Methods Inf Med 1984; 23(02): 63-74
DOI: 10.1055/s-0038-1635328
Original Article
Schattauer GmbH

Computers in Medical Care: A Review[*]

Computer in der ärztlichen Versorgung: ein Überblick
Hans W. Gottinger
1   (From the Institut für Medizinische Informatik und Systemforschung [MEDIS] der Gesellschaft für Strahlen- und Umweltforschung [GSF] Neuherberg near Munich)
› Author Affiliations
Further Information

Publication History

Publication Date:
20 February 2018 (online)


This survey provides an overview of major developments on the impact of computers in medical and hospital care over the last 25 years. Though the review emphasizes developments in the U. S. and their multi-faceted impacts upon resource allocation and regulation, a serious attempt is made to track those impacts being universally true in multinational environments.

Dieser Artikel gibt einen Überblick über die wichtigsten Entwicklungen der EDV im Gesundheitswesen während der letzten 25 Jahre und ihre Auswirkungen, hauptsächlich wie sie in den USA, aber auch in anderen westlichen Ländern beobachtbar sind. Fragen der Ressourcenverteilung und der Regulierung werden diskutiert.

* This review article has been written in cooperation with U. Kekeritz and J. Tritschler, both from the MEDIS-Institute.

  • References

  • 1 Austin J., Green B.. Hospital information systems: a current perspective. Inquiry 1978; 15: 97-120.
  • 2 Baer W. S., Johnson L. L., Merrow E. E.. Analysis of Federally Funded Demonstration Projects: Final Report. R-1926-DOC Santa Monica: Rand Corp 1976
  • 2a Barber B., Abbot L. W.. Computing and Operational Research at the London Hospital. London: Butterworths; 1972
  • 2b Barnett O. G.. Massachusetts General Hospital Computer System (Boston). In Collen M. F.. (Edit.) Hospital Computer System, pp. 517-545. New York: Academic Press; 1974
  • 2c Bakker A. R.. Scope and Limitation of a mini-based centralized Hospital Information System. In Lindberg D. A. B., Kaihara K.. (Eds) MEDINFO 80. pp. 505-509. Amsterdam; North Holland: 1980
  • 3 Bordage G., Elstein A., Winsonhaler J., Wagner C. Computer-aided and Computer-simulated Medical Diagnosis. In Computer Applications in Medical Care. IEEE Proc. First Annual Symp.. IEEE; New York: 1977
  • 3a Böhm M., Nicolae G. C, Höhne K.-H.. Advanced hardware and software tools for analysis of multitemporal images in a clinical environment. In Barber G., Grémy F., Überla K., Wagner G.. (Eds) Medical Informatics Berlin. 1979. pp. 445-451. Berlin - Heidelberg - New York: Springer; 1979
  • 4 Butts M. S., Ashford J. R.. Hospital activity analysis: a source of information about social hospital admissions. Int. J. biomed. Comput 1977; 8: 255-267.
  • 5 Chandrasekaran B., Mittal S.. Deep versus compiled knowledge approaches to diagnostic problem-solving. In AAAI Proceedings of the National Conference on Artificial Intelligence, Pittsburg, Pen-sylvania. 1982. pp. 349-354. Los Altos/Ca.: Kaufmann; 1982
  • 6 Chesler L. G., Hershdorfer A. M., Lincoln T. L.. The use of information in clinical problem-solving: a framework for analysis. Math. Biosci 1971; 7: 160-185.
  • 7 Clancey W.. Transfer of ruled-based expertise through a tutorial dialogue. Ph. D. Thesis. (Dept. of Computer Science, Stanford Univ 1979
  • 7a Cocklin M., Gourlay A. R., Jackson P., Kaye G., Miessler M., Kerr I., Lams P.. An image processing system for digital chest X-ray images. In van Bem-mel J. H., Ball M. J., Wigertz O.. (Eds) MEDINFO 83 pp. 377-380. Amsterdam; North-Holland: 1983
