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A national public and private "grand challenge" initiative should be undertaken to assure the American public that the telecommunications and computing revolutions improve health care, health education, and biomedical and health services research, and secure accountability for cost, quality, and access. The initiative should focus on meeting the needs of the patient and society at large. It needs to be a national vision, but it also ought to have regional [...]

This paper focuses on the basic principles of information technology (IT) organization within health sciences centers. The paper considers the placement of the leader of the IT effort within the health sciences administrative structure and the organization of the IT unit. A case study of the University of Missouri-Columbia Health Sciences Center demonstrates how a role-based organizational model for IT support can be effective for determining the boundary between centralized [...]

To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services.

A national survey conducted for the Office of Rural Health Policy in 1995 identified 558 participants in rural telemedicine; 499 (89%) responded to a detailed follow-up survey to describe type of use. While 84% of respondents reported using interactive video, only 25% reported access to e-mail for exchange of data. The challenge to medical informatics is to connect dispersed providers, not just with videoconferencing, but also with other information-sharing methods.

The Interactive Home Health Care Program is a demonstration project evaluating the use of in-home telemedicine to provide health care for elderly and disabled people. Local cable systems interconnect a base station staffed by a telemedicine nurse with a modified television in the home. Six months into the project, 38 patients are being cared for at three sites in rural Kansas. Individual patient profiles show improvement. Technical and social challenges [...]

Our premise is that from the perspective of maximum flexibility of data usage by computer-based record (CPR) systems, existing nursing classification systems are necessary, but not sufficient, for representing important aspects of "what nurses do." In particular, we have focused our attention on those classification systems that represent nurses' clinical activities through the abstraction of activities into categories of nursing interventions. In this theoretical paper, we argue that taxonomic, combinatorial [...]

To determine the extent to which a combination of existing machine-readable health terminologies cover the concepts and terms needed for a comprehensive controlled vocabulary for health information systems by carrying out a distributed national experiment using the Internet and the UMLS Knowledge Sources, lexical programs, and server.

In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record [...]