Digital patient records and the medical desktop: an integrated physician workstation for medical informatics training.

The Institute of Medicine and others have advocated a shift from a paper-based to an electronic medical record and many authorities have advanced the concept of a physician workstation that can provide access to a wide variety of both clinically and reference oriented medical information. We have developed a working model of an integrated physician workstation based on a graphically oriented "Medical Desktop," for personal computers. This system gives the user access to much of the information necessary for the practice of medicine, by integrating an electronic medical record (notes, orders, consults, lab values, and radiological studies, organized both independently and in a "Visual Chart") with tools such as drug references, clinical manuals, textbooks of medicine, literature searching, expert system decision support, and electronic communication. It contains an on-line help system that facilitates use and allows access to all the systems' capabilities. This system has been used to teach students and physicians the methods and potential of computer-based medical information management to prepare them for the impact of computers in their practices and educate them concerning the imperative for the involvement of all health care providers in implementing these changes.