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	Since this article does not have an abstract, we have provided the first 91 words of the full text and any section headings.

In Reply: I sympathize with Dr Zwelling-Aamot's feeling of being harassed by paperwork.

Health services research confirms both the limitations of administrative data for assessing quality of care^1-3 and the contributions of the computer-base patient record (CBPR)⁴ to improving patient safety.^5-6 However, the CBPR can have nationwide effect only with the widespread adoption of standardized, automated systems capable of seamless exchange of medical records. Such an infrastructure remains some years away.

David Hsia, JD, MD, MPH
Agency for Healthcare Research and Quality
US Department of Health and Human Services
Rockville, Md

1. Vermeulen LC, Windisch PA. Can administrative database studies inform medication use policy decisions? Am J Manag Care. 2001;7:89-90. PUBMED 2. Casebeer A, Johnson D. Potholes in the information highway: the use of health services utilization data by Alberta health care managers. Healthc Manage Forum. 2000;13:58-64. PUBMED 3. Maselli JH, Gonzales R. Measuring antibiotic prescribing practices among ambulatory physicians: accuracy of administrative data claims. J Clin Epidemiol. 2001;54:196-201. FULL TEXT | ISI | PUBMED 4. Dick RS, Steen EB, Detmer DE, eds. The Computer-Based Patient Record: An Essential Technology for Health Care. Rev ed. Washington, DC: Institute of Medicine; 1997. 5. Dexter PR, Perkins S, Overhage JM, Maharry K, Kohler RB, McDonald CJ. A computerized reminder system to increase the use of preventive care for hospitalized patients. N Engl J Med. 2001;345:965-970. FREE FULL TEXT 6. Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280:1311-1316. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:2648.

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