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Institutions all want electronic medical record (EMR) systems. They want them to solve their record movement problems, to improve the quality and coherence of the care process, to automate guidelines and care pathways to assist clinical research, outcomes management, and process improvement. EMRs are very difficult to construct because the existing electronic data sources, e.g., laboratory systems, pharmacy systems, and physician dictation systems, reside on many isolated islands with differing [...]

In general, there is agreement that robust integrated information systems are the foundation for building successful regional health care delivery systems. Integrated Advanced Information Management System (IAIMS) institutions that, over the years, have developed strategies for creating cohesive institutional information systems and services are finding that IAIMS strategies work well in the even more complex regional environment. The key elements of IAIMS planning are described and lessons learned are discussed [...]

The success of IAIMSs and other information technology plans depends to a great extent on the fit between the planning process and the nature of the organization. Planning processes differ as a function of both plurality of goals and the degree to which technology or the external environment changes. If all members of an organization share a common goal and the organization is in a relatively stable environment, the classic [...]

To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services.

The Read Thesaurus (Version 3 of the Read Codes) is a controlled medical vocabulary produced during the Clinical Terms Projects with the involvement of over 2,000 health care professionals from all United Kingdom specialties. In addition to allowing the transfer of clinical information in a meaningful way, it supports analysis of this information and provides a basis for the development of shareable medical knowledge bases. The thesaurus includes a comprehensive [...]

The Interactive Home Health Care Program is a demonstration project evaluating the use of in-home telemedicine to provide health care for elderly and disabled people. Local cable systems interconnect a base station staffed by a telemedicine nurse with a modified television in the home. Six months into the project, 38 patients are being cared for at three sites in rural Kansas. Individual patient profiles show improvement. Technical and social challenges [...]