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Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
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Index

A

Academic research, 8, 112, 114, 150, 159

Access issues, 62, 67, 74, 80, 81-83, 136, 179, 181

computer technology and, 4, 68, 101

insurers, 80, 209, 210

knowledge resources, 7

legal right to, 14, 83, 209-210, 214-216, 217-218

patient records, 6-7, 63

software source code, 220

system redundancy, fault tolerance, 118, 119

system response, 83, 106, 120, 126, 145-146, 220

see also Confidentiality

Accreditation, 65, 75, 77, 110, 149, 160, 168-169, 208, 214, 217, 218

Accredited Standards Committee, 13

Accuracy issues, 95, 110, 127, 207, 219

see also Errors and error analysis

Acute disorders and care, 66, 123-124, 131

Administrative functions, 46, 47, 51, 65, 89, 93, 95, 121, 181, 195

access to, 7, 21-22

billing, 64, 78, 106, 120

costs, 46, 51, 68, 98, 193

standards, 13

Advocacy, patients, 153-154

Agency for Health Care Policy and Research, 9, 66-67, 155, 164, 166 , 167, 175, 184, 185

AIDS, 215

Ambulatory care records, see Outpatient records

American College of Radiologists, 13, 108

American Health Information Management Association, 14

American Medical Society, 67, 206

American Society for Testing and Materials, 13, 108

Arden syntax, 14, 125

ARPANET, 4

Artificial intelligence, 201, 223

see also Knowledge-based systems

Attitudes

toward diffusion of innovations, 142, 143-144, 145, 152

public, 153, 195

systems vendors, 135-137

B

Bibliographic databases, 47, 69, 74, 92-93, 95, 119, 124, 181

Billing, 64, 78, 106, 120

Browser software, 4-5

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

C

Case studies

hospital information systems, 119-120

maternal and child health care, 173-175

Centers for Disease Control, 155-156, 185

Change agents, 151-161, 163, 166, 168-169, 183, 184

Chart Checker, 123-124

Chronic diseases, general, 46, 64, 66

Clinical practice guidelines, 2, 9, 51, 67, 98, 164, 181, 190

Clinical processes and systems, 47, 48, 56, 66-67, 85, 100-101, 121-126

decision support/problem solving, 7, 51, 53, 55, 61-62, 63-64, 68-69, 74, 81, 84, 90-93, 95, 105, 112, 117, 124-125, 136, 149, 181, 223

department-level information systems, 112, 113, 136

historical perspectives, 111-113

knowledge-based system, 74, 88, 92, 95, 105, 110, 119, 124-125, 181

laboratory tests, 64, 116, 123

linkages, 6, 88

Classification, see Standards: data exchange and vocabulary

Coding standards for data elements, 13-14, 25, 39

Common Object Request Broker Architecture, 31

Composite Health Care System, 121

Computer-based Patient Record Institute, 10, 14, 50, 167, 168, 177 , 182, 183-185, 187, 188, 189, 191-195

Davies CPR Recognition Program, 8, 16

Computer-Stored Ambulatory System Record Systems (COSTAR), 112, 115-117

Computers at Risk: Safe Computing in the Information Age, 189

Confidentiality, 46, 47, 48, 67, 82, 80, 86-87, 95, 147-148, 153, 169, 181, 188, 192, 200, 207, 208-209, 214-216, 221-222

contract provisions, 221

design for, 14-15, 40, 139

European systems, 37-38

future systems, 94

individual practitioners' patient records, 57, 67

insurer access and, 80, 209, 210

Internet and, 4

pharmacy records, 57

privacy defined, 67

secondary databases, 110

standards, 13, 40, 131, 188

state law, 147-148, 208-209

technological aspects, 110, 126, 127-129

Communications infrastructure, 7-8

see also Networks;

