Murphy J A, Ahlstrom J S
Clinical Information Systems, Information Services, Aurora Health Care, Milwaukee, Wisconsin 53215, USA.
Stud Health Technol Inform. 1997;46:323-9.
Increasingly, health care organizations are considering moving to Computer Based Patient Records (CPR), a trend driven by managed care and capitated payments. Central to the change is recognition of the need for community based and clinically relevant information systems that span the care continuum. Thus, Aurora Health Care chose to start their CPR effort in the ambulatory setting as the focus of health care delivery in the evolving paradigm. This paper describes computerization of the ambulatory record in a 45 physician clinic and associated workflow redesign. Months were spent in the processes of: current state documentation and analysis, future state design, detail system design, and workflow reengineering. There was substantial impact on nursing care delivery with computer system interaction at the point of care in the exam room. Access to clinically relevant longitudinal data was found key to the implementation and evaluation of Care Management strategies.
医疗保健机构越来越多地考虑转向基于计算机的患者记录（CPR），这一趋势是由管理式医疗和按人头付费推动的。这种转变的核心是认识到需要有基于社区且与临床相关的信息系统，以涵盖整个护理过程。因此，奥罗拉医疗保健公司选择在门诊环境中启动其CPR工作，作为不断演变的模式中医疗保健服务的重点。本文描述了一家拥有45名医生的诊所中门诊记录的计算机化以及相关工作流程的重新设计。在当前状态文档记录与分析、未来状态设计、详细系统设计和工作流程再造等过程中花费了数月时间。在诊室的护理点，计算机系统交互对护理服务产生了重大影响。人们发现获取与临床相关的纵向数据是实施和评估护理管理策略的关键。
