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April 1977

Problems in Record-Keeping: A New Approach Toward the Preservation of Continuity

Arch Intern Med. 1977;137(4):436. doi:10.1001/archinte.1977.03630160010005

Nephrology has been the simultaneous beneficiary and victim of the development of patient-care methodologies requiring frequent patient-physician encounters. The incorporation of hemodialysis and transplantation into practice has led to a wide variety of vexing and perplexing clinical problems of a long-term nature. The use of these "half-way Technologies"1 has also spawned voluminous quantities of paperwork. Longitudinal care of patients receiving these forms of therapy not only generates considerable quantities of information, but requires frequent review and correlation of previously obtained data. Such review and the performance of the necessary functions of correlating specific events frequently require exasperating, time-consuming searches of the traditional hospital record. This process becomes virtually impossible if the physician must correlate historical, physical, or laboratory data obtained as an outpatient or during previous hospitalizations with a new or changing problem. Thus, patient care, medical economy, and physicians' psyches frequently suffer in exponential fashion.

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