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Part of the book series: Health Informatics ((HI))

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Abstract

In the future, health care providers will need to interact directly with clinical information systems to take full advantage of the capacity of these systems for organization of information and clinical practice suport. This will require physicians and other providers to change the way they have traditionally recorded, retrieved, and utilized clinical data. This chapter discusses the major advantages resulting from physician use of clinical information systems, the barriers to the acceptance and use of these systems, methods that may increase their acceptance and use, and the ethical imperative for evaluation.

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References

  1. Kleinke JD. Bleeding edge: the business of health care in the next century. Gaithersburg, MD, Aspen Publishers; 1998.

    Google Scholar 

  2. Millenson, ML. Demanding medical excellence: doctors and accountability in the information age. Chicago: University of Chicago Press; 1997.

    Google Scholar 

  3. Dick, RS, Steen EB, Detmer DE, eds. The computer-based patient record. Rev. ed. Washington, DC: Institute of Medicine, National Academy Press; 1997.

    Google Scholar 

  4. Gallo AC, Lee VJ. Health Care Information Technology: Keeping Health Care Wired, Research report. Baltimore: Alex Brown; 1998, 1.

    Google Scholar 

  5. Kleinke JD. Release 0.0: Clinical information technology in the real world. Health Affairs. 1998;17:23–38.

    Article  PubMed  CAS  Google Scholar 

  6. Furfaros C, Muchoney K, Anania-Firouzan P. CPR by the year 2000: a myth? Healthcare Inf. 1996;13:45, 47.

    Google Scholar 

  7. McCormack J. When will smaller medical groups discover computers? Health Data Manage. 1997;5:50–52,54,56,58,60,63.

    CAS  Google Scholar 

  8. Anderson JG. Computer-based patient records and changing physician practice patterns. Topics Health Inform Manage. 1994;15:10–23.

    CAS  Google Scholar 

  9. Schoenbaum SC, Barnett GO. Automated ambulatory medical records systems: An orphan technology. J Technol Assess Health Care. 1992;8:598–609.

    CAS  Google Scholar 

  10. Sittig DF, Stead WW. Computer-based physician order entry: The state of the art. J Am Med Inf Assoc. 1994;1:108–123.

    CAS  Google Scholar 

  11. Kuperman GJ, Gardner RM, Pryor TA. HELP: a dynamic hospital information system. New York: Springer-Verlag, 1991.

    Google Scholar 

  12. Miller RA. Medical diagnostic decision support systems—past, present, and future: A threaded bibliography and brief commentary. J Am Med Inform Assoc. 1994;1:8–27.

    PubMed  CAS  Google Scholar 

  13. Johnston ME, Langton KB, Haynes RB, Mathieu A. Effects of computer-based clinical decision support systems on clinician performance and patient outcome: a critical appraisal of research. Ann Inter Med. 1994;120:135–142.

    CAS  Google Scholar 

  14. Tierney VM, Miller ME, Overhage JM, McDonald CJ. Physician inpatient order writing on microcomputer workstations: Effects on resource utilization. JAMA. 1993;269:379–383.

    Article  PubMed  CAS  Google Scholar 

  15. Rind DM, Safran C, Phillips RS, et al. The effect of computer-based reminders on the management of hospitalized patients. In: Clayton P, ed. Proceedings of the Fifteenth Annual Symposium on Computer Applications in Medical Care. Los Angeles, IEEE Computer Society; 1991:28–32.

    Google Scholar 

  16. Kohn LT, Corrigan JM, Donaldson MS, eds. To err is human: building a safer health system. Washington, DC: National Academy Press, 1999.

    Google Scholar 

  17. Thomas EJ, Studdert DM, Newhouse JP, et al. Costs of medical injuries in Utah and Colorado. Inquiry. 1999;36:255–264.

    PubMed  CAS  Google Scholar 

  18. Hunt DL, Haynes RB, Hanna SE, Smith K. Effects of computer-based clinical decision support systems on physician performance and patient outcomes: A systematic review. JAMA. 1998;280:1339–1346.

