Coverage List: a provider-patient database supporting advanced hospital information services

We have developed a provider-patient database system, known as Coverage List, which maintains the associations between house staff and inpatients in a teaching hospital. Coverage List automatically links each patient to the proper resident when the patient is admitted, and updates the linkage whenever the resident coverage changes due to night or weekend coverage, physician illness, changes in clinical rotations, and other factors. Using this association, decision-support applications that detect significant clinical events can transmit them directly to the responsible resident. Sign-out and patient-review systems, which collect information on all of a physician's patients, always know the patients for whom that physician is responsible. Nurses who need to contact a physician about a patient issue always know which physician is covering that patient. Coverage List also manages schedule entry and display for physicians, or for any other staff members. A physician can enter individual schedule changes, sign out her service and her pager for the day, and page consultants automatically without going through an operator. These functions support clinical practice directly and enhance the value of other clinical programs.