Electronic patient records

Introduction
in the beginning, contact between health care providers and health care consumers was limited in scope . it ecompassed the physician and the patient in a direct and immediate personal intercation . in sociological terms ,therefore, the scale of intercation was small.
of course there were exceptions to this .for instance,physicians sometimes inquired about their patients' symptoms from othre persons who stood in direct contact with the patients and who knew them .further ,in china and medieval europe physicians were often not in direct contact with socially exalted patient but communicated with them only through intermediaries.however, these were noteworty precisely because they were exceptions. in princiole,direct examination was the rule . consequently,from an information-and decision -theoretical point of view,the touchstone of traditional medical diagnosis and treatment decision-mqking was the direct interction between the physician and  the patient, where patient relative data were gathered in thies inter-personal encounter between the physician and the patient her-or himself.
This traditional physician-patient encounter, being immediate, was a temporally limited and evanesecent affair. at the same time,howevey,then as now ,health care decision frequently had to take into account data that were no longer available to direct medical inspection. therefore right from the start,physicians adopted the expedient of noting down for future reference the data that were obtqined in the physician -patient encounter.in a manner of speaking ,therefore ,these medical record vicariously extended the time-span ofthe contactbetweenphysician ans patient beyond the immediate persent. thise, however,did not disrupt the immediacy and directness of medical  decision-making.