Ten Commandments for Implementing Clinical Information Systems‪.‬

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. For example, the Fremont Area Medical Center began implementing computerized physician order entry (CPOE) in January 2004 (2); the Sisters of Charity of Leavenworth Health System began implementing CPOE in October 2003 (3); Aurora Health Care of Milwaukee is investing $75 million over the next 3 years in technology including CPOE (4); and Athens Regional Medical Center is making CPOE a component of a decade-long technology effort (5). Overall, information technology expenditures in health care totaled $21.6 billion in 2002. Expenditures are projected to increase every year: to $23.6 billion in 2003, $25.8 billion in 2004, $28.0 billion in 2005, and $30.5 billion in 2006 (6). At Cedars-Sinai Medical Center in Los Angeles, I have been involved in implementing clinical information systems for 10 intensive care units (ICUs), 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).