  • 8 Davis R.. Applications of meta-level knowledge to the construction, maintenance, and use of large knowledge bases. HPP Memo 76-7. Stanford Univ 1976;
  • 9 De Heaulme M., Mery C. REMEDE: An artificial language for medical reports on computers. In Anderson J., Forsythe J. M.. (Eds) MEDINFO 74. pp 935-941. Amsterdam; North-Holland: 1975
  • 10 De Heaulme M.. Artificial medical languages: a solution for clinical needs in documentation. Example using Remede system. In Anderson J.. (Edit.) Medical Informatics Europe 78. pp. 62-72. Berlin - Heidelberg - New York: Springer; 1978
  • 11 Deland E. C, Waxman B. D.. Review of hospital information systems. In Waxman B. D.. (Edit.) Handbook of Biomedical Information Systems.. Chicago, Ill.: Encyclopedia Britannica; 1971
  • 12 Dixon W. J.. (Edit.) BMD Biomedical Computer Programs. Los Angeles: Univ. of California Press; 1964
  • 13 Engelbrecht R., Schmeetz H.-D., Laude G., von Gaertner H.-O., Reichertz P. L.. Dynamics and administrative behavior of a multi-disciplinary medical center. Meth. Inform. Med 1976; 15: 199-205.
  • 14 Feigenbaum E. A., Barr A.. (Eds) Handbook of Artificial Intelligence, Vol. I. Los Altos, Ca.: W. Kaufmann; 1981
  • 15 Fox M. A.. ACIS: a clinical information system. In Anderson J.. (Edit.) Medical Informatics Europe 78. pp 9-18. Berlin -Heidelberg - New York: Springer; 1978
  • 16 Gheorghe A. V., Bali H. N., Hill W. J., Carson E. R.. Dynamic decision models for clinical diagnosis. Int. J. biomed. Comput 1976; 7: 81-92.
  • 17 Ginsberg A. S., Offensend F. L.. An application of decision theory to a medical diagnosis treatment problem. IEEE Trans. Syst. Sci. Cyber. SSC 1968; 4: 355-362.
  • 18 Ginsberg A. S.. Decision Analysis in Clinical Patient Management with an Application to the Pleural Effusion Syndrome. R-751-RC/NLM.. Santa Monica: Rand Corp; 1971
  • 19 Gorry G. A., Kassirer J. P., Essig A., Schwartz W. B.. Decision analysis as the basis for computer-aided management of acute renal failure. Amer. J. Med 1973; 55: 479-484.
  • 20 Gottinger H. W.. Elements of Statistical Analysis. Berlin: de Gruyter; 1980
  • 20a Grabner H., Grabner G.. Aims and structure of the Vienna General Medical Information System. In Anderson J., Forsythe J. M.. (Eds) MEDINFO 74. pp. 1078-1081. Amsterdam: North-Holland Publ. Co.; 1974
  • 21 Grams R. R.. Database technology in health care. J. med. Syst 1981; 5: 175-196.
  • 21a Greiller R., Pribilla P.. EDV im Klinikum Großhadern. Data Report 1974; 4: 15-20.
  • 22 Griesser G.. Das Klinik-Informationssystem des Klinikums der Christian-Albrecht-Universität zu Kiel, Kiel KIS. Kiel 1975
  • 23 Gustafson D. H., Kestly J. J., Griest J. H., Jensen N. M.. An initial evaluation of a subjective Bayesian diagnostic system. Hlth. Serv. Res 1971; 6: 204-213.
  • 24 Hart P. E.. Directions for the AI in the eighties. Sigart Newsletter 1982; 79: 11-16.
  • 25 Hilberman M., Kamm B., Tarter M., Osborn J. J.. An evaluation of computer-based patient monitoring at Pacific Medical Center. Comput. biomed. Res. 8 ‘ 1975; 447-460.
  • 25a Höhne K.-H., Böhm M., Nicolae G. C.. et al. The high resolution measurement and display of blood dynamics in organs such as the kidney and the liver by computer angiography. In Barber B., Grémy F., Überla K., Wagner G.. (Eds) Medical Informatics Berlin. 1979. pp. 452-459. Berlin - Heidelberg - New York: Springer; 1979