    Article  PubMed  CAS  Google Scholar 

  19. Raschke RA, Gollihare B, Wunderlich TA, et al. A computer alert system to prevent injury from adverse drug events. JAMA. 1998;280:1317–1320.

    Article  PubMed  CAS  Google Scholar 

  20. Anderson JG, Jay SJ, Anderson MM, Hunt TJ. Evaluating the potential effectiveness of using computerized information systems to prevent adverse drug events. In Masys D, ed. The emergence of internetable health care—systems that really work: Proceedings of the 1997 AMIA annual symposium. Philadelphia: Hanley S. Belfus, 1997:228–232.

    Google Scholar 

  21. Bates DW, Teich JM, Lee J, et al. The impact of computerized physician order entry on medication error prevention. J Am Med Inf Assoc. 1999;6:313–321.

    CAS  Google Scholar 

  22. Lorenzi NM, Gardner RM, Pryor TA, Stead WW. Medical informatics: The key to an organization’s place in the new health care environment. J Am Med Inf Assoc. 1995;2:391–392.

    CAS  Google Scholar 

  23. Barnett GO, Winickoff RN, Morgan MM, Zielstorff RD. A computer-based monitoring system for follow-up of elevated blood pressure. Med Care. 1983;21:400–409.

    Article  PubMed  CAS  Google Scholar 

  24. Dambro MR, et al. An unsuccessful experience with computerized medical records in an academic medical center. J Med Educ. 1988;63:617–623.

    PubMed  CAS  Google Scholar 

  25. Campbell JR, Givner N, Sellig CB, Greer AL, Patil K, Wigton RS, et al. Computerized medical records and clinic function. MD Computing. 1989;6: 282–287.

    PubMed  CAS  Google Scholar 

  26. Chessare JB, Torok KE. Implementation of COSTAR in an academic group practice of general pediatrics. MD Computing. 1993;10:23–27.

    PubMed  CAS  Google Scholar 

  27. Massaro TA. Introducing physician order entry at a major medical center: I. Impact of organizational culture and behavior. Acad Med. 1993;68:20–25.

    PubMed  CAS  Google Scholar 

  28. Massaro TA. Introducing physician order entry at a major medical center: II. Impact on medical education. Acad Med. 1993;68:25–30.

    PubMed  CAS  Google Scholar 

  29. Anderson JG, Aydin C. Theoretical perspectives and methodologies for the evaluation of health care information systems. In: Anderson JG, Aydin CE, Jay SJ, eds. Evaluating health care information systems: methods and applications. Thousand Oaks, Calif: Sage;1994:5–29.

    Google Scholar 

  30. Anderson JG, Jay SJ. Computers and clinical judgment: The role of physician networks. Soc Sci Med. 1985;20:969–979.

    Article  PubMed  CAS  Google Scholar 

  31. Anderson JG, Jay SJ, Schweer HM, Anderson MM, Kassing D. Physician communication networks and the adoption and utilization of computer applications in medicine. In: Anderson JG, Jay SJ, eds. Use and impact of computers in clinical medicine. New York: Springer-Verlag;1987:185–199.

    Google Scholar 

  32. Aydin CE, Anderson JG, Rosen PN, Felitti VJ, Weng HC. Computers in the consulting room: a case study of clinician and patient perspectives. Health Care Manage Sci. 1998;1:61–74.

    Article  CAS  Google Scholar 

  33. Friedman B, Kahn PH. Educating computer scientists: linking the social and the technical. Commun ACM. 1994;37:65–70.

    Article  Google Scholar 

  34. Leveson N, Turner C. An investigation of the Therac-25 accidents. Computer. 1993;26:18–41.

    Article  Google Scholar 

  35. Freudenheim M. A troubled Oxford Health takes action. TheNew York Times. November 7, 1997: D1.

    Google Scholar 

  36. Gantenbein D, Stepanek M. Kaiser takes the Cyber cure. Business Week. February 7, 2000. Available at: http://www.businessweek.com/2000/00_06/b3667061.htm. Accessed October 9, 2001.

