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Automated Ambulatory Medical Records Systems: An Orphan Technology

Published online by Cambridge University Press:  10 March 2009

Stephen C. Schoenbaum
Affiliation:
Harvard Community Health Plan
G. Octo Barnett
Affiliation:
Massachusetts General Hospital

Abstract

Automated ambulatory medical records systems (AAMRSs) have been operational for over 20 years but have not been adopted by more than a small fraction of their potential users. This paper presents a detailed analysis of the uses and benefits of the COSTAR-based AAMRS at the Harvard Community Health Plan and of the factors which have inhibited the dissemination of COSTAR. We conclude that AAMRSs have been an orphan technology and cite trends in health care that favor the future development of AAMRSs.

Type
Special Section: Orphan Technologies
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

1.Barnett, G. O.Computer-stored ambulatory record (COSTAR). Rockville, MD: U. S. Department of Health, Education and Welfare, DHEW Publication No. (HRA) 76–3145, 1976.Google Scholar
2.Barnett, G. O., Winickoff, R. N., Dorsey, J. L., et al. Quality assurance through automated monitoring and concurrent feedback using a computer-based medical information system. Medical Care, 1978, 16, 962-70.Google Scholar
3.Barton, M. B., & Schoenbaum, S. C.Improving influenza vaccination performance in an HMO setting: The use of computer generated reminders and peer comparison feedback. American Journal of Public Health, 1990, 80, 534–36.CrossRefGoogle Scholar
4.Berwick, D. M.Continuous quality improvement as an ideal in health care. New England Journal of Medicine, 1989, 320, 5354.CrossRefGoogle ScholarPubMed
5.Dambro, M. R., Weiss, B. D., McClure, C. L., & Vuturo, A. F.An unsuccessful experience with computerized medical records in an academic medical center. Journal of Medical Education, 1988, 63, 617–23.Google Scholar
6.Institute of Medicine (U.S.) Committee on Improving the Patient Record. The computer-based patient record: An essential technology for health care. Dick, R. S. & Steen, E. B. (eds.), Washington, DC: National Academy Press, 1991.Google Scholar
7.Laffel, G., & Blumenthal, D.The case for using industrial quality management science in health care organizations. Journal of the American Medical Association, 1989, 262, 2869–73.Google Scholar
8.Lyons, J. P., Ludwig, R. A., & Fishaut, M.The future of clinical computing in HMOs. HMO Practice, 1988, 2, 243–52.Google Scholar
9.Schoenbaum, S. C., & Gottlieb, L. G.Algorithm based clinical quality improvement. British Medical Journal, 1990, 301, 1374–76.CrossRefGoogle Scholar