  • 26 Huet B., Martin J.. Evaluation d’un système informatique de laboratoire à partir de la simulation d’une journée de travail au laboratoire. In Grémy F., Degoulet P., Barber B., Salamon R.. (Eds) Medical Informatics Europe 81. pp 290-297. Berlin - Heidelberg - New York: Springer; 1981
  • 27 Kurland L. T., Molgaard C. A.. The patient record in epidemiology. Sci. Amer. 245, No 1981; 4: 46-55.
  • 27a Lansbergen Q. P.. An online, interactive, information system for kidney transplantation. In Anderson J.. (Edit.) Medical Informatics Europe 78. pp. 37-47. Berlin - Heidelberg - New York: Springer; 1978
  • 28 Ledley R. S., Lusted L. B.. Medical diagnosis and modern decision making. In Proceedings of Symposia in Applied Mathematics, Vol. XIV, March. 1961. pp. 117-157. Providence, R. I.: Amer. Math. Soc.; 1962
  • 29 Lincoln T. L., Korpman R. A.. Computers, health care, and medical information science. Science 1980; 210: 257-263.
  • 30 Lindberg D. A. B.. The Growth of Medical Information Systems in the United States. Lexington, Mass.: Lexington Press; 1979
  • 31 Lorino H., Brault Y, Harf A., Atlan G., Laurent D.. Real time computation of pulmonary mechanics by digital computer. In J. Anderson (Edit.): Medical Informatics Europe 78, pp. 179-188. Berlin -Heidelberg - New York: Springer; 1978
  • 32 Lusted L. B.. Introduction to Medical Decision-Making. Springfield, Ill.: C. C. Thomas; 1968
  • 33 Maturi V. F., Du Bois R. M.. Recent Trends in Computerized Medical Information Systems for Hospitals Departments. Springfield, Va.: U. S. Dept. of Commerce: National Technical Information Service; 1981
  • 33a Myers A.Ch.. Computers in Knowledge-based Fields. Cambridge/Mass.: M. I. T. Press; 1980
  • 34 Michel H. A.. (Edit.) EDV-Systeme, Einsatz im Gesundheitswesen. Darmstadt: GIT-Verlag Ernst Giebeler; 1981
  • 35 McNeil B. J., Keeler E., Adelstein S. J.. Primer on certain elements of medical decision making. New Engl. J. Med 1975; 293: 211-215.
  • 36 MEDIPLAN Infas: Implementationen bei DOMINIG II - Projektbestand und Benutzersituation. 5. Zwischenbericht. Hamburg/München: Infas; 1979
  • 37 Meindl J. D.. Microelectronics and computers in medicine. Science 1982; 215: 792-797.
  • 37a Mellner C. H., Selander H., Wolodar-ski J.. The Karolinska hospital information system. Meth. Inform. Med 1974; 13: 125-140.
  • 38 NCHSR Research Digest Series: Automation of the Problem-oriented Medical Record. Publ. (HRA). 77-3177. Washington, D. C: U. S. Dept. of HEW; 1977
  • 39 National Academy of Science (NAS): Science and Technology: A Five-year Outlook. San Francisco: Freeman & Co. 1979
  • 40 National Research Council (NRC): Outlook for Science and Technology: The Next Five Years. San Francisco: W. H. Freeman; 1982
  • 41 Nelson R.. The Moon and the Ghetto: An Essay on Public Policy Analysis. New York: W. Norton; 1977
  • 42 Newell A., Simon H. A.. Human Problem Solving. Englewood Cliffs: Prentice Hall; 1972
  • 43 Nilsson N. J.. Principles of Artificial Intelligence. (Palo Alto, Ca.: Tioga Publ. Co 1980
  • 44 Osborn J. J., Beaumonta I. O., Raison C. A., Russel J., Gerbode F.. Measurement and monitoring of acutely ill patients by digital computer. Ann. Surg 1968; 64: 1059-1070.
  • 45 Page B.. Testing alternative inventory policies for a regional blood bank. In Anderson, J. (Edit.): Medical Informatics Europe 83, pp 403-412. Berlin - Heidelberg - New York: Springer 1978
