defines CPRs and CPR systems as the standard for future patient records; the second proposes an organizational framework within which barriers to CPR implementation can be systematically addressed and overcome. The remaining recommendations focus on specific impediments: needed research and development, promulgation of standards for CPR data and security, review of legal constraints and remedies, distribution of costs for CPR systems, and education of health care professionals.

The committee believes that the CPR can play an increasingly important role in the health care environment. This role begins in the care process as the CPR provides patient information when needed and supports clinical decision making. It extends to management of care through the establishment of a mechanism by which quality assurance procedures and clinical practice guidelines are accessible to health care professionals at the time and site of patient care. It also includes opportunities for reducing administrative costs and frustrations associated with health care financing and for capturing administrative data for internal and external review. Finally, the CPR's role extends to capturing relevant, accurate data necessary for provider and consumer education, technology assessment, health services research, and related work concerning the appropriateness, effectiveness, and outcomes of care.

The committee recognizes the considerable amount of work that remains to be done and the practical limitations that must be overcome before CPRs become the standard mode of documenting and communicating patient information and before they are perceived and used as a vital resource for improving patient care. The challenge of coordinating CPR development efforts in the pluralistic health care environment is great. Resources are limited and must be used wisely.

The committee is convinced that proper coordination and appropriate resources will lead to achievement of the goal of widespread CPR utilization within a decade. The desire to improve the quality of and access to patient data is shared by patients, practitioners, administrators, third-party payers, researchers, and policymakers throughout the nation. CPRs and CPR systems can respond to health care's need for a "central nervous system" to manage the complexities of modern medicine—from patient care to public health to health care policy. In short, the CPR is an essential technology for health care today and in the future.



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