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PURPOSE Our purpose is to counter the common wisdom that doctors are refractory to change and therefore responsible for the limited use of electronic medical records. METHODS We draw on experience with electronic medical records in two Harvard Medical School teaching hospitals dating back to the early 1980s. RESULTS Doctors quickly become ardent users(More)
Even the most extensive hospital information system cannot support all the complex and ever-changing demands associated with a clinical database, such as providing department or personal data forms, and rating scales. Well-designed clinical dialogue programs may facilitate direct interaction of patients with their medical records. Incorporation of extensive(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)
We discuss work-in-progress and propose an ontology driven framework for the development of a clinical expert system for chest pain risk assessment. The framework has the following key components: adaptive questionnaire, patient medical history, risk assessment and decision support. We intend to incorporate a range of chest pain assessment guidelines and(More)
Clinical risk assessment of chronic illnesses in the cardiovascular domain is quite a challenging and complex task which entails the utilization of standardized clinical practice guidelines and documentation procedures to ensure clinical governance, efficient and consistent care for patients. In this paper, we present a cardiovascular decision support(More)
Computing systems developed by the Center for Clinical Computing (CCC) have been in operation in Beth Israel and Brigham and Women's hospitals for over 10 years. Designed to be of direct benefit to doctors, nurses, and other clinicians in the care of their patients, the CCC systems give the results of diagnostic studies immediately upon request; offer(More)
The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and(More)