The Future of Computerized Decision Support in Critical Care

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As we write this final chapter, there is a foot of new snow on the ground in R.G.’s backyard in Salt Lake City, and the snow continues to fall. Last night three local television weather forecasters predicted we would only have two inches of snow, and all they had to do was predict one day into the future! With some trepidation, and without the equivalent of weather satellites and 40 years experience with forecasting, the authors will try to predict the future of computers and decision support systems in critical care. Our projections are based on two decades of experience and a generally optimistic outlook. We believe that seven broad areas will determine the pace of the future of computerized decision support in critical care: 1. Human, cultural, and sociological issues relating to how computers will be used in the intensive care unit (ICU). 2. Standardization in medicine and the ability to share medical knowledge will be essential. 3. Expanded medical knowledge will lead to better patient care. 4. Hardware and software will continue to advance at a rapid rate. 5. Data acquisition methods and instrumentation will provide more accurate, timely, and less expensive measurements. 6. Sharing of computer and clinical knowledge in computer form will become common and encouraged by government and the clinical community. 7. Better methods for prognostic decision-making will enable medical practitioners and society to make better ethical decisions about health care.