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PubMed1996

The informatics of health care reform.

Health care in the United States has entered a period of economic upheaval. Episodic, fee-for-service care financed by indemnity insurance is being replaced by managed care financed by fixed-price, capitated health plans. The resulting focus on reducing costs, especially in areas where there is competition fueled by oversupply of health services providers and facilities, poses new threats to the livelihood of medical libraries and medical librarians but also offers new opportunities. Internet services, consumer health education, and health services research will grow in importance, and organizational mergers will provide librarians with opportunities to assume new roles within their organizations.

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PubMed1996

Collaborative medical informatics research using the Internet and the World Wide Web.

The InterMed Collaboratory is an interdisciplinary project involving six participating medical institutions. There are two broad mandates for the effort. The first is to further the development, sharing, and demonstration of numerous software and system components, data sets, procedures and tools that will facilitate the collaborations and support the application goals of these projects. The second is to provide a distributed suite of clinical applications, guidelines, and knowledge-bases for clinical, educational, and administrative purposes. To define the interactions among the components, datasets, procedures, and tools that we are producing and sharing, we have identified a model composed of seven tiers, each of which supports the levels above it. In this paper we briefly describe those tiers and the nature of the collaborative process with which we have experimented.

Computer Communication Networks↗
PubMed1995

Uncertainty and decisions in medical informatics.

This paper presents a tutorial introduction to the handling of uncertainty and decision-making in medical reasoning systems. It focuses on the central role of uncertainty in all of medicine and identifies the major themes that arise in research papers. It then reviews simple Bayesian formulations of the problem and pursues the generalization to the Bayesian network methods that are popular today. Decision making is presented from the decision analysis viewpoint, with brief mention of recently-developed methods. The paper concludes with review of more abstract characterization of uncertainty, and anticipates the growing importance of analytic and "data mining" techniques as growing amounts of clinical data become widely available.

Bayes Theorem↗