Computers

Computer-based medical records promise to solve many of the access and legibility problems of the traditional paper chart. They can also influence the quality of care by calling attention to adverse trends and unattended medical problems reflected in the electronic chart. A small but increasing number of institutions are using such computer-based medical record systems and studying their effects on the efficiency and quality of care.¹ Computer systems do improve the availability of medical records—from 85% to 99% in one study.² However, they do not necessarily save patient and staff time. In the same study, the time spent in the clinic by patients who had computer-stored records increased by more than 5%, compared with the time spent by control patients, who had paper records.² This increase, however, may have been a side effect of a better quality of care. Patients in the study group had a greater