Time-Oriented Patient Records and a Computer Databank

Changes in clinical variables with time are critically important for evaluation of patient course, prognosis, and response to therapy. Traditional medical recording relates the individual observation to a "normal" value rather than to previous and subsequent observations. In a "time-oriented patient record," the record displays changes in clinical data with time, utilizing a "flow sheet" format. This record facilitates chart review and encourages use of data rather than memory in management decisions. The record is computer-compatible and permits development of a computer databank which may be flexibly utilized to answer a large variety of clinical questions. Patient status may be summarized, variables cross-correlated, clinical conditions reviewed, prognostic indicators measured, and response to various therapies compared. This type of computer record facilitates direct analysis of primary data and is a possible adjunct to traditional review of the literature. Output may be used for formal scientific study, for informal discussion, or for assistance in management of the individual patient.