COSTAR—A computer-based medical information system for ambulatory care

The storage, retrieval, and communication of information are key features of both the practice of medicine and the administration of health care. This paper describes a COmputer-STored Ambulatory Record (COSTAR) which replaces the traditional document-based patient medical record with a comprehensive, centralized, and integrated information system. COSTAR meets both the medical care and the financial/administrative needs of a variety of different medical practices (whether fee-for-service or prepaid) and can be implemented and operated without on-site programming support. COSTAR has a modular design to facilitate phased implementation, and uses a comprehensive dictionary of terms to standardize and store data. The physician records medical, administrative, and financial information on a single source document (the encounter form); data are input by clerical personnel; information is retrieved via different computer-generated displays and printouts which automatically select and organize the data. The system provides a High-level language which allows the user to access the database from a logical point of view and perform searches or prepare reports without programming support. COSTAR is available on minicomputers using commercially supported software and will be marketed by commercial organizations.