The Computer-Based Clinical Record— Where Do We Stand?

1 he practice of medicine depends on how we record, process, retrieve, and communicate information. Physi-cians are often frustrated with the inadequacies and duplication of the existing paper-based medical record and with the time wasted in locating medical informa-tion. The recognition of the need for more comprehen-sive and available documentation of patient care is not new. In her 1863 book Notes on a Hospital, Florence Nightingale wrote, "In attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records fit for any purposes of comparison. If they could be obtained... they would show subscribers how their money was being spent, what amount of good was really being done with it, or whether the money was no