Experience in the computer handling of clinical data for dialysis and transplantation units

The clinical management of patients on dialysis and after transplantation relies on an ever increasing accumulation of exact data. It is impossible to keep track of all the data with conventional records even if these are well designed and used with discipline. Patient notes are not always available, and data are often difficult to find and interpret. At best numerical variables are recorded on flow sheets or progress charts, creating a maze of paper. These difficulties are greatest for a new staff member who joins a center. Though clinical progress is best grasped as conceptual pictures of variations of numerical data over time, the resources and time to draw suitable graphs by hand are seldom available. The computer system to be described solves many of these problems. The system has been used to carry out functions that were often done badly or inefficiently before, or in some cases not done at all. The system has allowed doctors to get better access to information about their patients, to better understand their illness due to improved presentations of the information and has made it possible to improve care by improvements in the organization of a center. The system is based on a number of principles which we consider to be of major importance if a computer is to be successfully incorporated into the day-to-day clinical activity of a department and is to be accepted by doctors, nurses, and patients.