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The Editorial in this issue calls for the informatics community to think what systems could so easily have been in place that might have reduced the chance of such a tragedy occurring; we appear not to have learnt lessons known for many years.3 Laurence Weed not only developed problem-oriented medical records (POMR), but also computerised them. His computerised system: problem-oriented medical information system (PROMIS) was ahead of its time.4
Weed’s first computerised medical record (CMR) system (from Wright et al.)4
PROMIS was the first clinical information system to use a touch screen terminal. PROMIS was driven by a large medical knowledge base that was initially developed by Dr Weed and his wife Laura Weed1 and later by a team of clinicians, librarians and systems analysts. PROMIS was organised entirely around the POMR concept, with the nurse beginning to populate the database, followed by the patient, who would complete a 275-question review-of-systems. Medical students and residents then added additional information, and documented a physical exam – all in structured form. Once the database was populated, the problem list was constructed, plans were developed and progress notes developed. The knowledge base required to support all of these modules was vast, and eventually specialists were brought in to extend it.
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