Issues in designing an automated record system for clinical care and research.

Automated clinical record systems have the potential for amassing a rich database for clinically focused research. Several requirements must be met for this to occur, however. The data must be valid and reliable, and they must be structured in such a way that they can be analyzed. In addition, the data must be housed in a software environment that permits easy retrieval and manipulation. Clinicians have their own requirements for clinical record systems, which may conflict with the objective of achieving a database useful for research. This article reports the experience of one group in designing a system that serves as both a clinical record system and a database that can directly assess the impact of a coordinated care program for postacute care of the elderly.