Abstract

The environment of health care delivery is changing dramatically, matched by design trends in the organizations that are responsible for care delivery, whether at the hospital or the national level. However, the emerging goals of these organizations have a certain amount of uniformity independent of background, cultural assumptions or organizational size: they are all committed to the delivery of services that maximize satisfaction of system beneficiaries at a minimum of expense. Achievement of these goals will in part require the development of a management and delivery coordination infrastructure that links the key resource utilizers and administrative operators at the point of production. Merged computer and telecommunications systems connecting at user interface nodes called workstations represent a critical enabling technology for meeting the organizational goals described above. Future delivery systems will need to provide compassionate care, retaining the most highly regarded traditions of medical practice without ignoring considerations of cost, clinical outcome and financial sustainability. This paper describes some of the limitations of the current delivery system, and attempts to identify key design concepts and paradigms that might serve to guide future system development.

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