  • 46 Papageorgiou J. C. Some operations research applications to problems of health care systems (a survey). Int. J. biomed. Comput 1978; 9: 101-114.
  • 47 Pauker S. G., Kassirer J. P.. The threshold approach to clinical decision making. New Engl. J. Med 1980; 303: 1109-1117.
  • 48 Pauker S. G., Gorry G. A., Kassirer J. P., Schwartz W. B.. Towards the simulation of clinical cognition. Amer. J. Med 1976; 60: 981-996.
  • 49 Ream A. K.. Advances in medical instrumentation. In Abelson P. H.. (Edit.) Health Care: Regulation, Economics, Ethics, Practice, pp. 173-178. Washington, D. C: Amer. Ass. Adv. Science; 1978
  • 50 Reichertz P. L.. Medical School of Hannover Hospital Computer System (Hannover). In Collen M. F.. (Edit.) Hospital Computer Systems, pp. 598-661. New York: Wiley; 1974
  • 51 Reichertz P. L.. Informationssysteme in der Medizin. Bonn-Bad Godesberg: IBM Deutschland; 1975
  • 52 Russel L.. How much does Medical Technology Cost? Annual U. S. Health Conference. (New York: N. Y. Academy of Medicine 1977
  • 53 Schoolman H. M., Bernstein M.. Computer use in diagnosis, prognosis and therapy. In Abelson P. H.. (Edit.) Health Care: Regulation, Economics, Ethics, Practice, pp. 115-120. Washington, D. C: Amer. Ass. Adv. Science; 1978
  • 54 Schwartz W. B.. Medicine and the computer: the promise and problems of chance. New Engl. J. Med 1970; 283: 1257-1264.
  • 55 Shortliffe E. H.. Computer-Based Medical Consultations: MYCIN. New York: Elsevier 1976
  • 56 Shortliffe E. H.. MYCIN: A rule-based computer program for advising physicians regarding antimicrobial dissertation. Stanford Univ., Memo AIM-251. Stanford Artificial Intelligence Lab> 1972
  • 57 Slack W. V, van Cura L. J., Greist J. H.. Computers and doctors: uses and consequences. Comput. biomed. Res 1970; 3: 521-527.
  • 58 Sondak V, Schartz H., Sondak N.. (Eds) Computers and Medicine. Ded-ham, Mass.: Artech; 1979
  • 59 Starmer C. F, Lee K. L.. A mathematical approach to medical decisions: applications of Bayes’ rule to a mixture of continuous and discrete clinical variables. Comput. biomed. Res 1976; 6: 531-541.
  • 60 Summerfield A. B., Empey S.. Computer-based Information Systems for Medicine: A Survey and Brief Discussion of Current Projects. Santa Monica, Ca.: System Development Co; 1965
  • 61 Szolovits P.. (Edit.) Artificial Intelligence in Medicine. Boulder, Co.: Westview Press Inc; 1982
  • 62 Warner H. R., Rutherford B. D., Hout-chens B.. A sequential Bayesian approach to history-taking and diagnosis. Comput. biomed. Res 1972; 5: 256-262.
  • 63 Waxman B. D., Yamamoto W. S., Rockoff M. L.. Recent Trends in Health Care Technology. In Stacy R. W., Wax-man B.D.. (Eds) Computers in Biomedical Research, Vol. IV, pp. 1-13. New York: Academic Press; 1974
  • 64 Webber B. L., Nilsson N. Y.. (Eds) Readings in Artificial Intelligence. Palo Alto, Ca.: Tioga Publ. Co; 1981
  • 65 Weiss S. M., Kulikowski C. A., Amarel S.. A Model-based method for computer-aided medical decision making. Artif. Intell 1978; 11: 145-172.
  • 66 White R. L., Meindl J. D.. The impact of integrated electronics in medicine. In Abelson P. H., Hammond A. L.. (Eds). Electronics, the Continuing Revolution, pp.. 33-40. Washington, D. C: Amer. Ass. Adv. Science; 1977
  • 67 Willems J., Raymakers A.. Computer application in a hospital pharmacy. Meth. Inform. Med 1980; 14: 195-198.