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To understand and address patients' need for information surrounding ambulatory-care visits.

An evaluation of Internet end-to-end performance was conducted for the purpose of better understanding the overall performance of Internet pathways typical of those used to access information in National Library of Medicine (NLM) databases and, by extension, other Internet-based biomedical information resources.

Recent developments in medical informatics research have afforded possibilities for great advances in health care delivery. These exciting opportunities also present formidable challenges to the implementation and integration of technologies in the workplace. As in most domains, there is a gulf between technologic artifacts and end users. Since medical practice is a human endeavor, there is a need for bridging disciplines to enable clinicians to benefit from rapid technologic advances [...]

Medical informatics is an emergent interdisciplinary field described as drawing upon and contributing to both the health sciences and information sciences. The authors elucidate the disciplinary nature and internal structure of the field.

The authors describe a framework, based on the Ogden-Richards semiotic triangle, for understanding the relationship between the Unified Medical Language System (UMLS) and the source terminologies from which the UMLS derives its content. They pay particular attention to UMLS's Concept Unique Identifier (CUI) and the sense of "meaning" it represents as contrasted with the sense of "meaning" represented by the source terminologies. The CUI takes on emergent meaning through linkage [...]

Informatics and information technology hold the promise of a consumer-centered health enterprise--one that provides quality care at a cost society is willing to pay; one where need-based, adaptive, competency-based learning results in cost-effectiveness of health education; one where team-based health and learning on demand, coupled with monitoring of process outcomes and network access to expertise, guarantee quality. The barriers to this promise are the professional guilds, the cross-subsidies that support [...]

Since the 1970s, it has been clear that the health community needs to develop a health care system that matches a person's needs with the expertise and technology to address those needs. The logical solution is a multi-tiered system. In such a system, physicians would provide second- and third-tier services and other health professionals would provide first- and second-tier services. Medical informatics should take on the challenge of supporting the [...]

: To develop a generic methodology for the online assessment of medical education materials available on the World Wide Web and to implement it for pilot subject areas.

To allow exchange of clinical practice guidelines among institutions and computer-based applications.