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Patient Management

Systems

Terrence Adam, BS Pharm, MD, PhD

Assistant Professor, PCHS

University of Minnesota College of

Pharmacy

Background Interests

• Interest in clinical informatics with training in pharmacy,

medicine and medical informatics and currently a practicing

physician in the Veterans Administration system (17 year

training program)

• Inspired to do medical informatics after a summer pharmacy

internship in the pharmaceutical industry

• Interest in use of information technology to improve

medication safety

• Prior work in IT consulting—data reporting for a managed

care organization

• Involved in implementation of computerized provider order

entry in a major integrated hospital/clinic (Mayo Arizona)

• Interest in patient management systems with prior experience

as a clinical user in pharmacy and medicine, development

and evaluation of a patient monitoring system (lung

transplant), use of secondary data for surveillance

applications and evaluation of HIT for its effect on quality

Patient Management Systems

• Definition: Any tool used to assist in the delivery of

clinical care from the point of care initiation to completion

• Tools include paper-based systems, telecommunications

capabilities, health care organizations and information

technology systems

• Will focus primarily on the use of health information

technology (HIT) systems and their potential to improve

care delivery and their historical evolution in the US

• Identify potential impacts of major recent legislation to

effect implementation and use of health information

technology

Patient Management Systems

• Revolve around clinical encounters and

charts

• Historically limited role for documentation

• Limited Treatments and Diagnostics

• With growing medical complexity came the

need for effective documentation

– Billing

– Professional Communications

• Medical Legal document

Development of Documentation

• Part of slow evolutionary process

• Plummer Chart at Mayo—one of early efforts to

create...