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Hospitals that have been delaying investments in clinical information systems may not be able to wait much longer. A bill drafted by HHS and introduced in the Senate last month would require hospitals to computerize their medical records by Jan. 1, 1996. Although the bill has some loopholes to give some facilities until 1998, it certainly would turn hospitals into motivated buyers of such systems.

Whether it's through hardware or software, International Business Machines Corp. is intent on becoming a player in the potentially lucrative bedside computing market. IBM and its software partner, Baxter Healthcare Corp., are hedging their bets to ensure one or both companies will be in the running as a supplier when hospitals decide to employ computers at patients' beds.

In what probably sounds like an unusual arrangement, a Texas hospital is hooking up with a nuclear weapons lab as it develops an electronic medical records system. The hospital is tapping the lab's supercomputer to make its Macintosh-based system powerful as well as user-friendly. The facility hopes the result is a patient record that's as useful as traditional paper charts and also can be used for research purposes.

Computerizing medical records in an effort to improve quality of care and cut costs may sound like a terrific idea. And the technology for doing so is becoming more affordable for a growing number of hospitals. But a patchwork of nebulous and antiquated state laws makes automated recordkeeping technically illegal in 12 states and legally ambiguous in many more. Some experts are calling on the federal government to provide a comprehensive solution.

After six months of testing, Beth Israel Medical Center in New York City is ready to say "yes" to optical disk storage of medical records. Eventually, the system is expected to help eliminate storage costs for 4 million pieces of paper per year, microfilming costs of $200,000 per year and labor costs for pulling and refiling 700 charts every day.