This monograph series is intended to provide medical information scien-
tists, health care administrators, health care providers, and computer
sci- ence professionals with successful examples and experiences of
computer applications in health care settings. Through the exposition of
these com- puter applications, we attempt to show what is effective and
efficient and hopefully provide some guidance on the acquisition or
design of informa- tion systems so that costly mistakes can be avoided.
The health care industry is currently being pushed and pulled from all
directions - from the clinical side to increase quality of care, from
the busi- ness side to improve financial stability, from the legal and
regulatory sides to provide more detailed documentation, and, in a
university environment, to provide more data for research and improved
opportunities for educa- tion. Medical information systems sit in the
middle of all these demands. They are not only asked to provide more,
better, and more timely informa- tion but also to interact with and
monitor the process of health care itself by providing clinical
reminders, warnings about adverse drug interactions, alerts to
questionable treatment, alarms for security breaches, mail mes- sages,
workload schedules, etc. Clearly, medical information systems are
functionally very rich and demand quick response time and a high level
of security. They can be classified as very complex systems and, from a
devel- oper's perspective, as 'risky' systems.