Rethinking electronic health records to better achieve quality and safety goals.

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37203, USA.
Annual Review of Medicine (Impact Factor: 15.48). 02/2007; 58:35-47. DOI: 10.1146/
Source: PubMed

ABSTRACT Health care information technology changes the ecosystem of a practice. Human roles, process work flow, and technology infrastructure are tightly interrelated. Medical errors may increase if a change in one is not accommodated by a change in the others. Introduction of information technology should be approached as an iterative process of care improvement rather than as a one-time insertion of an information system into established practice. Information technology supports a family of technological approaches, each with distinct mechanisms of action, benefits, and side effects. By matching technological approach to task and staging introduction into practice, initial benefit can be obtained more quickly, at reduced cost, while managing risk of a misfit. A staged approach to turning direct access by patients to their health information into more effective care is presented as an example of this strategy.

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    ABSTRACT: SUMMARY Information systems assist in documentation and clinical decision support in settings ranging from an outpatient clinical encounter to the monitoring in an operating room. Such information, if stored and categorized well in a centralized database, offers a treasure trove of information for translational researchers. At Vanderbilt University Medical Center (TN, USA), there is an ongoing effort to advance information systems in all areas and couple this data with a robust genetic repository. It is hoped that such an effort will achieve improvements in quality of care and decreases in costs, while simultaneously providing a fertile ground for translational research.
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