Problem acuteness and medical record utility

We studied the usefulness of having the patient's medical record available to the pediatrician at the time of the patient's visit. For most acute problems, the medical record had no effect on the management of the patient, whereas the record frequently affected the handling of chronic or recurrent problems. These results suggest a means of improving the effectiveness of pediatric emergency room management and also a means for defining empirically criteria for evaluation of care by record audit.