help button home button JAMIA Hate scrolling?
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
First published April 18, 2006 as JAMIA PrePrint; doi:10.1197/jamia.M1988
Journal of the American Medical Informatics Association 2006;13(4):438-445
© 2006 American Medical Informatics Association

A more recent version of this article appeared on July 1, 2006
This Article
Right arrow Full Text (PDF)
Right arrow Data Supplement
Right arrow All Versions of this Article:
M1988v1
13/4/438    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Payne, T. H.
Right arrow Articles by Graham, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Payne, T. H.
Right arrow Articles by Graham, G.

Submitted on October 2, 2005
Accepted on April 8, 2006

Managing the Life Cycle of Electronic Clinical Documents

Thomas H. Payne MD1* and Gail Graham RHIA2

Affiliation of the authors: 1 UW Medicine Information Technology Services, University of Washington, Seattle, WA ; 2 Health Data and Informatics, Department of Veteran Affairs, Washington, D.C.

* To whom correspondence should be addressed.

Objective To develop a model of the life cycle of clinical documents from inception to use in a person's medical record, including workflow requirements from clinical practice, local policy, and regulation.

Design We propose a model for the life cycle of clinical documents as a framework for research on documentation within electronic medical record (EMR) systems. Our proposed model includes three axes: the stages of the document, the roles of those involved with the document, and the actions those involved may take on the document at each stage. The model includes the rules to describe who (in what role) can perform what actions on the document, and at what stages they can perform them. Rules are derived from needs of clinicians, and requirements of hospital bylaws and regulators.

Results Our model encompasses current practices for paper medical records and workflow in some EMR systems. Commercial EMR systems include methods for implementing document workflow rules. Workflow rules that are part of this model mirror functionality in the Department of Veterans Affairs (VA) EMR system where the Authorization/ Subscription Utility permits document life cycle rules to be written in English-like fashion.

Conclusions Creating a model of the life cycle of clinical documents serves as a framework for discussion of document workflow, how rules governing workflow can be implemented in EMR systems, and future research of electronic documentation.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 1994 by the American Medical Informatics Association.