AN INFORMATICS-BASED CHRONIC DISEASE PRACTICE - CASE-STUDY OF A 35-YEAR COMPUTER-BASED LONGITUDINAL RECORD SYSTEM

The authors present the case study of a 35-year informatics-based sing le subspecialty practice for the management of patients with chronic t hyroid disease. This extensive experience provides a paradigm for the organization of longitudinal medical information by integrating indivi dual patient care with clinical research and education. The kernel of the process is a set of worksheets Easily completed by the physician d uring the patient encounter. It is a structured medical record that ha s been computerized since 1972, enabling analysis of different groups of patients to answer questions about chronic conditions and the effec ts of therapeutic interventions. The recording process and resulting s tudies serve as an important vehicle for medical education about the n uances of clinical practice. The authors suggest ways in which compute rized medical records can become an integral part of medical practice, rather than a luxury or novelty.