History and trends in clinical information systems in the United States.
OBJECTIVE
To provide a synopsis of issues about clinical information systems for nurses not schooled in nursing informatics.


METHODS
The past, present, and future of clinical computing, including major factors resulting in the early hospital information systems (HIS) and decision support systems (DSS) in the United States, current advances and issues in managing clinical information, and future trends and issues.


METHODS
Literature review and analysis.


CONCLUSIONS
The first HIS and DSS were used in the late 1960s and were focused on applications for acute care. The change from fee-for-service to managed care required a change in the design of clinical information systems toward more patient-centered systems that span the care continuum, such as the computer-based patient record (CPR). Current difficulties with CPR systems include lack of systems integration, data standardization, and implementation. Increased advances in information and technology integration and increased use of the Internet for health information will shape the future of clinical information systems.
College of Nursing, University of Utah, 10 S. 2000 E. Front, Salt Lake City, UT 84112, USA. nancy.staggers@nurs.utah.edu
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Staggers
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Thompson
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Snyder-Halpern
D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical / Q000639:trends*; D006751:Hospital Information Systems; D006801:Humans; D020407:Internet; D016347:Medical Records Systems, Computerized; D009739:Nursing Services / Q000639:trends*; D018511:Systems Integration; D014481:United States