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Using cognitive evaluation techniques, this study examines the effects of an electronic patient record and electronic mail on the interactions of health care providers. We find that the least structured communication methods are also the most heavily used: face-to-face, telephone, and electronic mail. Positive benefits of electronically-mediated(More)
Computers are steadily being incorporated in clinical practice. We conducted a nonrandomised, controlled, prospective trial of electronic messages designed to enhance adherence to clinical practice guidelines. We studied 126 physicians and nurse practitioners who used electronic medical records when caring for 349 patients with HIV infection in a primary(More)
OBJECTIVE Although the patient Internet portal is a potentially transformative technology, there is little scientific information about the demographic and clinical characteristics of portal enrollees and the features that they access. DESIGN We describe two pilot studies of a comprehensive Internet portal called PatientSite. These pilots include a(More)
The Boston Electronic Medical Record Collaborative is working to develop a system that will use the World Wide Web to transfer computer-based patient information to clinicians in emergency departments. Maintaining adequate confidentiality of these records while still facilitating patient care is paramount to this effort. This paper describes an explicit(More)
BACKGROUND Electronic clinical knowledge support systems have decreased barriers to answering clinical questions but there is little evidence as to whether they have an impact on health outcomes. METHODS We compared hospitals with online access to UpToDate with other acute care hospitals included in the Thomson 100 Top Hospitals Database (Thomson(More)
Background. Since 1989, Beth Israel Hospital has been deploying an extensive online patient record (the OMR), which augmented a heavily used integrated hospital information system. Initially begun in a large primary care practice, the system is now used to share patient records among over 30 practices on three campuses. Although the system was intended to(More)
This paper presents results from a demonstration project of nationwide exchange of health data for the home care of diabetic patients. A consortium of industry, academic, and health care partners has developed reusable middleware components integrated using the HOLON architecture. Engineering approaches for multi-organization systems development, lessons(More)
Background. Drug allergies are an important part of the patient record. Unlike active problems, medications , and laboratory values, allergies are seldom removed from the record and are not subject to rapid change.' The common method of listing drug allergies in the patient record lacks important information about the allergy or reaction: What reaction(More)