radiology department, and test results are entered immediately. Allergy information is always accessible, so that caregivers are aware of preexisting conditions. Clinicians need not be physically or temporally co-located to collaborate since they can view and discuss data simultaneously. Providers with a legitimate need to know can access the record anytime, anywhere.

Intermountain Health Care identifies other benefits of automated patient records integrated with automated clinical information systems. These benefits include the following:

  • Data that are organized and legible—The nurse can see all of the prescribed drugs for a patient in one location; the doses are written clearly, and names are spelled correctly. Data are grouped to ensure that important data are not buried among the more routine. A problem list shows acute and chronic conditions and complete known allergies. Other health care team members can view the nurse’s concerns and respond to them. Abnormal findings are highlighted, and trends can be graphed and compared with interventions (e.g., temperature spikes correlated with drug administration). An integrated plan allows all members of the collaborative care process to see what is happening and decide what should occur in the future. Everyone knows who is responsible for the patient and who needs to communicate about the patient’s care.

  • Support for ongoing knowledge acquisition—The patient’s clinical data can be linked to reference literature to answer questions about policies, procedures, prognosis, diagnoses, educational material, appropriate drug dose, drug contraindications, and the like.

  • Generation of alerts, reminders, or suggestions when standards of care are not being followed—Rules can be implemented to address changes in the patient’s condition or to remind providers of process issues. For instance, Intermountain Health Care (IHC) manages patients receiving the medication coumadin by having the computer screen show the results of the most recent clotting factor test or the unanticipated absence of such results to see which patients are out of acceptable blood value ranges and need dosage adjustments or another test. Similar messages for ventilator management are sent directly to the provider. Intermountain Health Care also manages populations of people with diabetes by reminding providers which patients have not had glycosalated hemoglobin tests, retinal exams, and so on. Similar reminders are sent about pap smears, mammograms, and immunizations. Process reminders are also used. When documentation is not recorded that a wound dressing has been changed according to schedule, IV tubing has been changed, or drugs have been administered, the automated patient record generates reminders according to rules that are agreed upon by providers. These measures help integrate evidence-based medicine into the process of care.



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