Telecommunications

Connectivity, see Linkage and integration

Content issues, 59, 60-61, 80

definition of, 163, 183

outpatient records, 63

standards, 63, 140, 187

tables of, in computerized records, 82

Contracts, 200-201, 219-221

Coordination, see Organizational factors

Coordination and Continuity in Health Care (CoCo) project, 32, 33-34

COSTAR, 112, 115-117

Cost factors, 46, 49, 53, 58, 66, 68, 89, 93, 153, 154, 158, 161, 169-170, 178, 179, 181, 182, 186, 189-190

administrative, 46, 51, 68, 98, 193

clerical, 123, 141

computing technology, 7, 15-16, 69-70, 105-106, 112, 126, 127, 136 , 137, 141, 146

containment issues, 1-2, 15-16, 26, 35

data entry, 7, 84, 89, 126

demonstration projects, 157

design and development aspects, 15, 139, 140-142, 164

diffusion of technology, 145-146

hospital systems, 53, 63, 64, 137, 141

insurers, 65-66, 145, 154, 194

malpractice insurance, 124

maternal and child health care program, 156

medical information systems, 141, 146

per patient, 53, 145

secondary databases, 50, 110, 177, 193

sharing, 50, 51, 165-168, 177, 183, 193-194, 196

standards, 146

technological innovations, general, 69-70, 105-106, 112, 126, 127, 136, 137, 141, 146

voice recognition, 127

Council on Ethical and Judicial Affairs of the American Medical Association , 206

Court cases, see Litigation

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

D

Database management systems, 101, 103-104, 179

specific, 111-125

Databases, 50, 101-103, 148, 150, 179

AMA guidelines, 206

bibliographic, 47, 69, 74, 92-93, 95, 119, 124, 181

federal role, 67

linkage of, 49, 69, 88, 89, 95, 105, 106-107, 110-111, 124;

see also Networks

prescription drug, 36-37

problem-oriented medical record, 91

query languages, 106, 117

secondary, 49, 50, 55-56, 69, 74, 95, 77-78, 98, 110-111, 124, 161 , 163, 177, 179, 181, 182, 183, 191-193

specific, 111-125

see also Knowledge-based systems

Data entry, 117-118, 122, 125-126, 136, 137, 186

approaches, 29-32

cost factors, 84, 89, 126

errors, 84, 89, 105

physician orders, 2, 7, 25, 29-32, 126, 145, 168, 186

transcription, 25

voice recognition, 29, 106, 126-127, 131, 179, 186

Data quality, 84-86

Data retrieval, 47, 48, 53, 105-106, 111, 179, 181

Data storage, general, 81-90, 111

Decentralized Hospital Computer Program, 120-121

Decision support and problem solving, 51, 53, 55, 61-62, 63-64, 68 -69, 74, 81, 84, 90-93, 95, 105, 112, 117, 124-125, 136, 149, 181, 223

alerts, 8

knowledge-based systems, 12, 14, 74, 88, 92, 95, 105, 110, 119, 124 -125, 181

status in U.S., 8, 12, 14

Defense Advanced Research Projects Agency (DARPA), 150

Definitional issues, 55-56, 90, 95, 163, 183

change agents versus stakeholders, 151, 184

computer-based patient record, 9, 10-11, 13, 55, 95, 135-136, 139

contract law, 219

data integrity, 86-87

development versus diffusion, 138

health care needs, 74-79

hearsay, evidence, 212

patient records, 55, 95, 135-136, 139

privacy, 67

users, 75

Demographic factors, 46, 64, 66, 70, 116, 173-174, 195

see also Epidemiology

Demonstration projects, 49, 50, 67, 157, 160, 161, 163, 168, 182, 183, 185, 186

Department-level information systems, hospitals, 112, 113, 136

Department of Defense, 10, 121, 129-130, 141, 150, 157, 165, 166, 175

Department of Energy, 150

Department of Health and Human Services, 155, 164, 167, 185

see also specific subordinate agencies

Department of Veterans Affairs, 8, 120-121, 129-130, 141, 157-158, 165, 166, 175

Design and development, 49, 51, 67, 100, 138-142, 151-169, 182, 185

barriers to, 23, 40

costs, 139, 140-142, 164

defined, 138

modular, 116, 120-121, 124-125

problem-oriented medical record, 91

status, in U.S., 6-8, 12, 40

for system phasing, 93

user interfaces, 12

Diabcards, 34

Dictionaries, see Vocabulary control

Diffusion, innovations, 23-25, 45, 48-49, 69, 139, 142-151, 169, 182

attitudes, 142, 143-144, 145, 152

costs, 145-146

defined, 138

insurers, 143, 145, 146, 154-155

see also Education and training;

