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COMPUTERS IN CLINICAL MEDICINE: A CRITIQUE

IP.com Disclosure Number: IPCOM000131307D
Original Publication Date: 1978-May-01
Included in the Prior Art Database: 2005-Nov-10
Document File: 15 page(s) / 58K

Publishing Venue

Software Patent Institute

Related People

Stanton A. Glantz: AUTHOR [+3]

Abstract

University of California, San Francisco

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THIS DOCUMENT IS AN APPROXIMATE REPRESENTATION OF THE ORIGINAL.

This record contains textual material that is copyright ©; 1978 by the Institute of Electrical and Electronics Engineers, Inc. All rights reserved. Contact the IEEE Computer Society http://www.computer.org/ (714-821-8380) for copies of the complete work that was the source of this textual material and for all use beyond that as a record from the SPI Database.

COMPUTERS IN CLINICAL MEDICINE: A CRITIQUE

Stanton A. Glantz

University of California, San Francisco

In clinical medicine, computers are not an unmixed blessing. Sometimes their only observable effect is to drive up the costs of health care.

Medicine s technological imperative and weak cost control mechanisms make it an attractive market for equipment suppliers. The computer system, with data acquisition and display added to its computational power, epitomizes the application of technology to medicine. Small wonder, then, that many -- perhaps most -- physicians favor the clinical use of computers.' But despite the widespread acceptance of computers in medical applications, little progress has been made in solving the problems of software formulation, clinical effectiveness, pass-through of cost savings, and ethical responsibility.

While some applications merely extend established engineering techniques into medicine, others have to accommodate a combination of physiological and social variables that do not fit neatly into the mathematical formulations common in engineering. In consequence, they are not easily programmed.

Better patient data, one might suppose. should lead to improved clinical outcomes. In intensive care units, however, computerized acquisition and display of data have not produced this result.

Computerized electrocardiography, now about as accurate as traditional interpretations by cardiologists, 'could reduce costs, but only if increased physician productivity is translated into a saving for the patient.

Computerized diagnosis and decision-making appear to constitute a means of bringing together at the point of use the vast output of medical research and the best known methods of treatment. But who is to take control of and ethical responsibility for these enormous and complex programs?

How these very difficult questions can be answered within our current health care system is not presently clear. In view of the forces bearing upon medical practitioners to embrace (not always wisely) the latest technology, some additional policy mechanism may be needed. Third-party reimbursement agencies, including the insurance companies and state and federal governments, strongly influence the spread of new technology beyond research institutions. When computerization can produce results at least as good as those produced by traditional methods, and at lower cost, these agencies should adjust their reimbursement rates accordingly to encourage the technology to spread. When computerization cannot be shown to s...