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Evaluators must develop methods to characterize the use of the rapidly proliferating electronic networks that link patients with health services. In this article the 4-S framework is proposed for characterizing the use of health services delivered via computer networks. The utility of the 4-S framework is illustrated using data derived from a completed, randomized field experiment in which 47 caregivers of persons who had Alzheimer's disease accessed ComputerLink, a special [...]

Health care delivery systems and organizations around the world are undergoing reorganization and reengineering. Rational decision making about such activities must be based on information. Much of the presently available data is inadequate for this task, and therefore needs to be transformed. One such experience in the province of Alberta, Canada, is discussed. The development of a comprehensive information strategy, the need to apply information management principles, the organizational implications [...]

Conceptual models for diagnostic reasoning proposed in the medical literature are presented to stimulate discussion about the issue of the appropriateness of probabilistic knowledge-based systems for medical diagnosis. Evidence is presented to corroborate the authors' view that diagnosis is a problem-solving task, rather than a decision-making task. In the authors' opinion, probabilistic reasoning is better suited to situations dealing with choices for clinical intervention, rather than to those dealing with [...]

The overarching informatics grand challenge facing society is the creation of knowledge management systems that can acquire, conserve, organize, retrieve, display, and distribute what is known today in a manner that informs and educates, facilitates the discovery and creation of new knowledge, and contributes to the health and welfare of the planet. At one time the private, national, and university libraries of the world collectively constituted the memory of society's [...]

To explore the software design issues involved in implementing an operational information sources map (ISM) knowledge base (KB) and system of navigational tools that can help medical users access network-based information sources relevant to a biomedical question.

With the advent of hospital payment by diagnosis-related group (DRG), length of stay (LOS) has become a major issue in hospital efforts to control costs. Because the Columbia-Presbyterian Medical Center (CPMC) has had above-average LOSs for many DRGs, the authors tested the hypothesis that a computer-generated informational message directed to physicians would shorten LOS.

To develop a representational schema for clinical data for use in exchanging data and applications, using a collaborative approach.

To investigate the issues raised in applying a preliminary version of the GALEN compositional concept reference (CORE) model to a series of radiographic reports, and to demonstrate that the same underlying concept model could be used in conjunction with both a detailed, fine-grained model of medical records based on that used in the PEN&PAD project and with other more conventional medical-record models.

Interactive laserdiscs are of limited value in large group learning situations due to the expense of establishing multiple workstations. The authors implemented an alternative to laserdisc video by using indexed digital video combined with an expert system. High-quality video was captured from a laserdisc player and combined with waveform audio into an audio-video-interleave (AVI) file format in the Microsoft Video-for-Windows environment (Microsoft Corp., Seattle, WA). With the use of an [...]