Professional education

DIOGENE, 122, 127

Drugs, see Pharmacies and pharmaceuticals

E

Early Clinical Information System, 120

Economic issues

physician incentives, data entry, 126, 145, 168, 186

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

productivity, 46, 68, 94, 154, 193

see also Cost factors;

Financial factors;

Funding

Education and training, 49, 51, 67

change agents and stakeholders, 163, 183

diffusion of innovations, general, 142, 143-145, 146, 161

patient, 75, 83

users, general, 49, 83, 143-145

see also Professional education

Efficiency/effectiveness, 53, 58, 66, 67, 89-90, 95, 127, 161, 163 , 167, 179

system response time, 83, 106, 120, 126, 145-146, 220

Electrocardiogram interpretation system, 27

Electronic Data Interchange for Finance, Administration, Commerce,

and Trade (EDIFACT), 31, 33

Electronic mail, 33, 47, 119, 150, 189

Emergency care, see Acute disorders and care

Employers and employment, 66, 154-155

Encounter-oriented medical records, 115

Epidemiology, 88, 127

national, 66, 155, 174

risk factors, 66, 84, 93

Errors and error analysis, 219

data entry, 84, 89, 105

on-line, 90, 105

voice recognition, 127

see also Accuracy issues

European CPR

in hospitals, 26-32

in primary care, 23-26

privacy and confidentiality, 37-38

security, 39

for shared care, 32-34, 38

standardization, 38-39

status, general, 21-23

treatment protocols integrated with, 36-37

uses of data, 34-35

Evaluation, 75, 182

computer applications costs, 141

data validity tags, 87

of patient care, defined, 56

peer review, 65, 157

reliability of records, 59, 81, 109-110

see also Efficiency/effectiveness

Event-oriented medical records, 117

Exmouth Project, 122-123

Expert systems, see Knowledge-based systems

F

Federal government, 50, 65, 66-67, 120-121, 155-158, 161, 164-168, 173-175, 184-185

Computer-based Patient Record Institute, 8, 10, 14, 50, 167, 168, 177, 182, 183-185, 187, 188, 189, 191-195

cooperation with public sector, 131, 165-168, 182, 184, 185

funding, 50, 155, 164-168, 184-185

interagency coordination, general, 175, 184, 185

national information system, 9-10, 50, 95-98, 166-168, 169, 173, 174, 177, 182-185, 189

organizational role, general, 66-67, 175, 184, 185

research, 67, 155, 164-165, 174, 175

standards, 66, 67, 129-131, 155, 161

see also Laws, specific federal

Federal Networking Council, 150, 189

Federal Privacy Act, 208

Financial factors, 46, 49, 51, 65, 82, 98, 119-120

federal role, 65, 66-67

see also Billing;

Cost factors;

Funding;

Insurance and insurers, health

Flexibility, 87, 113, 137, 179, 181

Flow sheets, 61

Food and Drug Administration, 148-149, 185, 189

Format issues, records, 59, 61-62, 80, 90-91, 115

European, 38-39

outpatient records, 63

problem-oriented, 61-62, 90-91, 93, 115, 117, 124

standards, 12-14, 23, 38-39, 63, 140, 186, 191

tables of contents/indexes, 82

Foundations, 161, 163, 185, 189

Framework Programs on Research and Development of the European Union , 21, 23

France, 29, 36

Funding, 49, 50, 143, 155, 161, 165, 174, 177, 179, 182, 184-185

federal, 50, 155, 164-168, 184-185

hospital systems, 141

standards development, 129

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

G

General Accounting Office, 52-53, 141, 167-168

General practitioners, 23-26, 33

Germany, 34

Government role, see Federal government;

