Computers and the Prevention of Error
Electronic Tools for the Practice of Medicine
There are a variety of electronic tools that can aid you in your practice. A few of them are discussed below.
Electronic Medical Record (EMR)
- An electronic, paperless version of the traditional patient chart
- Can be combined with other resources to access test results, drug formularies and other information
- Alleviates problem of unavailable paper records
- Allows more than one person to access record simultaneously
Computerized Physician Order Entry (CPOE)
- Ordering tests, medications and treatments using computers
- Information is transferred to destination (lab, pharmacy, etc.) electronically
- Avoids illegible prescriptions and incomplete information
- Can interact with EMRs to flag potentially hazardous treatment contraindications
Decision and Knowledge Support Systems
- Electronic tools to enhance medical decision-making
- Includes references such as PDR, ePocrates, Sanford Guide to Antibiotic Use
- Information on best practices
- Can interface with patient EMR to generate case-specific alerts and reminders (routine testing, etc.)
Critical Event Alert System
- Works with pagers, cell phones and/or email to alert physician to changes in patient condition
- Can integrate laboratory, medication, and physiologic data alerts into a comprehensive, real-time wireless system
PIER (Physicians' Information and Education Resource)
- Answers clinical questions regarding preventing, screening, diagnosis and management
- Evidence-based information
- Direct links to PubMed abstracts and full text articles from Annals of Internal Medicine
Decision Algorithms
Choosing the right electronic resource depends on how you wish to impact the patient-physician interaction.
| Steps in Patient-Physician Interaction | Suitable Electronic Resource |
| Patient history | EMR |
| Access prior medications and treatments | EMR |
| Diagnostic options | Decision and knowledge support systems |
| Test orders and results | CPOE and EMR with interfaces |
| Medication orders and prescription writing | CPOE |
| Communication to other physicians | EMR with interfaces |
| Alerts and reminders | Decision support |
Practice size and setting can also determine the appropriate electronic tools.
| Practice Setting | Integration with Other Tools | Recommendations |
| Small office with limited budget | No integration | EMR, electronic knowledge resources |
| Small office with limited budget | Integration with lab, X-ray, etc. | EMR, CPOE, decision and knowledge support |
| Medium sized group practice with own lab and X-ray | No integration | EMR, CPOE, decision and knowledge support |
| Medium sized group practice with own lab and X-ray | Integration with hospital and other systems | EMR, CPOE, decision and knowledge support, consider critical event alert system |
| Hospital or medical center-based practice | Fully integrated practice | EMR, CPOE, decision and knowledge support, critical event alert system |
Related Links
Online Resources for Patients (Free)
- For Patients & Families
- MedlinePlus.gov (from the National Library of Medicine)
- InformationRx (MedlinePlus.gov)
- Patient Age Policy
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Practice Management Discussion Groups
Electronic Health Records
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