Ten commandments for implementing clinical information systems

M. Michael Shabot, MD

The need for electronic health care information systems is entering into public debate. In his 2004 State of the Union address, President George Bush called on the health care industry to adopt electronic medical records, stating that such technology could "avoid dangerous medical mistakes, reduce costs, and improve care" (1). With its plans to spend $119 million over the next 7 years on information systems, Baylor Health Care System is joining a number of other systems around the nation that are currently involved in such efforts. At Cedars-Sinai Medical Center in Los Angeles, Dr. Shabot was involved in implementing clinical information systems for 10 intensive care units, labor and delivery, and the emergency department (between 1991 and 2002), as well as a web-viewing system containing all inpatient and outpatient medical record information (in 1998). In this article, he shares a summary of their experience and focuses on 10 of the most important lessons, or "commandments," learned during the implementation of the clinical systems.