Costar in a specialty clinic: the mgh transplant unit system

COSTAR was originally designed for use in an ambulatory care clinic. This paper describes the adaptation of COSTAR for use in the Kidney Transplant Unit of the Massachusetts General Hospital. With few changes, the system was modified to make it compatible with the needs of the Transplant Unit that include the clinical care of both inpatients and outpatients as well as administration and research. COSTAR was chosen over other available file management systems because the time-orientation of the COSTAR record make it ideally suited to the tracking of time-dependent episodes in this population. The directories were modified to include the highly specialized medical vocabulary associated with renal disease and transplantation. Forms specific to rejection and complications of transplantation were developed. The flexibility of the Medical Query Language permitted the development of many features to meet special reporting needs.