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A picture archiving and communication system (PACS) is an electronic and ideally filmless information system for acquiring, sorting, transporting, storing, and electronically displaying medical images. PACS have developed rapidly and are in operation in a number of hospitals. Before widespread adoption of PACSs can occur, however, their cost-effectiveness must be proven. This article introduces the basic components of a PACS. The current PACS cost-analysis literature is reviewed. Some authors conclude [...]

Administrative records of the Department of Veterans Affairs (DVA) and the National Death Index were linked to create a four-year longitudinal database that describes the clinical status, hospital and nursing home use, and mortality for a nationwide cohort of persons admitted to DVA nursing homes (n = 23,039). Using Social Security Numbers as identifiers, the records of only 6% of these persons had logically inconsistent or implausible patterns. Nineteen percent [...]

The American Medical Informatics Association (AMIA) has begun the process of long-range strategic plan development. The AMIA Board of Directors established an Ad Hoc Strategic Planning Task Force, with the goal of initiating such planning in November 1992. In January 1993, the Task Force convened a group of AMIA members in order to develop an initial set of goals and objectives. The group consisted of past and present AMIA Board [...]

This article summarizes the origins of informatics, which is based on the science, engineering, and technology of computer hardware, software, and communications. In just four decades, from the 1950s to the 1990s, computer technology has progressed from slow, first-generation vacuum tubes, through the invention of the transistor and its incorporation into microprocessor chips, and ultimately, to fast, fourth-generation very-large-scale-integrated silicon chips. Programming has undergone a parallel transformation, from cumbersome, first-generation [...]

Development of a general natural-language processor that identifies clinical information in narrative reports and maps that information into a structured representation containing clinical terms.

Direct computer-based physician order entry has been the subject of debate for over 20 years. Many sites have implemented systems successfully. Others have failed outright or flirted with disaster, incurring substantial delays, cost overruns, and threatened work actions. The rationale for physician order entry includes process improvement, support of cost-conscious decision making, clinical decision support, and optimization of physicians' time. Barriers to physician order entry result from the changes required [...]

Careful study of medical informatics research and library-resource projects is necessary to increase the productivity of the research and development enterprise. Medical informatics research projects can present unique problems with respect to evaluation. It is not always possible to adapt directly the evaluation methods that are commonly employed in the natural and social sciences. Problems in evaluating medical informatics projects may be overcome by formulating system development work in terms [...]