Skip to main content
Bulletin of the Medical Library Association logoLink to Bulletin of the Medical Library Association
. 1995 Jan;83(1):48–56.

Design and implementation of the Indianapolis Network for Patient Care and Research.

J M Overhage 1, W M Tierney 1, C J McDonald 1
PMCID: PMC225997  PMID: 7703939

Abstract

We are creating a health care information network that will link a large community medical record system to three hospital emergency departments, fifty community pharmacies, ten clinics, four health-maintenance organization (HMO) offices, and twelve homeless care sites in Indianapolis, Indiana. This project will test the feasibility of linking care providers across organizational boundaries and measure the benefits of such a network. The network will supply three kinds of information services: a "mini-medical library," patient medical record information, and a citywide prescription database incorporating a computer-based prescription-writing system. The use of medical resources, the cost of care, provider time spent giving care, and providers' opinions of the services will be used as outcomes in randomized clinical trials. Through this project, we hope to expand the information base available to the target care sites; reduce unnecessary testing and increase the efficiency of care in emergency departments; improve emergency department, office, and clinic prescribing patterns; enlarge the consortium of health care providers connected by the network; and develop strategies for successfully implementing a comprehensive city medical record resource.

Full text

PDF
54

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnett G. O. The application of computer-based medical-record systems in ambulatory practice. N Engl J Med. 1984 Jun 21;310(25):1643–1650. doi: 10.1056/NEJM198406213102506. [DOI] [PubMed] [Google Scholar]
  2. Barnett G. O., Winickoff R. N., Morgan M. M., Zielstorff R. D. A computer-based monitoring system for follow-up of elevated blood pressure. Med Care. 1983 Apr;21(4):400–409. doi: 10.1097/00005650-198304000-00003. [DOI] [PubMed] [Google Scholar]
  3. Bleich H. L., Beckley R. F., Horowitz G. L., Jackson J. D., Moody E. S., Franklin C., Goodman S. R., McKay M. W., Pope R. A., Walden T. Clinical computing in a teaching hospital. N Engl J Med. 1985 Mar 21;312(12):756–764. doi: 10.1056/NEJM198503213121205. [DOI] [PubMed] [Google Scholar]
  4. Classen D. C., Pestotnik S. L., Evans R. S., Burke J. P. Computerized surveillance of adverse drug events in hospital patients. JAMA. 1991 Nov 27;266(20):2847–2851. [PubMed] [Google Scholar]
  5. Cummings K. M., Frisof K. B., Long M. J., Hrynkiewich G. The effects of price information on physicians' test-ordering behavior. Ordering of diagnostic tests. Med Care. 1982 Mar;20(3):293–301. doi: 10.1097/00005650-198203000-00006. [DOI] [PubMed] [Google Scholar]
  6. Friedman C., Sideli R. Tolerating spelling errors during patient validation. Comput Biomed Res. 1992 Oct;25(5):486–509. doi: 10.1016/0010-4809(92)90005-u. [DOI] [PubMed] [Google Scholar]
  7. Haynes R. B., McKibbon K. A., Walker C. J., Ryan N., Fitzgerald D., Ramsden M. F. Online access to MEDLINE in clinical settings. A study of use and usefulness. Ann Intern Med. 1990 Jan 1;112(1):78–84. doi: 10.7326/0003-4819-112-1-78. [DOI] [PubMed] [Google Scholar]
  8. Heagarty M. C., Robertson L. S., Kosa J., Alpert J. J. Some comparative costs in comprehensive versus fragmented pediatric care. Pediatrics. 1970 Oct;46(4):596–603. [PubMed] [Google Scholar]
  9. Hjortdahl P., Borchgrevink C. F. Continuity of care: influence of general practitioners' knowledge about their patients on use of resources in consultations. BMJ. 1991 Nov 9;303(6811):1181–1184. doi: 10.1136/bmj.303.6811.1181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Larsen R. A., Evans R. S., Burke J. P., Pestotnik S. L., Gardner R. M., Classen D. C. Improved perioperative antibiotic use and reduced surgical wound infections through use of computer decision analysis. Infect Control Hosp Epidemiol. 1989 Jul;10(7):316–320. doi: 10.1086/646035. [DOI] [PubMed] [Google Scholar]
  11. Lindberg D. A., Siegel E. R., Rapp B. A., Wallingford K. T., Wilson S. R. Use of MEDLINE by physicians for clinical problem solving. JAMA. 1993 Jun 23;269(24):3124–3129. [PubMed] [Google Scholar]
  12. Mc Donald C. J. Use of a computer to detect and respond to clinical events: its effect on clinician behavior. Ann Intern Med. 1976 Feb;84(2):162–167. doi: 10.7326/0003-4819-84-2-162. [DOI] [PubMed] [Google Scholar]
