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“What is the cause of this state of under achievement implementation of clinical computing systems when the need is so great and the technology so powerful?” asked Barnett & Greenes in 1969. This question has continued to be asked. Of 32 systems in clinical medicine surveyed in 1977, half had been abandoned or temporarily stopped and only 19% were used routinely (Friedman & Gustafson 1977). Enormous numbers of diagnostic systems have been developed (Wardle & Wardle 1978), yet the dissemination of any single system is limited.
David W. Young (Wed,) studied this question.
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