Computer-Stored Medical Records – Their Future Role in Medical Practice

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The idea of an electronic health record, by which a patient’s information would be stored electronically instead of on paper, has been around since the late 1960s. One of the first medical record systems was developed by the Regenstrief Institute in 1972. In this article, McDonald and Tierney of the Regenstrief Institute discuss benefits of an electronic health record and the barriers that must be surmounted to allow for its implementation on a broad scale.

McDonald and Tierney argue that an electronic health record system would solve many of the logistic problems of finding, organizing, and reporting patient information, as well as improve the efficiency and accuracy of physician’s decision by performing calculations and by identifying clinical events that need attention, and guide future policies and practices by analyzing past clinical experience within a hospital or a physician’s office.

They acknowledge the various problems and barriers to establishing an electronic health record system such as the difficulty of integrating diverse clinical data sources, costs of training and managing data-entry personnel, structuring and standardizing data transcription and ontologies, and even the cost of computer hardware. However, McDonald and Tierney remain optimistic, noting that in the past, economic, technical, and organizational barriers had prevented the widespread use of such systems but with the increasing capabilities of computers, their decreasing costs, and third-party incentives to store medical information on computers, they posited that electronic medical record systems would be widely available in the near future.

However, we now know that despite overcoming technical barriers, social barriers have proved much less surmountable. Although the concept was, and still is, widely hailed as a major advance in medicine and healthcare, physicians did not, and largely still will not, flock to the technology.

McDonald CJ, Tierney WM (1988). Computer-Stored Medical Records – Their Future Role in Medical Practice. JAMA 259:23 p3433-3440

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