A Medical Care Information System

Data from a computer-based medical information system were used to evaluate patterns of pediatric health maintenance over a one-year period at McMaster University Clinic. These data were then used as a guide to modify the delivery of pediatric health care to one more appropriate to Family Practice. The significant changes consisted of: a. a shift of responsibility to the nurse; b. a change in the content and frequency of patient contacts, and c. modification of the immunization and routine screening schedules. Evaluation of care one year later provided evidence of the usefulness of these changes. The study demonstrates the need for performance information in evaluating patterns of primary care, and illustrates the value of the nurse-practitioner role in pediatric health maintenance.