Editorial |

The Tension Between E-Health Innovation and E-Valuation

Amit X. Garg, MD, PhD; Marcello Tonelli, MD, SM
Arch Intern Med. 2005;165(20):2329-2330. doi:10.1001/archinte.165.20.2329.
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In commercial, industrial, and scientific spheres of activity, computers have become ubiquitous—improving safety, productivity, and timeliness. It seems likely that health care delivery has an equal potential for improvement through computerization (e-innovation). Accordingly, electronic medical records, computerized physician order entry systems, and computerized clinical decision support systems (CDSSs) are increasingly found in hospitals and outpatient settings. In CDSSs (software that is specifically designed to improve clinical decision-making), characteristics of individual patients are matched to a computerized knowledge base, and algorithms present patient-specific recommendations to the clinician. Patient characteristics can be manually entered by the user or queried through electronic databases. Computer-generated recommendations may then be delivered to the health care provider through the electronic medical record or through documents placed in a patient’s paper medical chart. Such systems have been developed for a myriad of clinical issues, including alerts to critical laboratory values, reminders of overdue preventive health tasks, advice for drug prescribing, critiques of existing health care orders, and suggestions for various active or chronic care issues.

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