Abstract In order to satisfy all the input and output requirements and process all the forms of essential medical information for all office and hospital visits for the lifetime of a patient, it has become necessary to develop a more complex programming system for a variable-length and variable-format computer-stored medical record. This programming system is designed to control and coordinate general and fundamental routines which include the handling of direct access storage, as well as remote terminal input and output devices. An encoded computer-stored patient medical record, organized basically as a tree-structure record, is partitioned into patients' visits which are subdivided into parts containing medical history, examination findings, diagnoses, laboratory and X-ray reports, ets. Active patient records are permanently stored on a large mass storage (Data Cell) device, but temporarily are moved to high-speed random-access disc drives while the patient is under actual care in the hospital or outpatient clinics. Although the computer record can store straight English text, in order to conserve storage space, the system utilizes an English word dictionary to encode diagnoses and an item catalog to identify standard tests and procedures, standard medical questions, etc. To permit convenient revision of input and output forms, the system includes an input language compiler, a medical report generator, and an information retrieval compiler. The multiprogramming system allows multiple medical funtions to operate simultaneously and permit access to the same patient's records. Such a system requires extensive communications equipment to handle input and output requirements for multiple facilities and at least some limited backup capabilities in the event of equipment failure.
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