Clearing the way for physicians' use of clinical information systems

Abstract

For almost three decades, computer-based information systems have been developed implemented in health care settings. Under cost-based reimbursement, hospital information systems were designed primarily for administrative purposes to ensure that all charges were billed and collected. Physicians on the whole wrote orders in their traditional manner while ward clerks entered: these written orders into the information system. The current goals of cost containment and outcomes measurement can not be met by the older administrative systems. These older systems ignored the fact that as much as 75% of health care costs are determined by the provider. Moreover, most of these information systems were incapable of providing data on patient outcomes and instead relied on manual chart reviews. In recognition of the critical importance that medical records play in the delivery of health care, the Institute of Medicine called for the development and implementation of computer-based patient records.