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The Computer-Based Patient Record , Richard S. Dick and Elaine B. Steen (eds.). Committee on Improving the Patient Record Division of Health Care Services, Institute of Medicine. Washington, DC: National Academy Press, 1991,190 pages, $24.95 hardbound.

To say that medical/health records are inadequate is like concluding that the health care system needs more "tuning." Suffice it to say, the medical record needs our immediate attention. This sentinel text on the model health record is the result of an 18-month project conducted by an Institute of Medicine (IOM) committee charged "to propose ideas and actions for improving the patient record." This action was proposed in response to increasing functional and technological advances that make automation feasible at this time. Further, there is a critical need to standardize the structure and content of the patient record if it is to be useful in medical research. This bookis an elegant summary of the thoughtful concerns and recommendations of over 200 private, public, and special interest groups concerned with the structure, content, and lack of usefulness of the current paper patient record. In this book, the committee synthesized and restructured the ideologic contributions and operational strategies proposed by major health-oriented institutions and organizations including, but not limited to: ISTAHC, the International Medical Informatics Association (IMIA), and the U.S. Agency for Health Care Policy and Research (AHCPR). The systematic efforts of the committee resulted in a set of succinct summaries and achievable recommendations, each presented in tabular form. The effect of the text is to alert both national and international health industries of the many advantages of a complete computerized health care record. This book also serves to demonstrate the accrued advantage of coordinating the efforts among many and varied special interests groups with disparate expertise. The specific problem, namely the dismal state of the patient medical/health record, is addressed by using a systems analytic approach. In this vein, the book identifies and lists all the strengths, weaknesses, and opportunities that can be accrued by a systematic, grass-roots movement to implement a "Computerized Patient Record," The case is clearly made that the medical record is a critical asset for all health care profes-