Thomas L Lincoln, Daniel J Essin and Willis H Ware
Creating a patient centered information system (PCIS) or electronic medical record system (EMRS) is now viewed by the health care community as necessary to coordinate modern patient care in a manner that can control costs. However, despite 25 years of significant effort, the distance between the information systems available today in health care and what will be needed to fulfill this promise remains large. Success depends on achieving 3 goals that are generally in conflict: 1. giving the users the full scope of features and detail needed to create and use electronic clinical records for decision making, 2. providing the speed and reliability necessary for their on-line use, and 3. preserving system security and patient confidentiality. A shift in perspective and a quantum leap in functionality are needed that markets, with their conservative momentum and incentives toward incremental change, do not encourage and that are beyond financial means of the vendors.