  37. Henderson G. SRMC report: 600 problems with system since July. Spartanburg Herald-Journal, Spartanburg, South Carolina, March 22, 2000: A1.

    Google Scholar 

  38. Ash JS, Anderson JG, Gorman PN, Zielstorff RD, Norcross N. Pettit J, Yao P. Managing change: analysis of a hypothetical case. J Am Med Inf Assoc. 2000;7:125–134.

    CAS  Google Scholar 

  39. Collins WR, Miller KW, Spielman BJ, Wherry P. How good is good enough? An ethical analysis of software construction and use. Commun ACM. 1994;27:81–91.

    Article  Google Scholar 

  40. Anderson JG, Aydin CE. Technology assessment of health care information systems. Int J Technol Assess Health Care. 1997;13:380–393.

    PubMed  CAS  Google Scholar 

  41. Anderson JG, Aydin CE. Evaluating medical information systems: Social contexts and ethical challenges. In: Goodman KW, ed. Ethics, computing andmedicine: informatics and the transformation of healthcare. New York: Cambridge University Press; 1998: 57–74.

    Google Scholar 

  42. Anderson JG. Increasing the acceptance of clinical information systems. MD Computing. 1999;16;62–65.

    PubMed  CAS  Google Scholar 

  43. Anderson JG, Jay SJ, Perry J, Anderson MM. Modifying physician use of a hospital information system: A quasi-experimental study. In: Anderson JG, Aydin CE, Jay SJ, eds. Evaluating health care information systems: methods and applications. Thousand Oaks, Calif: Sage 1994:276–287.

    Google Scholar 

  44. Martin-Baranera M, Planas I, Palau J, et al. Assessing physicians’ expectations and attitudes towards hospital information systems. The IMASIS experience. MD Computing. 1999;16:73–76.

    PubMed  CAS  Google Scholar 

  45. Schroeder CG, Pierpaoli PG. Direct order entry by physicians in a computerized hospital information system. Am J Hosp Pharm. 1986;43:355–359.

    PubMed  CAS  Google Scholar 

  46. Berkowitz LL. Breaking down the barriers: Improving physician buy-in of CPR systems. Healthcare Inf. 1997;14:73–76.

    CAS  Google Scholar 

Further Readings

  • Anderson JG. Information technology in health care: Social and ethical challenges. In: M Witten, ed. Computational medicine, public health and biotechnology: building a man in the machine. River Edge, NJ: World Scientific Publishing Co; 1995:1533–1544.

    Google Scholar 

  • Anderson JG. Clearing the way physician’s use of clinical information systems. Commun ACM. 1997;40:83–90.

    Article  Google Scholar 

  • Anderson JG, Aydin CE. Evaluating the impact of health care information systems. Int J Technol Assess Health Care. 1997;13:380–393.

    PubMed  CAS  Google Scholar 

  • Anderson JG, Aydin CE. Overview: theoretical perspectives and methodologies for the evaluation of health care information systems. In: Anderson JG, Aydin CE, Jay SJ, eds. Evaluating health care information systems: methods and applications. Thousand Oaks, Calif: Sage; 1994;5–29.

    Google Scholar 

  • Anderson JG, Aydin CE, Jay SJ, eds. Evaluating health care information systems: methods and applications. Thousand Oaks, Calif: Sage Publications; 1994.

    Google Scholar 

  • Anderson JG, Aydin CE, Kaplan B. An analytical framework for measuring the effectiveness/impacts of computer-based patient record systems. In: Nunamaker JF, Sprague RH Jr, eds. Proceedings: Twenty-Eighth International conference on Systems Science, Vol. IV: information systems—collaboration systems and technology, organizational systems and technology. Los Alamitos: IEEE Computer Society Press; 1995:767–776.

