Abstract
In the previous chapter, hospital information systems were discussed. The patients served by the HIS receive comprehensive treatment over a period of days or weeks. Each is suffering from an acute episode that requires some degree of continuous monitoring. The facility normally treats fewer than 500 patients at any one time and has a large staff to accommodate their needs. In addition to providing the care function, the hospital also supports a full range of hotel functions: food services, housekeeping, registration, etc. Thus, the hospital has a small number of patients, a great deal of information to manage for each patient, a large staff and overhead, and many ancillary functions to support. In this environment, it is not unrealistic to add $5.00 or more per patient day for a computer system to help manage the patient’s (and institution’s) data.
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References
For Further Reading
The book of readings Information Systems for Patient Care (ed, B. I. Blum, Springer-Verlag, 1984) has 14 papers dealing with ambulatory care systems including chapters on COSTAR, RMRS, TMR, SCAMP, CORE, and several office practice systems.
J. Zimmerman and A. Rector, Computers for the Physician’s Office, Research Studies Press, 1978, provides an earlier overview of the subject. These references, those previously cited, and the notes provide a good set of initial readings.
There are several books designed to provide an introduction to computers and medical practice. H. D. Covvey and N. H. McAlister have produced a very readable two volume Computers in the Practice of Medicine, (Addison-Wesley, 1980).
An AAMSI committee has sponsored B. B. Oberst and R. A. Reid (eds) Computer Applications to Private Office Practice (Springer-Verlag, 1984).
Both are introductory in nature and contain little specific details about office practice systems. E. J. Neiburger, Computers for Professional Practice (Andent, Inc., Waukegan, IL, 1984) is a thorough introduction and “how to” softcover. Finally, there is a continuing series of articles on office practice systems in the journal M. D. Computer.
References
Kuhn, I. M., G. Wiederhold, et al, Automated Ambulatory Medical Record Systems in the U.S., Stanford Report CS-80–928, August 1982, and the summarized report in B. I. Blum (ed) Information Systems for Patient Care, Springer-Verlag, 1984, pp. 199–217.
Kuhn, I. M., G. Wiederhold, et al, Automated Ambulatory Medical Record Systems in the U.S., Stanford Report CS-80–928, August 1982, and the summarized report in B. I. Blum (ed) Information Systems for Patient Care, Springer-Verlag, 1984, p. 5.
Fiddleman, R. H., Proliferation of COSTAR—A Status Report, in B. I. Blum (ed) Information Systems for Patient Care, Springer-Verlag, 1984, p. 303.
COSTAR figures can be found in Barnett, G. O., COSTAR, A Progress Report, MGH, no date, COSTAR Functional Specifications (Version 5.3), MGH, 4/15/1977,
and Barnett, G. O., The Application of Computer-Based Medical-Record Systems in Ambulatory Practice, NEJ Med., 310 1984. Search examples are taken from P. D. Beaman, N. S. Justice and G. O. Barnett, A Medical Information System and Data Language for Ambulatory Practices, Computer 12:11 1979.
McDonald, C. J., G. A. Wilson, and G. P. McCabe, Physician Response to Computer Reminders, JAMA 244 1980 p. 1579.
The CARE examples which follow have been taken from the chapter on RMRS in B.I. Blum (ed) Information Systems for Patient Care, Springer-Verlag, 1984,
and the description of the CARE language, Appendix C in C. J. McDonald Action-Oriented Decisions in Ambulatory Medicine, Year Book Medical Publishers, 1981.
Taken from W. W. Stead, W. E. Hammond and M. J. Straube, A Chartless Record— Is It Adequate, J. Med. Sys., (7,2) 1983, pp. 103–109.
Taken from J. E. Rodnick, The Use of Automated Ambulatory Medical Records, J. Fam. Pract. (5,2) 1977, pp. 253–264.
This example is taken from the ARAMIS users manual (V. Weiderhold, Stanford University, September 1976). The manual also illustrates the input sequence and an equivalent text report.
Examples are taken from the A. R. Shapiro, SCAMP System, in B. I. Blum (ed) Information Systems for Patient Care, Springer-Verlag, 1984.
Simborg, D. W. and Q. E. Whiting-O’Keefe, Summary Time Oriented Record—A Progress Report, SCAMC-5, 1981, pp. 100–104.
See E. E. McColligan, Care Record System, in B. I. Blum (ed) Information Systems for Patient Care, Springer-Verlag, 1984.
Blum, B. I. C. J. Johns, E. E. McColligan, C. R. Smith, D. M. Steinwachs, Low Cost Ambulatory Medical Information Systems, J. Clin. Eng. (4,4) 1979, 372–377.
Whiting-O’Keefe, D. W. Simborg and W. V. Epstein, A Controlled Experiment to Evaluate the Use of a Time-Oriented Summary Medical Record, Medical Care, (18,8) 1980 pp. 842–852.
McDonald, C. J., Use of a Computer to Detect and Respond to Clinical Events: Its Effect on Clinical Behavior, Ann. Int. Med (84) 1976 pp. 162–167.
McDonald, C. J. Protocol-Based Computer Reminders, The Quality of Care and the Non-Perfectability of Man, N. E. J. Med., (295) 1976 pp. 1351–1355.
Barnett, G. O., R. N. Winicoff, J. L. Dorsey, et al, Quality assurance through automated monitoring and concurrent feedback using a computer-based medical information system, Med. Care 16, 1978, pp. 462–769.
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Blum, B.I. (1986). Ambulatory Care Systems. In: Clinical Information Systems. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-26537-6_8
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DOI: https://doi.org/10.1007/978-3-662-26537-6_8
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