The Renewed Promise of Medical Informatics
20. Mai 2016
06. März 2018 (online)
The promise of the field of Medical Informatics has been great and its impact has been significant. In 1999, the Yearbook editors of the International Medical Informatics Association (IMIA) - also the authors of the present paper - sought to assess this impact by selecting a number of seminal papers in the field, and asking experts to comment on these articles. In particular, it was requested whether and how the expectations, represented by these papers, had been fulfilled since their publication several decades earlier. Each expert was also invited to comment on what might be expected in the future. In the present paper, these areas are briefly reviewed again. Where did these early papers have an impact and where were they not as successful as originally expected? It should be noted that the extraordinary developments in computer technology observed in the last two decades could not have been foreseen by these early researchers. In closing, some of the possibilities and limitations of research in medical informatics are outlined in the context of a framework that considers six levels of computer applications in medicine and health care. For each level, some predictions are made for the future, concluded with thoughts on fruitful areas for ongoing research in the field.
- 1 Weed LL. Medical records that guide and teach. N Engl J Med 1968; 278: 652-7.
- 2 Collen MF. General requirements for a medical information system. Comp Biomed Res 1970; 3: 393-406.
- 3 Côté RA. The SNOP-SNOMED concept: Evolution towards common medical nomenclature and classification. Pathologist 1979; 31: 383-9.
- 4 Reichertz PL, Möhr JR, Schwarz B, Schlatter A, von Gärtner-Holthoff G, Filsinger E. Evaluation of a field test of computers for the doctor’s office. Methods Inf Med 1979; 18: 61-70.
- 5 Barnett GO, Justice NS, Somand ME, Adams BD, Waxman PD, Beaman MS. et al. COSTAR - A computer-based medical information system for ambulatory care. Proc IEEE 1979; 67: 1226-37.
- 6 Pipberger HV, Arms RJ, Stallmann FW. Automatic screening of normal and abnormal electrocardio-grams by means of a digital electronic computer. Proc Soc Exp Biol Med 1961; 106: 130-32.
- 7 Robb RA, Ritman E, Harris LD, Wood EH. Dynamic three-dimensional X-ray computed tomography of the heart, lungs and circulation. IEEE Trans Nucl Sci 1979; 26: 1646-60.
- 8 Ledley RS, Lusted LB. Reasoning foundations medical diagnosis. Science 1959; 130: 9-21.
- 9 Gorry GA. Sequential diagnosis by computer. J Amer Med Ass 1968; 205: 141-6.
- 10 Warner HR. HELP, a program for medical decision making. Comp Biomed Res 1972; 5: 65-74.
- 11 Pauker SG, Kassirer JP. Therapeutic decision making: A cost-benefit analysis. N Engl J Med 1975; 293: 229-34.
- 12 De Dombal FT, Leaper DJ, Staniland JR, McCann AP, Horrocks JC. Computer-aided diagnosis of acute abdominal pain. BMJ 1972; 2: 9-13.
- 13 McDonald CJ. Protocol-based computer reminders, the quality of care and the non-perfectibility of man. N Engl J Med 1976; 295: 1351-5.
- 14 Shortliffe EH, Buchanan BG. A model of inexact reasoning in medicine. Math Biosci 1975; 23: 351-79.
- 15 Miller RA, Pople HE, Myers JD. INTERNIST-1: An experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med 1982; 307: 468-76.
- 16 Grémy F. Why teach information sciences in medicine? Will they contribute to a solution in the present crisis of medicine. Methods Inf Med 1983; 22: 121-3.
- 17 Blois MS. On the proper use of men and machine. In: Information and Medicine. The Nature of Medical Description. University of California Press; 1984. p. 235-55
- 18 Grémy F. Hardware, software, peopleware, subjectivity. A philosophical promenade. Methods Inf Med 2005; 44 (Suppl. 03) 352-8.
- 19 Lindberg DAB, Humphreys BL. Rising expectations: access to biomedical information. Yearb Med Inform 2008; 165-72.
- 20 Boyer C, Selby M, Scherrer JR, Appel RD. The Health on the Net Code of Conduct for medical and health Web sites. Comp Biol Med 1998; 28: 603-10.
- 21 Van Bemmel JH. A comprehensive model for medical information processing. Methods Inf Med 1983; 22: 12430.
- 22 Shortliffe EH. Computer-Based Medical Consultations: MYCIN. New York: Elsevier; 1976