    Google Scholar 

  • Anderson JG, Jay SJ. Hospitals of the future. In: Anderson JG, Jay SJ, eds. Use and impact of computers in clinical medicine. New York: Springer-Verlag; 1987;343–350.

    Google Scholar 

  • Anderson JG, Jay SJ. The social impact of computer technology on physicians. Computers and Society. 1991;20:28–33.

    Google Scholar 

  • Anderson JG, Jay SJ, Schweer HM, Anderson MM. Physician utilization of computers in medical practice: Policy implications based on a structural model. Soc Sci Med. 1986;23:259–267.

    Article  PubMed  CAS  Google Scholar 

  • Anderson JG, Jay SJ, Schweer HM, Anderson MM. Why doctors don’t use computers: Some empirical findings. J Royal Soc Med. 1986;79:142–144.

    CAS  Google Scholar 

  • Aydin CE. Occupational adaptation to computerized medical information systems. J Health Soc Behav. 1989;30:163–179.

    Article  PubMed  CAS  Google Scholar 

  • Aydin CE. Professional agendas and computer-based patient records: Negotiating for control. Topics Health Inform Manage. 1994;15:41–51.

    CAS  Google Scholar 

  • Aydin CE, Anderson JG, Rosen PN, Felitti V, Weng HC. Computers in the consulting room: A case study of clinician and patient perspectives. Health Care Manage Sci. 1998;1:61–74.

    Article  CAS  Google Scholar 

  • Berkowitz LL. Breaking down the barriers: Improving physician buy-in of CPR systems. Healthcare Inf. 1997;14:73–76.

    CAS  Google Scholar 

  • Brenner DJ, Logan RA. Some considerations in the diffusion of medical technologies: Medical information systems. Commun Yearbook. 1980;4:609–623.

    Google Scholar 

  • Davies BL. A discussion of safety issues for medical robots. In: Taylor RS, Lavallee, S. Burdea GC, Mosges, R, eds. Computer integrated surgery: technology and clinical applications. Cambridge, Mass: MIT Press; 1996:287–296.

    Google Scholar 

  • Davis DA, Taylor-Vaisey A. Translating guidelines into practice: a systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. Can Med Assoc J 1997;157:408–416.

    CAS  Google Scholar 

  • Dick RS, Steen EB, Detmer DE, eds. The computer-based patient record: an essential technology for health care, Rev. ed. Washington, DC: National Academy Press; 1997.

    Google Scholar 

  • Esterhay RJ. The medical record: Problem or solution? MD Comput. 1993;10:78–80.

    PubMed  Google Scholar 

  • Fortess EE, Kapp MB. Medical uncertainty, diagnostic testing, and legal liability. J Law Med Healthcare. 1985;13:213–218.

    CAS  Google Scholar 

  • Friedman CP, Wyatt JC. Evaluation methods in medical informatics. New York: Springer; 1997.

    Google Scholar 

  • Furfaros C, Muchoney K, Anania-Firouzan P. CPR by the year 2000: a myth? Healthcare Inform. 1996;13:45, 47.

    Google Scholar 

  • Goodman KW. Ethics and system evaluation. Physic Comput. 1994;121:12–14.

    Google Scholar 

  • Gotterbarn D. The moral responsibility of software developers: Three levels of professional software engineering. J Inform Ethics. 1995;4:54–64.

    Google Scholar 

  • Heeks R, Mundy D, Salazar A. Why health care information systems succeed or fail. Information Systems for Public Sector Management Working Paper Series, Working paper No. 9, Institute for Development Policy and Management, University of Manchester, Manchester, UK. Available at: http://www.man.ac.uk/idpm/isps_wp9.htm/. Accessed: August 18, 2000.

    Google Scholar 

  • Kaplan B. Reducing barriers to physician data entry for computer-based patient records. Top Health Inform Manage. 1994;15:24–34.