State governments;

and specific departments and agencies

Graphics, 32, 47, 93, 95, 104, 105-106, 150, 179

picture archiving and communication system, 27

windowing, 117, 137

see also Images and image processing

Group practices, 114-115

H

Harvard Community Health Plan, 112, 115-117

Harvard Medical School, 119

HEALTH, 155

Health Care Financing Administration, 65, 129-130, 131, 156-157, 164-165, 166, 175, 185, 207

Health care system, structure of, 1-5, 22, 26, 142-143, 179

Health Evaluation through Logical Processing (HELP), 112, 118-119, 125, 127

Health maintenance organizations, 115-117

Health Plan Employer Data and Information Set (HEDIS), 3

Health Resources and Services Administration, 156, 173-174, 175, 185

Hearsay, evidence, 212-214

High-Performance Computing Act, 150

High-Performance Computing and Communications contracts, 9

Historical perspectives, 48, 52, 56-57, 111-113

committee study, 53-55

COSTAR, 112, 115-117

hospital systems, 111, 141

networks, 150

THERESA, 112, 117-118

HL 51 standards, 108

Hospital systems, 82, 89, 111, 117-121, 136

costs, 53, 63, 64, 137, 141

defined, 56

department-level information systems, 112, 113, 136

European, 26-32

historical perspectives, 111, 141

licensure laws, 147, 201-205, 217

multi-institution, 68, 88, 120-121, 141, 157, 165

THERESA, 112, 117-118, 127

Human-computer interface, see Users

Hypertext markup language (HTML), 5

Hypertext transfer protocol (HTTP), 5

I

Images and image processing, 13, 31, 39, 64, 68, 104, 106, 107, 114 -115, 150, 179, 189

see also Graphics

Indexes, 82

Information Security Foundation, 189

Insurance and insurers, health, 47, 50, 65-66, 75, 77, 78, 158, 169 -170, 177, 194

confidentiality and access by, 80, 209, 210

contract provisions, 221

cost factors, 65-66, 145, 154, 194

diffusion of innovation and, 143, 145, 146, 154-155

electronic claims submission, 89

employer provided, 154-155

health maintenance organizations, 115-117

physician incentives, data entry, 145, 168

smart cards, 34

see also Medicaid;

Medicare

Insurance Information and Privacy Protection Model Act, 210

Insurance, malpractice, 124

Institute of Electronic and Electrical Engineers, 13, 187

Institute of Medicine, 45, 53-54, 59, 67, 135, 158, 176, 195

Integrated Academic Information Management System, 160

Integrated delivery system (IDS), 3, 4, 6, 15-16

Integrated Services Digital Network, 109

Intellectual property, 220

Intelligence, 49, 80, 81

artificial intelligence, 201, 223

see also Knowledge-based systems

Intermountain Health Care Corporation, 118

International Classification for Primary Care, 25

International programs and activities, 21-40, 122-123, 139, 187-188

Internet, 4, 12, 150

see also World Wide Web

Intranet, 5

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

J

Joint Commission on Accreditation of Healthcare Organizations, 65, 160, 165, 208, 214, 217, 218

K

Knowledge-based systems, 28, 31-32, 74, 88, 92, 95, 105, 110, 119, 124-125, 181

Knowledge resources, access to, 7

L

Laboratory tests, 64, 116, 123

Laws, specific federal

Federal Privacy Act, 208

High-Performance Computing Act, 150

Insurance Portability and Accountability Act of 1996, 13, 14

Omnibus Budget Reconciliation Act, 66-67, 157

Social Security Act, 173, 174

Uniform Health-Care Information Act, 192, 210, 222

Leadership issues, 8, 14, 16-17

Legacy systems, 27, 31

Legal issues, 49, 142, 147-149, 161, 182, 183, 192-193, 200-223

contracts, 200-201, 219-221

evidentiary, 211-214

licensure laws, 147, 192, 200, 201-206, 220, 221-222

information access, right to, 83, 209-210, 214-216, 217-218;

see also Confidentiality

intellectual property, 14, 220

malpractice, 124, 144

ownership of data, 14, 147, 192, 211, 220

systems defect liability, 149, 200

vendors, 149, 200-201, 202, 219-221

viruses, computer, 217, 222

see also Laws, specific federal;

