Integrated electronic records as the resolution of ethical tensions between clinical and managerial objectives.

Traditionally there is considerable tension between the objectives of clinicians and managers--each claiming an ethical grounding, one to optimize care to the individual and the other to optimize the use of health resources for the client population. Hitherto, there has been a latent challenge in finding empirically supported common ground. However, the development of integrated electronic records, particularly for patients receiving preventive, rehabilitative, or long-term care, has provided a common medium. A successful major development in the United Kingdom is described.