Problem-oriented medical record: experience in 238 rehabilitation institutions

Area of Science:

• Rehabilitation Medicine
• Medical Informatics
• Healthcare Administration

Background:

• The Problem-Oriented Medical Record (POMR) was introduced by Lawrence Weed.
• Individual rehabilitation institutions have shared their experiences with POMR.
• A comprehensive understanding of POMR adoption across diverse US rehabilitation settings is needed.

Purpose of the Study:

• To survey the extent of Problem-Oriented Medical Record (POMR) adoption and usage in US rehabilitation institutions.
• To compare the experiences and practices related to POMR between University-Affiliated Departments (UAD) and Free-Standing Rehabilitation Centers (FSRC).

Main Methods:

• A questionnaire was distributed to 253 rehabilitation institutions nationwide.
• Responses were received from 238 institutions (94% response rate).
• Data from 132 UAD and 106 FSRC were analyzed to identify differences in POMR utilization and related practices.

Main Results:

• 65.1% of institutions reported some experience with POMR, with 39.5% currently using it.
• Significant differences were found between UAD and FSRC in POMR experience, application for medical/rehabilitation issues, functional evaluation integration, and professional roles.
• No significant differences were observed in POMR use for medical audit, need for staff training, perceived advantages, or reasons for non-adoption.

Conclusions:

• POMR adoption is widespread but not universal in US rehabilitation settings.
• Institutional type (UAD vs. FSRC) influences POMR implementation and associated practices.
• Findings have implications for patient care, medical education, record-keeping standards, and research in rehabilitation.