Litigation;

Regulations

Legislation, 90

model, 50, 192-193, 210, 221-222

see also Laws, specific federal

Licensure laws, 147, 192, 200, 201-206, 220

national, 221-222

Linkage and integration, 47, 62, 80, 87-89, 95, 181

confidentiality and, 147

of databases, 49, 69, 88, 89, 95, 105, 106-107, 110-111, 124, 179, 181;

see also Secondary databases

development and diffusion resources, 49, 51

financial-care information, 65

14C project, 28-29, 30-31

multi-site care, 32-34, 68, 88, 120-121

platforms, European, 27-28

unique health identifiers, 13

see also Internet;

Organizational factors

Litigation, 65, 79

contracts, 219

evidentiary issues, 211-214

systems defect liability, 149, 200

Lockheed Corporation, 120

Longitudinal approaches, 66

institutional planning, 65

patient records, 37, 47, 48, 61, 66, 68, 174

M

Malcolm Baldrige Quality Award Program, 16

Malpractice, 124, 144

Managed care, 2, 7, 26

Management of care, general, 65, 78, 93, 94;

see also Administrative functions

Maternal and child health care program, 156, 173-175

Medicaid, 157, 174, 206

Medical information systems, 111

access to, 7

costs, 141, 146

defined, 56

Medical Logic Modules, 124-125

The Medical Record (TMR), 114-115

Medicare, 156-157, 158, 165

peer review, 65, 157

regulations, 206-208, 214, 217

Medix, standards, 108

MEDLARS, 155

MEDLINE, 124, 155

MILNET, 150

Modular design, 116, 120-121, 124-125

Multimedia records, 11

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

N

National Aeronautics and Space Administration, 150

National Association of Insurance Commissioners, 210

National Committee for Quality Assurance, 3

National Committee on Vital and Health Statistics, 14

National Conference of Commissioners on Uniform State Laws, 148

National Electrical Manufacturers Association, 108

National Institute of Standards and Testing, 10

National Institutes of Health, 53, 155

National Library of Medicine, 9, 13, 124, 155, 160, 166

National Research and Education Network, 150-151, 189

National Research Council, 54

National Science Foundation, 150

Natural language processing, 29-31

Netherlands, The, 23-24, 26, 29, 36, 37

Networks, 5, 49, 51, 68, 95, 109, 150, 186, 189

design for, 139

diffusion of innovations, 142, 149-151

electronic mail, 47, 119, 150, 189

European, 22-23, 26-27, 32

national information systems, 9, 50, 95-98, 150-151, 163, 166-168, 169, 173, 174, 177, 182-185, 189

security, 4, 88, 96, 148, 216

for shared care, 32-34, 38

standards, data exchange and vocabulary, 5, 9, 12-14, 27, 39, 48, 50, 51, 85-86, 96, 106, 107-109, 116, 126, 127, 129-131, 140, 149-151, 155, 163, 168, 169, 174, 175, 177, 179, 181, 183, 186-188, 191-192, 196