  13. McDonald C. J., Hui S. L., Smith D. M., Tierney W. M., Cohen S. J., Weinberger M., McCabe G. P. Reminders to physicians from an introspective computer medical record. A two-year randomized trial. Ann Intern Med. 1984 Jan;100(1):130–138. doi: 10.7326/0003-4819-100-1-130. [DOI] [PubMed] [Google Scholar]
  14. McDonald C. J. Protocol-based computer reminders, the quality of care and the non-perfectability of man. N Engl J Med. 1976 Dec 9;295(24):1351–1355. doi: 10.1056/NEJM197612092952405. [DOI] [PubMed] [Google Scholar]
  15. McDonald C. J., Tierney W. M. Computer-stored medical records. Their future role in medical practice. JAMA. 1988 Jun 17;259(23):3433–3440. [PubMed] [Google Scholar]
  16. McDonald C. J., Tierney W. M., Overhage J. M., Martin D. K., Wilson G. A. The Regenstrief Medical Record System: 20 years of experience in hospitals, clinics, and neighborhood health centers. MD Comput. 1992 Jul-Aug;9(4):206–217. [PubMed] [Google Scholar]
  17. McDonald C. J., Tierney W. M. The Medical Gopher--a microcomputer system to help find, organize and decide about patient data. West J Med. 1986 Dec;145(6):823–829. [PMC free article] [PubMed] [Google Scholar]
  18. McDonald C. J., Wilson G. A., McCabe G. P., Jr Physician response to computer reminders. JAMA. 1980 Oct 3;244(14):1579–1581. [PubMed] [Google Scholar]
  19. McPhee S. J., Bird J. A., Fordham D., Rodnick J. E., Osborn E. H. Promoting cancer prevention activities by primary care physicians. Results of a randomized, controlled trial. JAMA. 1991 Jul 24;266(4):538–544. [PubMed] [Google Scholar]
  20. Osheroff J. A., Forsythe D. E., Buchanan B. G., Bankowitz R. A., Blumenfeld B. H., Miller R. A. Physicians' information needs: analysis of questions posed during clinical teaching. Ann Intern Med. 1991 Apr 1;114(7):576–581. doi: 10.7326/0003-4819-114-7-576. [DOI] [PubMed] [Google Scholar]
  21. Safran C., Slack W. V., Bleich H. L. Role of computing in patient care in two hospitals. MD Comput. 1989 May-Jun;6(3):141–148. [PubMed] [Google Scholar]
  22. Soumerai S. B., Avorn J. Principles of educational outreach ('academic detailing') to improve clinical decision making. JAMA. 1990 Jan 26;263(4):549–556. [PubMed] [Google Scholar]
  23. Stead W. W., Hammond W. E. Computerized medical records. A new resource for clinical decision making. J Med Syst. 1983 Jun;7(3):213–220. doi: 10.1007/BF00993282. [DOI] [PubMed] [Google Scholar]
  24. Tierney W. M., Hui S. L., McDonald C. J. Delayed feedback of physician performance versus immediate reminders to perform preventive care. Effects on physician compliance. Med Care. 1986 Aug;24(8):659–666. doi: 10.1097/00005650-198608000-00001. [DOI] [PubMed] [Google Scholar]
  25. Tierney W. M., McDonald C. J., Hui S. L., Martin D. K. Computer predictions of abnormal test results. Effects on outpatient testing. JAMA. 1988 Feb 26;259(8):1194–1198. [PubMed] [Google Scholar]
  26. Tierney W. M., McDonald C. J., Martin D. K., Rogers M. P. Computerized display of past test results. Effect on outpatient testing. Ann Intern Med. 1987 Oct;107(4):569–574. doi: 10.7326/0003-4819-107-4-569. [DOI] [PubMed] [Google Scholar]
  27. Tierney W. M., Miller M. E., McDonald C. J. The effect on test ordering of informing physicians of the charges for outpatient diagnostic tests. N Engl J Med. 1990 May 24;322(21):1499–1504. doi: 10.1056/NEJM199005243222105. [DOI] [PubMed] [Google Scholar]
  28. Tierney W. M., Miller M. E., Overhage J. M., McDonald C. J. Physician inpatient order writing on microcomputer workstations. Effects on resource utilization. JAMA. 1993 Jan 20;269(3):379–383. [PubMed] [Google Scholar]
  29. Whiting-O'Keefe Q. E., Simborg D. W., Epstein W. V., Warger A. A computerized summary medical record system can provide more information than the standard medical record. JAMA. 1985 Sep 6;254(9):1185–1192. [PubMed] [Google Scholar]
  30. Wilson G. A., McDonald C. J., McCabe G. P., Jr The effect of immediate access to a computerized medical record on physician test ordering: a controlled clinical trial in the emergency room. Am J Public Health. 1982 Jul;72(7):698–702. doi: 10.2105/ajph.72.7.698. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Wirtschafter D., Carpenter J. T., Mesel E. A consultant-extender system for breast cancer adjuvant chemotherapy. Ann Intern Med. 1979 Mar;90(3):396–401. doi: 10.7326/0003-4819-90-3-396. [DOI] [PubMed] [Google Scholar]
  32. al Mahdy H., Seymour D. G. How much can elderly patients tell us about their medications? Postgrad Med J. 1990 Feb;66(772):116–121. doi: 10.1136/pgmj.66.772.116. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Bulletin of the Medical Library Association are provided here courtesy of Medical Library Association

RESOURCES