PubMed · 8418758
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J R Beck. 1993. Does feedback reduce inappropriate test ordering?. https://pubmed.ncbi.nlm.nih.gov/8418758/
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Computerized prescribing in the practice of medicine is a change that is overdue. Virtually all prescriptions in the United States are still handwritten. Instead, medications should be ordered on a computer interacting with 3 databases: patient drug history, scientific drug information and guideline reference, and patient-specific (weight, laboratory) data. Current problems with prescribing on which computerized prescribing could have a positive impact include (1) drug selection; (2) patient role in pharmacotherapy risk-benefit decision making; (3) screening for interactions (drug-drug, drug-laboratory, drug-disease); (4) linkages between laboratory and pharmacy; (5) dosing calculations and scheduling; (6) coordination between team members, particularly concerning patient education; (7) monitoring and documenting adverse effects; and (8) postmarketing surveillance of therapy outcomes. Computerized prescribing is an important component of clinician order entry. Development of this tool has been impeded by a number of conceptual, implementation, and policy barriers. Overcoming these constraints will require clinically and professionally guided vision and leadership.
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Workflow management is a serious concern in any organisation and a clinical laboratory is a particularly good example of where the information system (LIS) needs to be well integrated with the physical system comprising the doctors, technicians and the machines necessary to analyse and report on samples. It is the points of synchronisation between events and decision making in the outside world and control flow inside the information system that constitute the problem domain of workflow management. We propose an extension to the workflow management solution described in the OpenLabs architecture specification in which the emphasis is moved away from an essentially message orientated workflow system to one where the system may reasonably expect to deal with data that includes many different types of information such as images, diagrams, graphs and sound. Our key point is extensibility; the proposed extension of the OpenLabs architecture is able to deal with new data types without significant modification of the workflow management software. Our approach has been based on using some of the desirable features of the Hypertext Markup Language (HTML) and Uniform Resource Locators (URLs) found in the World Wide Web (WWW) and the use of industry standard object technology based on the Object Management Group's (OMG) Common Object Request Broker Architecture (CORBA).