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. 1998 Jan-Feb;5(1):88-103.
doi: 10.1136/jamia.1998.0050088.

An informatics-based chronic disease practice: case study of a 35-year computer-based longitudinal record system

R A Nordyke  1 , C A Kulikowski
Affiliations

An informatics-based chronic disease practice: case study of a 35-year computer-based longitudinal record system

R A Nordyke et al. J Am Med Inform Assoc. 1998 Jan-Feb.

Abstract

The authors present the case study of a 35-year informatics-based single subspecialty practice for the management of patients with chronic thyroid disease. This extensive experience provides a paradigm for the organization of longitudinal medical information by integrating individual patient care with clinical research and education. The kernel of the process is a set of worksheets easily completed by the physician during the patient encounter. It is a structured medical record that has been computerized since 1972, enabling analysis of different groups of patients to answer questions about chronic conditions and the effects of therapeutic interventions. The recording process and resulting studies serve as an important vehicle for medical education about the nuances of clinical practice. The authors suggest ways in which computerized medical records can become an integral part of medical practice, rather than a luxury or novelty.

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Figures

<b>Figure 1</b><i>A</i>
Figure 1A
Computerized Thyroid Workup. This printed worksheet is used as the primary document to record information in our practice.
<b>Figure 1</b><i>B</i>
Figure 1B
, Continuation of the printed worksheet. Notice the many opportunities to insert free language.
Figure 2
Figure 2
Thyroid Follow-up Visit. The physician takes this follow-up flowsheet and the printed worksheets into the examining room.
Figure 3
Figure 3
The typed report generated by the computer from the coded and free language data keyed in from the worksheet and flowsheet. The report is ready within a few minutes and can be put into the patient's chart immediately.
Figure 4
Figure 4
Liver/Spleen Scan. This is the printed worksheet for a liver/spleen scan report.
Figure 5
Figure 5
The typed report generated by computer from the liver/spleen scan worksheet.
See this image and copyright information in PMC

Comment in

References

    1. Van Bemmel JH. Medical informatics, art or science? Methods Inf Med. 1996;35: 157-72. - PubMed
    1. Kulikowski CA. The scope of medical informatics as art and science. Methods Inf Med. 1996;35: 185-8. - PubMed
    1. Nordyke RA. Experiences with a protocol for thyroid disorders. In: Kallstrom, Yarnall (eds). Advances in Patient Care. 1975; 125.
    1. Nordyke RA, Gilbert FI Jr, Mussen GA. Semi-automated reporting system for a nuclear medicine department. Proc Am Assoc Med Sys. 1982; 183-7.
    1. Gilbert FI Jr, Nordyke RA, Higgins MP, Raney JD, Smith CJ. A computer-assisted hospital and outpatient information system for patients served by Straub Clinic and Hospital, Inc. Straub Foundation Proceedings. 1985;50: 5-7.

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