Problem-oriented medical record: experience in 238 rehabilitation institutions.

Since Lawrence Weed introduced the Problem-Oriented Medical Record (POMR) nine years ago, several individual rehabilitation institutions have reported their experiences with POMR. As the author was interested in learning of the experiences of other rehabilitation institutions throughout the United States, questionnaires were sent to 253 such institutions. Replies were received from 238 (94%), 132 University-Affiliated Departments of Physical Medicine and Rehabilitation (UAD) and 106 Free-Standing Rehabilitation Centers (FSRC). Some experience with POMR was reported by 155 institutions (65.1%), including 94 (39.5%) which currently use POMR. A comparison between UAD and FSRC revealed statistically significant differences in experience with POMR, the use of POMR for medical and rehabilitation problems, the use of functional evaluation systems and POMR, and professional areas of responsibility. There were no statistically significant differences between UAD and FSRC in the use of POMR for medical audit, the need for formal workshops to orient staff to POMR concepts, the advantages of POMR, and the principal reason an institution was not using POMR. The implications of these findings for patient care, medical education, record keeping, and research are discussed in detail.