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AHCPR		Computer-Based Patient Records			Budget Code:
The objective of the computer-based patient record program activity is to improve the uniformity, accuracy, and retrievability of data about patient care in the community and to promote its use for improved clinical decisions. It requires the development of clinical data standards and the integration of information systems in diverse locations within institutions and across institutions and health care providers. Testing the application of computer-based patient record systems, decision support algorithms, and knowledge servers in physicians' offices, hospitals, patients' homes and other locations is of national importance to bring rapidly the benefits of HPCC to the provider and consumer of health care throughout the U.S.							Budget ($ M) FY 95 Act 4.10 FY 96 Pres 8.40 FY 96 Est 3.20 FY 97 Rqst 4.20 Program Component Areas   FY 96 FY 97 HECC     LSN     HCS     HuCS 3.20 4.20 ETHR     Agency Ties DARPA   NSF   DOE   NASA   NIH Partner NSA   NIST   NOAA   EPA   ED   AHCPR   VA
Milestone Changes	Fostered collaboration of the U.S. patient care data standards developers through AHCPR's support of the American National Institute's Healthcare Informatics Standards Planning Panel. Initiated two AHCPR-sponsored meetings of international (American, European, Australian, Japanese, and other) experts: `Terminology and Semantics in Health Care (Washington, D.C.)` and `Computer-based Patient Records and Modeling (Boston)
FY 1995 Actual Milestones			FY 1996 Estimated Milestones	FY 1997 Agency Requested Milestones
Supported scientific inquiry into applied research relevant to an electronic medical record. AHCPR and NLM collaborated to fund 8 cooperative agreement testbeds that show applications of the computer-based patient record. The first application is developing and testing a common medical terminology. These studies will support extending computer-based patient record systems and show their incorporation of guidelines, decision aids, expert systems, and reminder systems. Supported investigations into the uses of automated patient care data for patient care, research, quality assessment, patient outcome analysis, and electronic transmission of such data among institutions and providers. Supported development of and access to automated patient care data bases for research.			Support private sector development and testing of clinical patient care data standards for: (1) the definition and coding of medical terms, (2) the content of specific data sets for decision making, and (3) the electronic exchange of patient care data. Support the evaluation of electronic medical record applications to determine the extent to which they improve: clinical decision making; the delivery of health services; and patient outcomes. These evaluations should include: (1) how such systems are received by health care providers and patients; (2) how physician and patient behavior changes; and (3) how patient outcomes, productivity, and costs of care are affected.	Support research into the barriers to a successful installation of comprehensive health information systems, emphasizing the speed, cost, and human factors that affect success-to accelerate the transfer of computer-based information technology. Evaluate the medical effectiveness and economic impact (cost benefits) of automated clinical decision support systems in diverse health care settings.