Nurses, chart writing, time spent, 63

O

Office of Technology Assessment, 141

Omnibus Budget Reconciliation Act, 66-67, 157

ORCA, 28

Organizational factors, 49-50, 51, 52, 162-168, 176, 179-180, 182-183

accreditation, 65, 75, 77, 110, 149, 160, 168-169, 208, 214, 217, 218

change agents and stakeholders, 151-161, 163, 166, 168-169, 179, 183, 184

Computer-based Patient Record Institute, 50, 167, 168, 177, 182, 183-185, 187, 188, 189, 191-195

cost sharing, 50, 51, 165-168, 177, 183, 193-194, 196

federal interagency coordination, 175, 184, 185

federal role, general, 66-67, 175, 184, 185

health care system, general structure, 1-5, 22, 26, 40, 142-143, 179

institutional planning, 65, 136

medical record practices, physicians, 59, 61, 63

private/public cooperation, 131, 165-168, 182, 184, 185

professional associations, 50, 65, 67, 143, 153, 160, 165, 168, 179-181, 194, 206, 208, 210, 214, 217, 218

standard-setting organization, 170

technological innovation, 138, 151-161, 168-169

see also Administrative functions;

Format issues, records;

Linkage and integration;

Management of care, general

Outcomes reporting requirements, 3

Outpatient records, 63, 112, 141

COSTAR, 112, 115-117

summary time-oriented record, 62

Ownership issues, 147, 192, 211, 220

P

PaperChase, 119

Paper records, 57-63, 81, 84, 90, 178

Patient record, general, 56-57

defined, 55, 95, 135-136, 139

paper, 57-63, 81, 84, 90, 178

patient-derived information, 11

transcription, 25

users and uses, 29, 34-35, 75-78

Patients, general, 153-154

access to information, legal right, 83, 209-210, 214-216, 217-218

cost per, 53, 145

as data users, 65, 83

education, 75, 83

see also Confidentiality

Peer review, 65, 157

personal computers, 123, 124

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

Personal identification numbers, 148

Pharmacies and pharmaceuticals, 13, 25, 26, 34, 36, 39, 57, 64, 157

Physician Payment Review Commission, 158

Physicians, 47, 64, 87, 114-115

confidentiality, 57, 67

critiquing systems, 34, 35

diffusion of innovations, 23-25, 26, 144

group practices, 114-115

managers, relationship, 93

medical record practices, 59, 61, 63

order entry, 7, 25, 29-32, 126, 145, 168, 186

personal computer system, England, 123

time factors, 63, 83

Physicians' Desk Reference, 119

Policy development, 77, 79, 82

politics, 46, 48-49, 195

public opinion, 153, 195

Population-based care, 26

Population dynamics, see Demographic factors

Poverty, 156

maternal and child health care, 156, 173-175

Medicaid, 157, 174, 206

Primary care, CPR in, 2, 23-26

Primary patient record, general, 77, 78

defined, 55

Privacy, see Confidentiality

Private sector, 50, 79, 129, 165-166, 168, 177

cooperation with public sector, 50, 131 165-168, 177, 182, 184, 185

employers, 154-155

foundations, 161, 163, 185, 189

information system vendors, 100, 135-137, 149, 160-161, 162, 169, 185, 200-201, 202, 219-221

see also Insurance and insurers, health;

Professional associations and societies

Problem-knowledge coupler, 124

Problem-oriented medical record (POMR), 61-62, 90-91, 93, 115, 117 , 124

Problem solving, see Decision support and problem solving

Productivity

health professionals, 46, 68, 94, 193

insurers and, 154

Professional associations and societies, 50, 65, 143, 153, 168, 179 -181, 194, 210

AMA, 67, 206

JCAHO, 65, 160, 165, 208, 214, 217, 218

Professional education, 50, 68-69, 75, 77, 79, 92-93, 159-160, 168 , 169, 177, 182, 183, 194-195

academic research, 112, 114, 150, 159

diffusion of innovations, 142, 143-145, 146, 161

European, 25

physicians, 25, 83

teaching hospitals, 82

Professionals, general, 50, 51, 76, 152-153, 168, 178, 180-181

licensure laws, 206

productivity, 46, 68, 94, 193

see also Nurses;

Physicians;

