Full-text document storage and retrieval in a clinical information system.
The overall design of the CIS at CPMC is heavily influenced by the decision support component. The type of automated decision support being implemented dictates the need for highly structured or coded data. The value of decision support systems has been well documented. The current reliance on free-text documents is natural and a rewarding first step to a more valuable mix of coded and free text. While the health care provider might find the textual comments of the various reports extremely useful, the capability of an automated system to vigilantly review every data element for trends and anomalies is becoming invaluable in today's ever more complex health care delivery environment. Other approaches such as optical imaging systems would facilitate human decision support, but do not supply data in a format that can be processed by automated decision support systems. The developers of the CIS at CPMC believe that data are most valuable when available for both human and automated decision support.
Sideli
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RV
Columbia-Presbyterian Medical Center, New York City.
Johnson
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SB
Clayton
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PD
D015510:Clinical Medicine; D003196:Computer Graphics; D003199:Computer Systems; D003625:Data Collection; D003658:Decision Making, Computer-Assisted; D017721:Hospital Costs; D006751:Hospital Information Systems / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D016247:Information Storage and Retrieval / Q000592:standards*; D016490:Integrated Advanced Information Management Systems / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D009519:New York City