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May 12, 1989

The Computer-Stored Medical Record

Author Affiliations

Regenstrief Research Institute Indianapolis, Ind

Regenstrief Research Institute Indianapolis, Ind

JAMA. 1989;261(18):2636-2637. doi:10.1001/jama.1989.03420180060022

To the Editor.—  Two diametrically opposite approaches are being marketed to solve hospitals' information-processing problems.1,2 The first follows a centralized model where all processing software is purchased from a single vendor. The other follows a distributed model and interconnects the independent systems, eg, laboratory, pharmacy, and order entry systems, systems that might already exist in a hospital.We argued that the fastest way for most hospitals to create an automated hospital record system is to draw on the data that already exist, including those stored in independent laboratory and pharmacy systems when they are present. However, we were describing current opportunities, not arguing for a future reality. Whether the centralized or distributed model will be predominant in the future is not a question to argue in a learned journal; it is a question the marketplace will decide. We accept that Drs Korpman and Lincoln's persuasive arguments for a centralized,