Users

Projections, 56, 94-98, 181

digital switching, 109

imaging, 107

text processing systems, 106

Prospective Payment Assessment Commission, 158

Protocols, treatment, integration of, 34, 36-37

Prototypes, see Demonstration projects

Public Health Service, 66, 175, 185

Public opinion, 153, 195

Q

Quality control, 75, 77, 84-86, 186, 190-191

accreditation, 65, 75, 77, 110, 149, 160, 168-169, 208, 214, 217, 218

of care, 3, 7, 17, 34, 35, 46, 51, 64, 68, 93, 94, 123, 145, 153, 154, 158, 178, 181, 190-190

of data, 84-86, 90

on-line, 90, 105

see also Accreditation;

Errors and error analysis;

Regulations;

Standards

Query languages, 106, 117

R

Read Clinical Classification, 13, 108

Real time, 111, 157

Recommendations, IOM, general, 50-51, 176-196

Redundancy, fault tolerance, 118, 119

Registered Record Administrators (RRAs), 195

Regulations, 50, 79, 90, 147-149, 177, 192-193, 204-205

clinical reporting requirements, 3

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

Medicare, 206-208, 214, 217

see also Licensure laws;

Standards

Reliability, 59, 81, 95, 109-110, 179, 218

design for, 139

see also Accuracy issues

Research, 47, 48, 49, 50, 54, 68, 75, 77, 79, 110, 169, 182, 185-186, 190, 222

academic, 112, 114, 150, 159

demonstration projects, 49, 50, 67, 157, 160, 161, 163, 168, 182, 183, 185, 186

epidemiology, 66, 88, 84, 93, 127, 155, 174

federal role, 67, 155, 164-165, 174, 175

health services, support of, 45, 46, 94

problem-oriented medical record, 91

uniform record systems, 86

see also Design and development

Risk factors, 66, 84, 93

S

Secondary databases, 49, 50, 69, 74, 77-78, 95, 98, 110-111, 124, 161, 163, 177, 179, 181, 182, 183, 191-193

costs, 50, 110, 177, 193

defined, 55-56

Security, data, 86-87, 109-110, 126, 127-129, 147-148, 179, 214-217

design for, 14-15, 139

networks, 4, 88, 96, 148, 216

standards, 48, 50, 51, 96, 131, 163, 168, 177, 183, 186, 188-189, 191-192, 196

see also Confidentiality

Shared care environments, 32-34, 38

Smart cards, 32, 34, 39, 122-123

Social factors, 147-149, 156, 174

politics, 46, 48-49, 153, 195

public opinion, 153, 195

Social Security Act, 173, 174

Speech-recognition, see Voice recognition

Stakeholders, 151-161, 166, 179, 183

Standard Guide for Nosologic Standards and Guides for Construction of New Biomedical Nomenclature, 108

Standards, 49, 50, 51, 110, 131-132, 160, 161, 163, 177, 180-181, 186-192, 221-222

accreditation, 65, 75, 77, 110, 149, 160, 208, 214, 217, 218

clinical practice guidelines, 51, 67, 98, 164, 181, 190

confidentiality, 131, 188

content, general, 63, 84-86, 140, 186, 187

cost factors, 146

database queries, 106, 117

data exchange and vocabulary, 12-14, 31, 34, 38, 48, 50, 51, 85-86, 96, 106, 107-109, 116, 126, 127, 129-131, 140, 149-151, 155, 163, 168, 169, 174, 175, 177, 179, 181, 183, 186-188, 191-192, 196

federal role, 66, 67, 129-131, 155, 161

format, general, 38-39, 63, 84-86, 87, 191

international, 27, 38-39, 123, 187-188

outpatient records, 63

security, 48, 50, 51, 96, 131, 163, 168, 177, 183, 186, 188-189, 191-192, 196

state-level, general, 204

see also Licensure laws

State governments, 50, 157, 159, 161, 169, 174-175, 177, 192, 200-223

confidentiality laws, 147-148, 208-209

demonstration projects, 157, 168

licensure laws, 147, 192, 200, 201-206, 217, 221-222

model legislation, 50, 192-193, 210, 221-222

standards, 204

Statistical analysis, 93, 95, 118

Summary time-oriented record, 62

Surgery, 121

Systematized Nomenclature of Medicine, 108

T

Task-oriented medical records, 115, 117

Technicon, 120

Technological innovations, 46, 48, 68, 74, 81, 94, 100-132, 135-137, 138

advances, 3-6

barriers, general, 10-17, 126-131

computer processing power, 3

confidentiality and, 110, 126, 127-129

costs, 69-70, 105-106, 112, 126, 127, 136, 137, 141, 146

see also Design and development;

