Regenstrief Medical Informatics. Experiences with Clinical Decision Support Systems.

Paul Biondich, Brian Dixon, Jon Duke, Burke Mamlin, Shaun Grannis, Blaine Takesue, Stephen Downs, William Tierney

Research output: Chapter in Book/Report/Conference proceedingChapter

4 Citations (Scopus)

Abstract

The discipline of clinical informatics endeavors to improve the process and outcomes of health care by enabling efficient access to information. Care providers can then use this information, both in the form of medical knowledge and in the form of patient data collected during clinical practice, to make decisions and comply with appropriate standards of care. The Regenstrief Institute began work on clinical information systems in 1972, when Dr. Clement McDonald and colleagues conceptualized and began construction of a computerized patient management system for outpatient diabetes care, developed to meet three primary goals: first, it was built to eliminate the problems inherent in paper records by making clinical data available to authorized users "just-in-time" as medical decisions are made; second, it was designed to aid in the recognition of diagnoses and adoption of pertinent care practices by assisting clinicians during their record-keeping activities; third, the system was designed to aggregate and analyze clinical information to be used in health care support systems, such as those for public health, health services research, and quality improvement. The first installation of the Regenstrief Medical Record System (RMRS) at Wishard Memorial Hospital occurred in 1974 and, over the next few years, the use of this system expanded outside of the diabetic clinic into a few of the hospital's many general medicine clinics. From early in its history, the Regenstrief system has included mechanisms for tailoring rules based on the data, to generate reminders and alerts to care providers. This chapter provides a history of the development and growth of the RMRS into a region-wide source of clinical data, the Indiana Network for Patient Care (INPC), and a summary of the research on the decision support interventions themselves, made possible by this infrastructure. Additionally, lessons learned throughout the more than 30 years of experience in both building and maintaining this system are detailed, alongside some reflections that may be useful for future system builders.

Original languageEnglish
Title of host publicationClinical Decision Support: The Road to Broad Adoption: Second Edition
PublisherElsevier Inc.
Pages165-187
Number of pages23
ISBN (Print)9780123984760
DOIs
StatePublished - May 2014

Fingerprint

Clinical Decision Support Systems
Medical Informatics
Decision support systems
Health care
Medical Records
Delivery of Health Care
Access to Information
Information Storage and Retrieval
Health Services Research
Information use
Public health
Standard of Care
Ambulatory Care
Medical problems
Quality Improvement
Growth and Development
Information Systems
General Hospitals
Medicine
Patient Care

Keywords

  • Clinical informatics
  • Computerized physician order entry (CPOE)
  • Health information exchange
  • Indiana Network for Patient Care (INPC)
  • Regenstrief Medical Record System

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Biondich, P., Dixon, B., Duke, J., Mamlin, B., Grannis, S., Takesue, B., ... Tierney, W. (2014). Regenstrief Medical Informatics. Experiences with Clinical Decision Support Systems. In Clinical Decision Support: The Road to Broad Adoption: Second Edition (pp. 165-187). Elsevier Inc.. https://doi.org/10.1016/B978-0-12-398476-0.00005-1

Regenstrief Medical Informatics. Experiences with Clinical Decision Support Systems. / Biondich, Paul; Dixon, Brian; Duke, Jon; Mamlin, Burke; Grannis, Shaun; Takesue, Blaine; Downs, Stephen; Tierney, William.

Clinical Decision Support: The Road to Broad Adoption: Second Edition. Elsevier Inc., 2014. p. 165-187.

Research output: Chapter in Book/Report/Conference proceedingChapter

Biondich, P, Dixon, B, Duke, J, Mamlin, B, Grannis, S, Takesue, B, Downs, S & Tierney, W 2014, Regenstrief Medical Informatics. Experiences with Clinical Decision Support Systems. in Clinical Decision Support: The Road to Broad Adoption: Second Edition. Elsevier Inc., pp. 165-187. https://doi.org/10.1016/B978-0-12-398476-0.00005-1
Biondich P, Dixon B, Duke J, Mamlin B, Grannis S, Takesue B et al. Regenstrief Medical Informatics. Experiences with Clinical Decision Support Systems. In Clinical Decision Support: The Road to Broad Adoption: Second Edition. Elsevier Inc. 2014. p. 165-187 https://doi.org/10.1016/B978-0-12-398476-0.00005-1
Biondich, Paul ; Dixon, Brian ; Duke, Jon ; Mamlin, Burke ; Grannis, Shaun ; Takesue, Blaine ; Downs, Stephen ; Tierney, William. / Regenstrief Medical Informatics. Experiences with Clinical Decision Support Systems. Clinical Decision Support: The Road to Broad Adoption: Second Edition. Elsevier Inc., 2014. pp. 165-187
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