A clinical information system for ambulatory care

This article describes a clinical information system developed for ambulatory care nurse practitioners. An overview of the clinical information system is presented, followed by a detailed description. The clinical information system uses the relational database structure proposed by Hettinger and Brazile (1992), and creates a longitudinal electronic health care record. The database design includes the Nursing Minimum Data Set and provides links to external aggregate data sets such as the U. S. Census data. Special features are discussed such as the ability to select from several problem classification schemes, including North American Nursing Diagnosis Association, Omaha, and International Classification of Diseases, 9th Revision; insert new menu selections whenever needed; create and track groups; and store detailed outcome data. A brief summary of implementation considerations is included.