Diffusion, innovations;

Research

Telecommunications, 109

electronic mail, 47, 119, 150, 189

European, 22

reliability, 95

workstation linkages, 88

see also Networks

Text processing, 106-107, 108, 126, 127, 131, 179

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
×

THERESA, 112, 117-118, 127

Third-party payers, see Insurance and insurers,

health;

Medicaid;

Medicare

Time factors, 64

chart writing, 63

clerical functions, 123, 141

clinician/MEDLINE linkage, 124

data timeliness, 87

design and development of systems, 141

system response, 83, 106, 120, 126, 145-146, 220

see also Longitudinal approaches

Time-oriented medical record, 115, 117

TMR (The Medical Record), 114-115

Transfer of technology, see Diffusion, innovations

Treaty for the Protection of Human Rights and Fundamental Freedom, 37-38

U

Unified Medical Language System (UMLS), 9, 13, 106-107, 108-109, 155, 188

Uniform Clinical Data Set, 131, 156-157

Uniform Commercial Code, 200, 219, 221

Uniform Health-Care Information Act, 192, 210, 222

Unique health identifier, 13

United Kingdom, 23-24, 26, 29, 36, 108, 122-123

Universities, 159-160

academic research, 112, 114, 150, 159

University of California at Los Angeles, 4

UNIX, 28, 137

U.S. CPR systems, status

advances, 3-4, 9-10

barriers/challenges, 10-17

implementation, 8-9

market, 6-8

practice environment, 1-5

Users, 46-47, 58, 65, 70, 74-93, 143-145, 181

authentication/identification, 14, 39

computer interface with, general, 4-5, 7, 11-12, 29, 87, 88, 126-127, 179

diffusion of innovations, 142, 143-145

needs, general, 46-47, 76-93

multiple, 65

patients as, 65, 83

projections, 94-98

see also Access issues;

Change agents;

Stakeholders

V

Vendors, 100, 160-161, 162, 169, 185

legal issues, 149, 200-201, 202, 219-221

survey of, 135-137

Veterans Administration, see Department of Veterans Affairs

Viruses, computer, 217, 222

Vocabulary control, 9, 11, 13-14, 25, 31, 39, 48, 50, 51, 85-86, 96, 106, 107-109, 116, 126, 127, 129-131, 140, 149-151, 155, 163, 168, 169, 174, 175, 177, 179, 181, 183, 186-188, 191-192, 196

Voice recognition, 29, 32, 106, 126-127, 131, 179, 186

W

Windowing, 117, 137

Windows NT/95 environment, 28

Word processing, see Text processing

Workstations, 26-28, 88, 104-105, 179

World Wide Web, 4-5

Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
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Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
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Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
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Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
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Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
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Suggested Citation:"Index." Institute of Medicine. 1997. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Washington, DC: The National Academies Press. doi: 10.17226/5306.
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The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition Get This Book
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Most industries have plunged into data automation, but health care organizations have lagged in moving patients' medical records from paper to computers. In its first edition, this book presented a blueprint for introducing the computer-based patient record (CPR). The revised edition adds new information to the original book. One section describes recent developments, including the creation of a computer-based patient record institute. An international chapter highlights what is new in this still-emerging technology. An expert committee explores the potential of machine-readable CPRs to improve diagnostic and care decisions, provide a database for policymaking, and much more, addressing these key questions:

  • Who uses patient records?
  • What technology is available and what further research is necessary to meet users' needs?
  • What should government, medical organizations, and others do to make the transition to CPRs? The volume also explores such issues as privacy and confidentiality, costs, the need for training, legal barriers to CPRs, and other key topics.
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