Informatics in Primary Care: Strategies in Information Management for the Healthcare Provider. By Thomas E. Norris, Sherrilynne S. Fuller, Harold I. Goldberg, and Peter Tarczy-Hornoch. 241 pp. New York, Springer-Verlag, 2002. $39.95 (paper). ISBN 0-387-95333-7
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* David M. Gimlett

This book was written to address the needs of primary care physicians in understanding the challenges and promises of the developing science of medical informatics. The computerized medical record is only the starting point for the electronic system, which can and should augment the medical care provided in the physician-patient relationship. Entering and tracking orders, data management, links to laboratory results and imaging, real-time use of knowledge resources and decision-support tools, and care management tools, such as health maintenance, alerts, and patient notification, are all part of the ideal integrated system. In the new environment of patient-physician partnership, there will be increased emphasis on patient access to the computerized medical record and knowledge base as well as electronic communications between the partners.

The separate chapters of this book are written by different authors who have a wide range of expertise. The first five chapters offer an excellent introduction to the technical aspects of the computerized medical record and the importation of data from other sources, such as other programs and databases, laboratory data, and images. Chapter 3, by James I. Hoath, contains a superb discussion of the HL7 interface and standards for exchanging information between various systems of health information.

Chapters 6 through 10 cover the usefulness of the computerized medical record for incorporating evidence-based medicine, clinical decision support, knowledge resources, patient education, and workflow automation. Chapter 13 describes the role of the computerized medical record in quality improvement through reporting and practice analysis.

The remaining chapters discuss electronic billing, privacy and security issues, and telecommunications in primary care.

Physicians in small offices or groups do not have the advantage of having an information technology department and therefore must amass a level of knowledge sufficient to acquire, implement, and utilize their electronic systems with the help of outside resources. Larger institutions need the advice and expertise of clinicians who understand both the clinical and the technical parameters for developing an expert computer information system.

This book gives a superb introduction to medical informatics for the primary care physician. It is recommended for anyone involved with introducing computerization to a small office, clinic, or larger medical institution.