OBJECTIVE: To describe advanced clinical information systems in the context in which they have been implemented and are being used. DESIGN: Case series of five U.S. hospitals, including inpatient, ambulatory and emergency units. Descriptive study with data collected from interviews, observations, and document analysis. MEASUREMENTS: The use of computerized results, notes, orders, and event monitors and the type of decision support; data capture mechanisms and data form; impact on clinician satisfaction and clinical processes and outcomes; and the organizational factors associated with successful implementation. RESULTS: All sites have implemented a wide range of clinical information systems with extensive decision support. The systems had been well accepted by clinicians and have improved clinical processes. Successful implementation required leadership and long-term commitment, a focus on improving clinical processes, and gaining clinician involvement and maintaining productivity. CONCLUSION: Despite differences in approach there are many similarities between sites in the clinical information systems in use and the factors important to successful implementation. The experience of these sites may provide a valuable guide for others who are yet to start, or are just beginning, the implementation of clinical information systems.
OBJECTIVE: To describe advanced clinical information systems in the context in which they have been implemented and are being used. DESIGN: Case series of five U.S. hospitals, including inpatient, ambulatory and emergency units. Descriptive study with data collected from interviews, observations, and document analysis. MEASUREMENTS: The use of computerized results, notes, orders, and event monitors and the type of decision support; data capture mechanisms and data form; impact on clinician satisfaction and clinical processes and outcomes; and the organizational factors associated with successful implementation. RESULTS: All sites have implemented a wide range of clinical information systems with extensive decision support. The systems had been well accepted by clinicians and have improved clinical processes. Successful implementation required leadership and long-term commitment, a focus on improving clinical processes, and gaining clinician involvement and maintaining productivity. CONCLUSION: Despite differences in approach there are many similarities between sites in the clinical information systems in use and the factors important to successful implementation. The experience of these sites may provide a valuable guide for others who are yet to start, or are just beginning, the implementation of clinical information systems.
Authors: D W Bates; G J Kuperman; E Rittenberg; J M Teich; J Fiskio; N Ma'luf; A Onderdonk; D Wybenga; J Winkelman; T A Brennan; A L Komaroff; M Tanasijevic Journal: Am J Med Date: 1999-02 Impact factor: 4.965
Authors: G J Kuperman; J M Teich; M J Tanasijevic; N Ma'Luf; E Rittenberg; A Jha; J Fiskio; J Winkelman; D W Bates Journal: J Am Med Inform Assoc Date: 1999 Nov-Dec Impact factor: 4.497
Authors: J Marc Overhage; Paul R Dexter; Susan M Perkins; William H Cordell; John McGoff; Roland McGrath; Clement J McDonald Journal: Ann Emerg Med Date: 2002-01 Impact factor: 5.721
Authors: C J McDonald; S L Hui; D M Smith; W M Tierney; S J Cohen; M Weinberger; G P McCabe Journal: Ann Intern Med Date: 1984-01 Impact factor: 25.391
Authors: Paula A Rochon; Terry S Field; David W Bates; Monica Lee; Linda Gavendo; Janet Erramuspe-Mainard; James Judge; Jerry H Gurwitz Journal: CMAJ Date: 2006-01-03 Impact factor: 8.262