Computer Application in Medicine
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COMPUTER APPLICATIONS IN MEDICAL CARE
The expanding influence of computers on society is being felt in medicine as well. Essentially all hospitals and clinics depend on computers for administrative and financial functions and for providing access to clinical data. Most physicians have been exposed to the powerful available systems for searching the biomedical literature by computer. Modern imaging techniques depend on computers for image generation, small computers have become mandatory elements in the research laboratory, and information systems are becoming vital topics for medical education. The clinical community has long anticipated the day when computers would be able to assist with diagnosis and with making decisions about patient management. Examples show that technology increasingly will provide physicians with clinically useful decision-support tools. This chapter describes some of the issues in building such systems and in making them easily available, clinically useful, and broadly acceptable.
About 30 years ago, the first research programs for medical diagnosis were shown to be highly accurate in their diagnostic predictions. Why have such systems resisted widespread implementation and acceptance in the intervening years? The barriers reflect the subtleties of the medical practice environment and the increasing recognition that good advice from such programs cannot ensure their use and acceptance. Confounding the implementation efforts have been logistical constraints, the sometimes awkward mechanics of computer use, confusion about whether such programs are intended to be tools for rather than competitors with clinicians, and a pervasive belief that computers do not really "understand" medicine and therefore cannot be
COMPUTER APPLICATIONS IN MEDICAL CARE
The expanding influence of computers on society is being felt in medicine as well. Essentially all hospitals and clinics depend on computers for administrative and financial functions and for providing access to clinical data. Most physicians have been exposed to the powerful available systems for searching the biomedical literature by computer. Modern imaging techniques depend on computers for image generation, small computers have become mandatory elements in the research laboratory, and information systems are becoming vital topics for medical education. The clinical community has long anticipated the day when computers would be able to assist with diagnosis and with making decisions about patient management. Examples show that technology increasingly will provide physicians with clinically useful decision-support tools. This chapter describes some of the issues in building such systems and in making them easily available, clinically useful, and broadly acceptable.
About 30 years ago, the first research programs for medical diagnosis were shown to be highly accurate in their diagnostic predictions. Why have such systems resisted widespread implementation and acceptance in the intervening years? The barriers reflect the subtleties of the medical practice environment and the increasing recognition that good advice from such programs cannot ensure their use and acceptance. Confounding the implementation efforts have been logistical constraints, the sometimes awkward mechanics of computer use, confusion about whether such programs are intended to be tools for rather than competitors with clinicians, and a pervasive belief that computers do not really "understand" medicine and therefore cannot be
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