Information, Computers, and Clinical Practice

INFORMATION management is integral to clinical practice. Clinicians and patients interact within a complex information matrix. The physician is an information manager who acquires, processes, stores, retrieves, and applies information related to (1) individual patient history and clinical course, (2) diagnostic and therapeutic protocols, (3) disease patterns in patient populations, (4) functioning of the health care system, and (5) the vast store of published knowledge. Little occurs in the clinical encounter that is not in some way related to obtaining, processing, or applying information. Optimal performance of clinical informational tasks has for years exceeded the cognitive capability of the human mind; the physician-patient interaction is an individual, handcrafted activity of uneven quality. The facts of the clinical history depend on the patient's often inadequate recall, the physician's intuitive problem-solving strategies, the time and emotional constraints of the interview, and an archaic record system. Diagnosis is an uncertain science, reflecting the