ORCA: The Versatile CPR

Abstract

The introduction of computer-based patient records (CPRs) that fully replace paper records proves especially difficult in specialized care, despite the potential advantages of CPRs for patient care and research. Improved data legibility, availability, sharing of records, and decision support may directly benefit patient care. Barriers to the introduction of CPR applications at institutions may be caused by lack of infrastructure, or by financial or organizational issues. To have clinicians interactively enter data at the point of care is still a big challenge. This paper presents an overview of ORCA (Open Record of CAre): a generic CPR, designed for integration with existing systems, presentation of multi-media patient data, and the collection of structured data, directly by clinicians. ORCA can easily be tailored to the needs of a variety of medical specialists without the need for changes to its data model, functionality, or interface. The paper describes the essence of the architecture of ORCA and the user benefits with emphasis on the support of structured data entry.

Keywords

Medical Records - Knowledge Representation - User Interface - Structured Data Entry - System Integration

• REFERENCES

• 1 van der Lei J, Duisterhout JS, Westerhof HP. et al. The introduction of computer-based patient records in The Netherlands. Ann Intern Med 1993; 119: 1036-41.
• 2 Barnett GO. The application of computer-based medical-record systems in ambulatory practice [Review]. N Engl J Med 1984; 310: 1643-50.
• 3 Schoenbaum SC, Barnett GO. Automated ambulatory medical records systems. An orphan technology. Int J Technol Assess Health Care 1992; 8: 598-609.
• 4 McDonald CJ, Tierny WM, Overhage JM, Martin DK, Wilson GA. The Regenstrief Medical Record System: 20 years of experience in hospitals, clinics, and neighborhood health centers. MD Comput 1992; 9: 206-17.
• 5 Dick RS, Steen EB, Detmer DE. The computer-based patient record: an essential technology for health care. Revised Edition. Committee on Improving the Patient record Division of Health Care Services. Institute of Medicine. National Academy Press; 1997
• 6 Reiser SJ. The clinical record in medicine. Part 2: Reforming content and purpose [see comments]. Ann Intern Med 1991; 114: 980-5.
• 7 McDonald CJ, Tierney W, Blevins L. The benefits of automated medical record systems for ambulatory care. In: Blum BI. ed. Information Systems for Patient Care. Heidelberg, Berlin, New York: Springer; 1984: 63-83.
• 8 Whiting-O’Keefe QE, Simborg DW, Epstein WV, Warger A. A computerized summary medical record system can provide more information than the standard medical record. JAMA 1985; 254: 1185-92.
• 9 Howkins TJ, Kay S, Rector AL. et al. An overview of the PEN & PAD project. In: Rienhoff O, Lindberg DAB. eds Lecture Notes in Medical Informatics 1990; 40: 73-8.
• 10 Trace D, Naeymi-Rad F, Haines D. et al. Intelligent Medical Record-entry (IMR-E). J Med Syst 1993; 17: 139-51.
• 11 Bernauer J. Conceptual graphs as an operational model for descriptive findings. In: Clayton PD. ed. Proceedings of the 15th SCAMC. New York: McGraw-Hill; 1991: 214-8.
• 12 Poon AD, Fagan LM. The design and evaluation of a pen-based computer system for structured data entry. In: Ozbolt JG. ed. Proceedings of the 18th SCAMC. Special issue of JAMIA; 1994: 447-51.
• 13 van Ginneken AM. Structured Data Entry in ORCA: the Strengths of two Models Combined. In: Cimino JJ. ed. Proceedings of the AMIA Annual Fall Symposium. J Am Med Assoc; 1996: 797-81.
• 14 Van Ginneken AM, de Wilde M, van Mulligen EM, Stam H. Can data representation and interface demands be reconciled? Approach in ORCA. In: Masys DR. ed. J Am Med Inform Assoc, symposium supplement; 1997: 779-83.
• 15 Moorman PW, van Ginneken AM, van der Lei J, van Bemmel JH. A model for structured data entry based on explicit descriptional knowledge. Method Inform Med 1994; 33: 454-63.
• 16 van Mulligen EM, Timmers T. Trends in integrated clinical workstations (Review paper). In: Van Bemmel JH, McCray AT. eds. Yearbook of Medical Informatics; 1996: 101-10.
• 17 Rind DM, Safran C. Real and imagined barriers to an electronic medical record. Proc Annu Symp Comput Appl Med Care 1993: 74-8.
• 18 Cimino JJ. Data storage and knowledge representation for clinical workstations. Int J Biomed Comput 1994; 34: 185-94.
• 19 Wyatt JC. Clinical data systems, Part 3: Development and evaluation. Lancet 1994; 344: 1682-8.
• 20 Kent DL, Shortliffe EH, Carlson RW, Bischoff MB, Jacobs CD. Improvements in data collection through physician use of a computer-based chemotherapy treatment consultant. J Clin Oncol 1985; 3: 1409-17.
• 21 Gouveia-Oliveira A, Salgado NC. A unified approach to the design of clinical reporting systems. Method Inform Med 1994; 33: 479-87.
• 22 Moorman PW, van Ginneken AM, Siersema PD. et al. Evaluation of Reporting Based on Descriptional Knowledge. JAMIA 1995; 2: 365-73.
• 23 Campbell KE, Musen MA. Creation of a systematic domain for medical care: the need for a comprehensive patient-description vocabulary. In: Lun KC. et al., eds. Proceedings of MEDINFO 92,. 1992: 1437-42.
• 24 Deliverable 4 of I4C (Integration and Communication for the Continuity of Cardiac Care) of the fourth Framework program of the European Community, 1999
• 25 Lotgering FK. Electronische Verloskunde Status. TMI 1993; 22: 160-5.