Clinical Decision-Support Systems

If you ask people what the phrase “computers in medicine” means, they often describe a computer program that helps physicians to make diagnoses. Although computers play numerous important clinical roles, from the earliest days of computing people have recognized that computers might support health-care workrs by helping these people to sift through the vast collection of possible diseases and symptoms. This idea has been echoed in futuristic works of science fiction. In Star Trek, for example, medical workers routinely point devices at injured crew members to determine instantly what is the problem and how serious is the damage. The prevalence of such expectations, coupled with a general societal concern about the influence of computers on interpersonal relationships and on job security, has naturally raised questions among health workers. Just what can computers do today to support clinical decision-making? How soon will diagnostic tools be generally available? How good will they be? What will their effects be on the practice of medicine, on medical education, and on relationships among colleagues or between physicians and patients? We can view the contents of this entire book as addressing clinical data and decisionmaking. In Chapter 2, we discussed the central role of accurate, complete, and relevant data in supporting the decisions that confront clinicians and other healthcare workers. In