    CAS  Google Scholar 

  • Kaplan B. Addressing organizational issues into the evaluation of medical systems. J Am Med Inform Assoc. 1997;4:94–101.

    PubMed  CAS  Google Scholar 

  • Kassirer JP. A report card on computer-assisted diagnosis. N Engl J Med. 1994;330:1824–1825.

    Article  PubMed  CAS  Google Scholar 

  • Leveson N, Turner C. An investigation of the Therac-25 accidents. Computer. 1993;26:18–41.

    Article  Google Scholar 

  • Lundsgaarde HP. Evaluating medical expert systems. Soc Sci Med. 1987;24:805–819.

    Article  PubMed  CAS  Google Scholar 

  • Lyytinen K, Hirschheim R. Information systems failure—A survey and classification of empirical literature. Oxford Surv Inform Technol. 1987;4:257–309.

    Google Scholar 

  • Mason RO. Four ethical issues of the information age. MIS Quarterly. 1986;10:4–12.

    Article  Google Scholar 

  • McCormick J. When will smaller medical groups discover computers? Health Data Manage. 1997;5:50–63.

    Google Scholar 

  • Miller RA. Medical diagnostic decision support systems—past, present, and future: A threaded bibliography and brief commentary. J Am Med Inform Assoc. 1994;1:8–27.

    PubMed  CAS  Google Scholar 

  • Miller RA, Schaffner KF, Meisel A. Ethical and legal issues related to the use of computer programs in clinical medicine. Ann Intern Med. 1985;102:529–536.

    PubMed  CAS  Google Scholar 

  • Miller RA, Goodman KW. Ethical challenges in the use of decision-support software. In: Goodman KW, ed. Ethics, computing and medicine: informatics and the transformation of health care. New York: Cambridge University Press; 1998:102–115.

    Google Scholar 

  • Mortimer H. Computer-aided medicine: Present and future issues of liability. Comput Law J. 1989;9:177–203.

    Google Scholar 

  • Neumann PG. Computer-related risks. New York: ACM Press; 1995.

    Google Scholar 

  • Nissenbaum H. Computing and accountability. Commun ACM. 1994;37:73–80.

    Article  Google Scholar 

  • Nissenbaum H. Accountability in a computerized society. Sci Eng. 1996;2:25–42.

    Google Scholar 

  • Schoenbaum SC, Barnett GO. Automated ambulatory medical records systems: An orphan technology. J Technol Assess Health Care. 1992;8:598–609.

    Article  CAS  Google Scholar 

  • Siegler M, Toulmin S, Zimring FE, Schaffner KF, eds. Medical innovation and bad outcomes: legal, social, and ethical responses. Ann Arbor, Mich: Health Administration Press; 1987.

    Google Scholar 

  • Simborg DW, Gabler JM. Reengineering the traditional medical record: The view from industry. MD Computing. 1992;9:198–200, 272.

    Google Scholar 

  • Sitting DF, Stead WW. Computer-based physician order entry: The state of the art. J Am Med Inform Assoc. 1994;1:108–123.

    Google Scholar 

  • Snapper JW. Responsibility for computer-based errors. Metaphilosophy. 1985;16:289–295.

    Google Scholar 

  • Stead WW. A quarter-century of computer-based medical records. MD Computing. 1989;6:75–81.

    Google Scholar 

  • Wyatt JC, Spiegelhalter DJ. Evaluating medical expert systems: What to test and how? Med Inform. 1990;15:205–217.

    CAS  Google Scholar 

  • Young DW. What makes doctors use computers? Discussion paper. J Royal Soc Med. 1984;77:663–667.

    CAS  Google Scholar 

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(2002). Evaluation: An Imperative to Do No Harm. In: Anderson, J.G., Goodman, K.W. (eds) Ethics and Information Technology: A Case-Based Approach to a Health Care System in Transition. Health Informatics. Springer, New York, NY. https://doi.org/10.1007/978-0-387-22488-6_6

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  • DOI: https://doi.org/10.1007/978-0-387-22488-6_6

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