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An evaluation of the cognitive processes used in the translation of a clinical guideline from text into an encoded form so that it can be shared among medical institutions.

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 Arizona Telemedicine Program was established in July 1996 by the Arizona state legislature. The organizational center for the program is the Arizona Health Sciences Center in Tucson. Key goals for the program include increased access to specialty services for rural, underserved populations; development of cost-effective telemedicine services; and expansion of opportunities for education of health professionals in rural areas. The program provides several levels of services based on both [...]

This primary goal of this project was to develop a software architecture to support the Food and Drug Administration (FDA) generic drug application process by making it more efficient and effective. The secondary goal was to produce a scalable, modular, and flexible architecture that could be generalized to other contexts in interorganizational health care communications. The system described here shows improvements over the old system for the generic drug application [...]

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 [...]

Even though medical informatics is most often viewed from the perspective of its host disciplines in clinical and biologic medicine, it has an identity and agenda of its own. This paper is an attempt to promote discussion about the long-term role and agenda for medical informatics as a discipline into the next decade. The discussion has two main lines of argument, one about the "engineering" goals of informatics and the [...]

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 [...]

Medical informatics is defined largely by its host disciplines in clinical and biological medicine, and to project the agenda for informatics into the next decade, the health community must envision the broad context of biomedical research. This paper is a sketch of this vision, taking into account pressures from changes in the U.S. health care system, the need for more objective information on which to base health care decisions, and [...]

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 [...]

The 1998 Scientific Symposium of the American College of Medical Informatics (ACMI) was devoted to developing visions for the future of health care and biomedicine and a strategic agenda for health and biomedical informatics in support of those visions. This symposium focus was prompted by the many major changes currently underway in health care delivery, education, and research, as well as in our health and biomedical enterprises, and by the [...]