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Computers and the Future of Medical Practice

Paul J. Rosch, MD; Elliott C. Rosch, MD; Peter J. Reynolds, RPA
Arch Intern Med. 1986;146(7):1451. doi:10.1001/archinte.1986.00360190243043.
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To the Editor.  —Essin and Steen's editorial1 notes that, "Computer-aided data management has the potential to resolve the problems of legibility, completeness, retrievability, and organization, all of which are so difficult to accomplish by hand." As indicated in a previous related article, a computer-based medical-record system for ambulatory practice should ideally be "designed to facilitate individualized attention to each patient to a system that is efficient, cost effective, and professionally satisfying to the physician.... The primary dilemma in the use of a computer-based medical-record system is how to reconcile the physician's custom of recording free-form narrative on a blank page with the computer's need for structure and a predefined vocabulary."2 For nearly three years, we have used the Gabrieli Medical Information Systems "Praktice" medical record system which appears to satisfy these concerns.We record patient medical information by hand, in unrestricted natural language, using our customary terminology. At


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