Methods Inf Med 2002; 41(01): 51-54
DOI: 10.1055/s-0038-1634313
Original Article
Schattauer GmbH

Closing the Loop between Clinical Practice, Research, and Education: The Potential of Electronic Patient Records

J. van der Lei
1   Department of Medical Informatics, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Publikationsverlauf

Publikationsdatum:
07. Februar 2018 (online)

Summary

Objective: To discuss the possible contribution of electronic patient records in closing the loop among clinical practice, research and education.

Results and conclusions: Applying Information and Communication Technology (ICT) to a given medical domain is not merely adding a new technique. When introduced into an environment, ICT will initially often emulate or resemble the already existing processes. When workers and researchers in that domain begin to appreciate the potential of ICT, this initial stage is followed by more fundamental changes in that domain that take advantage of the potential of ICT. To understand the scope of the potential changes enabled by electronic records, three principle changes need to be understood. First, data recorded in computer memories can be readily retrieved and re-used for a variety of purposes. Second, once data are available in computer memories, the data can be transported easily. Third, as physicians (and patients) are using computers to record medical data, the same electronic record can be used to introduce other computer programs that interact with the user. New usage of data, however, generates additional requirements. Thus the experience in developing decision support systems and analyzing observational databases feeds back into the requirements for electronic medical records.

Each patient-physician encounter, each investigation, each laboratory test, and each treatment in medical practice constitutes, in principle, an experiment. Ideally, we learn from each experiment. Electronic medical records will facilitate research that relies on data recorded in routine medical practice. The potential and challenge, however, of Medical Informatics lies in its ability to close the loop among clinical practice, research, and education.

 
  • References

  • 1 Van Bemmel JH, Musen MA. editors. Handbook of Medical Informatics. Heidelberg, Germany: Springer Verlag; 1997
  • 2 Institute of Medicine, Committee on Improving the Patient Record.. The Computer-Based Patient Record: An Essential Technology for Health Care (Revised Edition). Washington DC: National Academy Press; 1997
  • 3 Van der Lei J, Duisterhout JS, Westerhof HP, Van der Does E, Cromme PVM, Boon WM. et al. The introduction of computer-based patient records in the Netherlands. Ann Intern Med 1993; 119: 1036-41.
  • 4 Burnum JF. The misinformation era: The fall of the medical record. Ann Intern Med 1989; 110: 482-4.
  • 5 Van der Lei J, Musen MA, Van der Does E, Man in’t Veld AJ, Van Bemmel JH. Comparison of computer-aided and human review of general practitioners’ management of hypertension. Lancet 1991; 338: 1505-8.
  • 6 Knottnerus JA. The role of electronic patient records in the development of general practice in the Netherlands. Methods Inf Med 1999; 38: 350-5.
  • 7 Hunt DL, Haynes RB, Hanna SE, Smith K. Effects of computer-based decision support systems on physician performance and patient outcomes: A systematic review. JAMA 1998; 280 (Suppl. 15) 1339-46.
  • 8 Vlug AE, Van der Lei J, Mosseveld BMT, Van Wijk MAM, Van der Linden PD, Sturkenboom MCJM. et al. Postmarketing surveillance based on electronic patient records: The IPCI project. Methods Inf Med 1999; 38: 339-44.