS  PubMed  Google Scholar 

  68. McDonald CJ, Murray R, Jeris D, Bhargava B, Seeger J, Blevins L. A computer-based record and clinical monitoring system for ambulatory care. Am J Public Health. 1977;67:240–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  69. McDonald CJ, Overhage JM, Tierney WM, Dexter PR, Martin DK, Suico JG, et al. The Regenstrief medical record system: a quarter century experience. Int J Med Inform. 1999;54:225–53.

    Article  CAS  PubMed  Google Scholar 

  70. McNabb ME. 90-day nonselective menus by computer. Hospitals. 1971;45:88–91.

    CAS  PubMed  Google Scholar 

  71. Monmouth. Monmouth medical shapes a total system. Systems. 1966. pp. 12–48.

    Google Scholar 

  72. ONC/HHS. Connecting health and care for the nation. A 10 year vision to achieve an interoperable health IT infrastructure. Washington, DC: Health and Human Services, Office of the National Coordinator; 2015.

    Google Scholar 

  73. PCAST. Report to the president. Realizing the full potential of health information technology to improve the health of Americans: the path forward. Washington, DC: President’s Council of Advisors on Science and Technology (PCAST); 2010. Available at www.thewhitehouse.gov.

  74. Pratt AW. Progress towards a medical information system for the research environment. In: Fuchs G, Wagner G, editors. Sonderdruck aus Krankenhaus-Informationsysteme. New York: Schattauer-Verlag; 1972. p. 319–36.

    Google Scholar 

  75. Pryor TA, Gardner RM, Clayton PD, Warner HR. The HELP system. J Med Syst. 1983;7:87–102.

    Article  CAS  PubMed  Google Scholar 

  76. Rothrock JJ. ASTM: the standards make the pieces fit. Proc AAMSI congress. 1989. pp. 327–35.

    Google Scholar 

  77. Runck HM. Computer planning for hospitals-large-scale education and involvement of employees. Comput Autom. 1969;18:33.

    Google Scholar 

  78. Rutt TE. Work of IEEE P1157 medical data interchange committee. Int J Clin Monit Comput. 1989;6:45–57.

    Article  CAS  PubMed  Google Scholar 

  79. Schenthal JE. Clinical concepts in the application of large scale electronic data processing. Proc 2nd IBM medical symposium. 1960. pp. 391–9.

    Google Scholar 

  80. Schenthal JE, Sweeney JW, Nettleton W. Clinical application of electronic data processing apparatus: II. New methodology in clinical record storage. JAMA. 1961;178:267–70.

    Article  CAS  PubMed  Google Scholar 

  81. Schultz JR, Davis L. The technology of PROMIS. Proc IEEE. 1979;67:1237–44.

    Article  Google Scholar 

  82. Shieman BM. Medical information system, El Camino Hospital. IMS Ind Med Surg. 1971;40:25–6.

    CAS  PubMed  Google Scholar 

  83. Siegel SJ. Developing an information system for a hospital. Public Health Rep. 1968;83:359–62.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  84. Silva J, Seybold N, Ball M. Usable health IT for physicians. Smart point-of-care and comparative effectiveness research form the true basis for meaningful use. Healthc Inform. 2010;27:40–3.

    PubMed  Google Scholar 

  85. Simborg DW. An emerging standard for health communications: the HL7 standard. Healthc Comput Commun. 1987;4:58–60.

    CAS  PubMed  Google Scholar 

  86. Slack WV, Bleich HL. The CCC system in two teaching hospitals: a progress report. Int J Med Inform. 1999;54:183–96.

    Article  CAS  PubMed  Google Scholar 

  87. Sneider RM. Using a medical information system to improve the quality of patient care. Proc SCAMC. 1978;594.

    Google Scholar 

  88. Stead WW, Hammond WE. Calculating storage requirements for office practice systems. Proc SCAMC. 1985;68.

    Google Scholar 

  89. Stead WW, Hammond WE, Winfree RG. Beyond a basic HIS: work stations for department management. Proc SCAMC. 1984;197.

    Google Scholar 

  90. Tolchin SG, Barta W. Local network and distributed processing issues in the Johns Hopkins Hospital. J Med Syst. 1986;10:339–53.

    Article  CAS  PubMed  Google Scholar 

  91. Vallbona C, Spencer WA. Texas institute for research and rehabilitation hospital computer system (Houston). In: Collen MF, editor. Hospital computer systems. New York: Wiley; 1974. p. 662–700.

    Google Scholar 

  92. Warner HR. A computer-based patient monitoring. In: Stacy RW, Waxman B, editors. Computers in biomedical research, vol. III. New York: Academic; 1972. p. 239–51.

    Google Scholar 

  93. Watson RJ. A large-scale professionally oriented medical information system – five years later. J Med Syst. 1977;1:3–21.

    Article  CAS  PubMed  Google Scholar 

  94. Weed LL. Problem-oriented medical information system (PROMIS) laboratory. In: Giebink GA, Hurst LL, editors. Computer projects in health care. Ann Arbor: Health Administration Press; 1975. p. 199–203.

    Google Scholar 

  95. Wheeler PS, Simborg DW, Gitlin JN. The Johns Hopkins radiology reporting system. Radiology. 1976;119:315–9.

    Article  CAS  PubMed  Google Scholar 

  96. Wheeler LA, Wheeler ML. Review of microcomputer nutrient analysis and menu planning programs. MD Comput. 1984;1:42–51.

    CAS  PubMed  Google Scholar 

  97. Wiederhold G. Summary of the findings of the visiting study team automated medical record systems for ambulatory care. Visit to Duke University Medical Center, CDD-5 HRA Contract, June 29. 1975.

    Google Scholar 

  98. Witschi J, Kowaloff H, Bloom S, Slack W. Analysis of dietary data; an interactive computer method for storage and retrieval. J Am Diet Assoc. 1981;78:609–13.

    CAS  PubMed  Google Scholar 

  99. Zhang J, Walji M. Better EHR: usability, workflow and cognitive support in electronic health records. Houston: National Center for Cognitive Informatics and Decision Making in Health Care; 2014.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Silva Consulting Services, LLC, Eldersburg, MD, USA

    John S. Silva M.D., F.A.C.M.I.

Authors
  1. Morris F. Collen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John S. Silva M.D., F.A.C.M.I.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John S. Silva M.D., F.A.C.M.I. .

Editor information

Editors and Affiliations

  1. Oakland, California, USA

    Morris F. Collen

  2. IBM Research, Baltimore, Maryland, USA

    Marion J. Ball

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Collen, M.F., Silva, J.S. (2015). Clinical Support Information Systems (CSISs). In: Collen, M., Ball, M. (eds) The History of Medical Informatics in the United States. Health Informatics. Springer, London. https://doi.org/10.1007/978-1-4471-6732-7_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6732-7_11

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6731-0

  • Online ISBN: 978-1-4471-6732-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation