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# Reduce the manpower needed in clinical bookkeeping and managing patients. An electronic recording system automatically reminds patients of their laboratory results and diagnoses.
# Reduce the manpower needed in clinical bookkeeping and managing patients. An electronic recording system automatically reminds patients of their laboratory results and diagnoses.
# Create informational 'gold' in the medical record. All the information would be accessible to clinical, epidemiological, outcomes and management research.
# Create informational 'gold' in the medical record. All the information would be accessible to clinical, epidemiological, outcomes and management research.
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=== The Three-Legged Stool ===
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The RMRS is built upon three crucial foundations- each of which may be considered a three-legged stool:[http://himss.files.cms-plus.com/FileDownloads/1997%20OrganizationRegenstrief%20Institute%20for%20Health%20Care.pdf]
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Foundation I: Committed support of the leadership and close collaboration between-
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# The Regenstrief Institute
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# The Wishard Memorial Hospital
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# The Indiana University School of Medicine, with it's faculty and the affiliated clinical practices
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Foundation II: The tripartite a mission of an academic medical center-
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# Teaching
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# Research
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# Public service
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Foundation III:
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# Careful analysis and improvement of processes
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# Technical excellence
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# Responsiveness to user need
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== Technology ==
== Technology ==
The RMRS has served as the laboratory for many high quality studies of the application of clinical information systems to hearth care, including a landmark study of the impact of [[CPOE|physician order entry]] within a hospital.
The RMRS has served as the laboratory for many high quality studies of the application of clinical information systems to hearth care, including a landmark study of the impact of [[CPOE|physician order entry]] within a hospital.
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=== Hardware ===
=== Hardware ===
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The Gopher workstation also allows the printing of personalized patient information handouts, permits doctors and nurses to communicate via confidential email and can even display satellite weather photos. . The system also allows for printing of hard copy inpatient paper reports, referred to as ‘scut’ cards, that fit neatly into a physician’s lab coat pocket in the form of a small booklet that provides a compact overview of the patient’s state. Physicians can also access past issues of leading medical journals and the American Hospital Formulary drug monographs to research specific topics or learn more about a certain medication. For clinical questions, they can consult the Journal of the American Medical Association, New England Journal of Medicine, Annals of Internal Medicine, the Yearbook of Medicine, NLM’s Medline, and full bibliographic references for any numbered citation on the user interface.
The Gopher workstation also allows the printing of personalized patient information handouts, permits doctors and nurses to communicate via confidential email and can even display satellite weather photos. . The system also allows for printing of hard copy inpatient paper reports, referred to as ‘scut’ cards, that fit neatly into a physician’s lab coat pocket in the form of a small booklet that provides a compact overview of the patient’s state. Physicians can also access past issues of leading medical journals and the American Hospital Formulary drug monographs to research specific topics or learn more about a certain medication. For clinical questions, they can consult the Journal of the American Medical Association, New England Journal of Medicine, Annals of Internal Medicine, the Yearbook of Medicine, NLM’s Medline, and full bibliographic references for any numbered citation on the user interface.
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=== Search and retrieval capabilities— cross-patient reports ===
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Cross-patient searches can be performed for IRB-approved research and quality management purposes. CARE language can be used to search the entire data base, a subset of the data base, or several institutions’ databases for patients whose EMR contains particular patterns of data. [http://www.ncbi.nlm.nih.gov/pubmed/10405881/]
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Fast retrieval is a second way to search the data base. It uses direct indexes by clinical variable (e.g. glucose, chest X-ray) and by results within the medical record files to provide fast access to medical records based on the content of those records. Fast retrieval produces a list of patients who satisfy the search criteria. It can then retrieve specific data elements from each of those patient’s medical records. This functionality lends itself well to retrospective clinical research.
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=== Future challenges ===
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*Complete capture of care provider notes
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*Dictation & Voice recognition (eg. Active X component that Dragon System's voice understanding)
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*Note capture system from Datamedic
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*Wireless provider carried devices
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*User identification (eg. Biometric identification)
==References==
==References==
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# McDonald CJ. The Regenstrief Medical Record System: a quarter century experience. International Journal of Medical Informatics. 1999. 54(1999)225-53
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[http://www.ncbi.nlm.nih.gov/pubmed/10405881]
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# McDonald CJ. The Regenstrief Medical Record System: a quarter century experience. International Journal of Medical Informatics. 1999. 54(1999)225-53 [http://www.ncbi.nlm.nih.gov/pubmed/10405881]
# McDonald, C.J., Tierney, W.M., Overhage J.M., et al. (1997). [https://www.himss.org/content/files/davies_1997_regenstrief.pdf The three-legged stool: Regenstrief institute for health care.] In J.M. Teich (Ed.), The third annual Nicholas E. Davis award: Proceedings of the CPR recognition symposium: (pp. 131-158). Shaumburg, IL.
# McDonald, C.J., Tierney, W.M., Overhage J.M., et al. (1997). [https://www.himss.org/content/files/davies_1997_regenstrief.pdf The three-legged stool: Regenstrief institute for health care.] In J.M. Teich (Ed.), The third annual Nicholas E. Davis award: Proceedings of the CPR recognition symposium: (pp. 131-158). Shaumburg, IL.
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# McDonald CJ, Tierney WM, Overhage JM, Dexter PR. The Three Legged Stool: Regenstrief Institute for Health Care. Proc 3rd Annual N.E. Davis CPR Recognition Symp. 1997; 101-147
# [http://www.medicine.indiana.edu/news_releases/archive_00/regenstrief_mrs_00.html Indiana School of Medicine]
# [http://www.medicine.indiana.edu/news_releases/archive_00/regenstrief_mrs_00.html Indiana School of Medicine]
# [http://www.regenstrief.org/medinformatics/rmrs RMRS Introduction]
# [http://www.regenstrief.org/medinformatics/rmrs RMRS Introduction]