Automation of clinical and patient records.

BACKGROUND With advances in computer technology and mounting pressure to cut health care costs, there is a desire to automate clinical and patient records. METHODS We reviewed the barriers that hindered automation in the past, changes in the business environment, and the recent developments that could encourage automation, including the enactment of the Health Insurance Portability and Accountability Act (HIPAA). RESULTS Although conditions for automation have improved, significant barriers remain, including variation in state laws, lack of comprehensive data to assure return on automation investment, and most importantly, lack of clinical data and record-keeping standards. CONCLUSIONS Congress needs to enact HIPAA follow-up legislation that addresses the legal and standards issues. To minimize the risks for automation, institutions are advised to take a buy-a-little, test-a-little, and fix-a-little approach.