Variation in health care - the roles of the electronic medical record

Variation in the use of clinical resources, outcomes, costs, access to heal th care and quality is a well recognized, ever present feature of health ca re. It is a phenomenon that affects all sectors of the health care delivery process and is important to clinicians, administrators and patients. As a phenomenon variation can be appropriate or inappropriate and the eliminatio n of inappropriate variation is a fundamental principal behind continuous q uality improvement in health care. The primary tools for the management of variation exists within the electronic medical record (EMR). The EMR utiliz es the existing and evolving information storage technologies (data reposit ories) and information management tools (applications), to integrate the el ements within this long-term data storage. Through this integration the EMR systems are able to provide knowledge representation in differing formats to the decision-makers and this will facilitate more accurate and appropria te decision-making with subsequent improvements in health care delivery. (C ) 1999 Elsevier Science Ireland Ltd, All rights reserved.