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[Diagnosis--therapy and documentation].

作者信息

Schaub W, Thoma W, Volke M

机构信息

Orthopädische Universitäts- und Poliklinik, Frankfurt/Main.

出版信息

Z Orthop Ihre Grenzgeb. 1992 Sep-Oct;130(5):364-6. doi: 10.1055/s-2008-1039635.

Abstract

The procedures of documentation of diagnostic findings are well established--but different in their graphical and structural appearance of patients histories. Out of multiple findings a retrieval with valid informations is very clumsy. In order to increase quality a complete and reliable registration of clinical data base is necessary. For this purpose the use of electronic media is profitable if the requirements of the data-base are well defined. A nationwide agreement on one key-system--including the transformation of textual structures--is proposed. Only this way leads to comparable results in therapeutic procedures.

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