The Use of Computers for Clinical Care: A Case Series of Advanced U.S. Sites
Open Access
- 1 January 2003
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of the American Medical Informatics Association
- Vol. 10 (1), 94-107
- https://doi.org/10.1197/jamia.m1127
Abstract
Objective: To describe advanced clinical information systems in the context in which they have been implemented and are being used. Design: Case series of five U.S. hospitals, including inpatient, ambulatory and emergency units. Descriptive study with data collected from interviews, observations, and document analysis. Measurements: The use of computerized results, notes, orders, and event monitors and the type of decision support; data capture mechanisms and data form; impact on clinician satisfaction and clinical processes and outcomes; and the organizational factors associated with successful implementation. Results: All sites have implemented a wide range of clinical information systems with extensive decision support. The systems had been well accepted by clinicians and have improved clinical processes. Successful implementation required leadership and long-term commitment, a focus on improving clinical processes, and gaining clinician involvement and maintaining productivity. Conclusion: Despite differences in approach there are many similarities between sites in the clinical information systems in use and the factors important to successful implementation. The experience of these sites may provide a valuable guide for others who are yet to start, or are just beginning, the implementation of clinical information systems.Keywords
This publication has 31 references indexed in Scilit:
- Evaluating informatics applications—clinical decision support systems literature reviewInternational Journal of Medical Informatics, 2001
- Controlled Trial of Direct Physician Order Entry: Effects on Physicians' Time Utilization in Ambulatory Primary Care Internal Medicine PracticesJournal of the American Medical Informatics Association, 2001
- Improving Response to Critical Laboratory Results with Automation: Results of a Randomized Controlled TrialJournal of the American Medical Informatics Association, 1999
- The Regenstrief Medical Record System: a quarter century experienceInternational Journal of Medical Informatics, 1999
- Identifying Adverse Drug Events: Development of a Computer-based Monitor and Comparison with Chart Review and Stimulated Voluntary ReportJournal of the American Medical Informatics Association, 1998
- A Computer-Assisted Management Program for Antibiotics and Other Antiinfective AgentsThe New England Journal of Medicine, 1998
- A Randomized Trial of "Corollary Orders" to Prevent Errors of OmissionJournal of the American Medical Informatics Association, 1997
- Implementation of Physician Order Entry: User Satisfaction and Self-Reported usage PatternsJournal of the American Medical Informatics Association, 1996
- Evaluation of User Acceptance of a Clinical Expert SystemJournal of the American Medical Informatics Association, 1994
- The Effect on Test Ordering of Informing Physicians of the Charges for Outpatient Diagnostic TestsThe New England Journal of Medicine, 1990