The Medical Record (TMR)

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The Medical Record (TMR), is a comprehensive medical information system developed at Duke University Medical Center by William Stead, M.D. and Edward Hammond, Ph.D.

The original goal of the TMR was to replace the paper chart with a computer-based record that would serve the needs of a practicing physician. Development started in 1969 and by 1974 the TMR system could process 1,000 patients a week.

Some of the early functions of the TMR system was to record any data that could be found in a traditional ambulatory record or inpatient chart. It could also maintain a complete list of diagnoses, procedures, and time-oriented records containing subjective and physical findings, laboratory data, and therapeutic interventions. As the system evolved, more features were added such as administrative management functions.

The TMR was created for ambulatory care, and has grown to include inpatient care, including the Labor and Delivery Unit and Surgical Intensive Care Unit at Duke. A recent project connected inpatient and outpatient computer-based patient records for the Bone Marrow Transplant Unit. Medical informatics trainees work in the TMR Laboratory, giving them hands-on experience.


References

Stead WW, Hammond EW. TMR - The Medical Record Spanning the Spectrum of Patient Care.