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
knowledge resources, 7
legal right to, 14, 83, 209-210, 214-216, 217-218
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
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
ARPANET, 4
Artificial intelligence, 201, 223
see also Knowledge-based systems
Attitudes
toward diffusion of innovations, 142, 143-144, 145, 152
systems vendors, 135-137
B
Bibliographic databases, 47, 69, 74, 92-93, 95, 119, 124, 181
Browser software, 4-5
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
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
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
technological aspects, 110, 126, 127-129
Communications infrastructure, 7-8
see also Networks;
Telecommunications
Connectivity, see Linkage and integration
outpatient records, 63
tables of, in computerized records, 82
Coordination, see Organizational factors
Coordination and Continuity in Health Care (CoCo) project, 32, 33-34
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
computing technology, 7, 15-16, 69-70, 105-106, 112, 126, 127, 136 , 137, 141, 146
containment issues, 1-2, 15-16, 26, 35
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
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
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
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
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
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
defined, 138
modular, 116, 120-121, 124-125
problem-oriented medical record, 91
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
Drugs, see Pharmacies and pharmaceuticals
E
Early Clinical Information System, 120
Economic issues
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
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,
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
Errors and error analysis, 219
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
standardization, 38-39
status, general, 21-23
treatment protocols integrated with, 36-37
uses of data, 34-35
computer applications costs, 141
data validity tags, 87
of patient care, defined, 56
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
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
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
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
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
networks, 150
HL 51 standards, 108
Hospital systems, 82, 89, 111, 117-121, 136
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
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
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
see also World Wide Web
Intranet, 5
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
Uniform Health-Care Information Act, 192, 210, 222
Leadership issues, 8, 14, 16-17
Legal issues, 49, 142, 147-149, 161, 182, 183, 192-193, 200-223
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
ownership of data, 14, 147, 192, 211, 220
systems defect liability, 149, 200
vendors, 149, 200-201, 202, 219-221
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
multi-site care, 32-34, 68, 88, 120-121
platforms, European, 27-28
unique health identifiers, 13
see also Internet;
Organizational factors
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
Management of care, general, 65, 78, 93, 94;
see also Administrative functions
Maternal and child health care program, 156, 173-175
Medical information systems, 111
access to, 7
defined, 56
Medical Logic Modules, 124-125
The Medical Record (TMR), 114-115
regulations, 206-208, 214, 217
Medix, standards, 108
MEDLARS, 155
MILNET, 150
Modular design, 116, 120-121, 124-125
Multimedia records, 11
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
national information systems, 9, 50, 95-98, 150-151, 163, 166-168, 169, 173, 174, 177, 182-185, 189
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
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
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
see also Confidentiality
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
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
Physicians' Desk Reference, 119
Policy development, 77, 79, 82
Population-based care, 26
Population dynamics, see Demographic factors
Poverty, 156
maternal and child health care, 156, 173-175
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
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
teaching hospitals, 82
Professionals, general, 50, 51, 76, 152-153, 168, 178, 180-181
licensure laws, 206
see also Nurses;
Physicians;
Users
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
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
see also Accreditation;
Errors and error analysis;
Regulations;
Standards
R
Read Clinical Classification, 13, 108
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
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
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
S
Secondary databases, 49, 50, 69, 74, 77-78, 95, 98, 110-111, 124, 161, 163, 177, 179, 181, 182, 183, 191-193
defined, 55-56
Security, data, 86-87, 109-110, 126, 127-129, 147-148, 179, 214-217
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
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
content, general, 63, 84-86, 140, 186, 187
cost factors, 146
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
Third-party payers, see Insurance and insurers,
health;
Medicaid;
Medicare
Time factors, 64
chart writing, 63
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
U.S. CPR systems, status
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
multiple, 65
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
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
Windows NT/95 environment, 28
Word processing, see Text processing
Workstations, 26-28, 88, 104-105, 179
World Wide Web, 4-5