The impact of a private group practice of converting to an automated medical information system

As hardware and software developments make medical information systems increasingly available to physicians office practices and outpatients facilities, there is a need to focus on systems installation and conversion issues. In addition to the detailed step-by-step implementation plan, the overall impact of the new system should be anticipated. The purchasers should consider such issues as new information flow and user communication patterns between patient care and ancillary and support departments; restructuring of fundamental approaches to work allocation for either batch or real-time systems; and new emphasis on any departments vital to problem-spotting and solving. At California Primary Physicians (CPP), an awareness of these changes did not develop until well after the official "live" data had passed and the staff had been successfully using the system for several months. This paper explains how the above issues have emerged and the impact they have had on CPP, and provides a framework for anticipating such matters in any system installation.