Abstract
THERE is an urgent need to take a fresh look at hospital information systems (HIS) from the perspective of the organizational structure of hospitals, the funding of such systems, and the role that physicians should play in their operation. Failing this, we believe that HIS and their medically related components will continue to suffer serious developmental lags. This commentary, an admittedly brief foray into a complex topic, has two purposes. First, we analyze why little progress has been made in the development of medically oriented information systems in hospitals. Second, using our frame-work for the organization of HIS as a reference, we offer a prescriptive view of the future organization and development of such systems, emphasizing the need for an expanded role for physicians. Such a shift of responsibility will not occur rapidly or spontaneously, but we will discuss implementation elsewhere. Most existing automated system applications in hospitals are administrative
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