Preface to the fourth edition informatics concepts, computers, and advanced communication devices one day may pervade every aspect of biomedical research and clinical practice The Study of Computer Applications in Biomedicine The actual and potential uses of computers in health care and biomedicine form a remarkably broad and complex topic. However, just as you do not need to understand how a telephone or an ATM machine works to make good use of it and to tell when it is functioning poorly, we believe that technical biomedical-computing skills are not needed by health workers and life scien- tists who wish simply to become effective users of evolving information tech- nologies. On the other hand, such technical skills are of course necessary for individuals with career commitment to developing information systems for biomedical and health environments. Thus, this book will neither teach you to be a programmer, nor show you how to fix a broken computer(although it might motivate you to learn how to do both). It also will not tell you ab every important biomedical-computing system or application; we shall u extensive bibliography to direct you to a wealth of literature where review articles and individual project reports can be found. We describe specific sys- tems only as examples that can provide you with an understanding of the conceptual and organizational issues to be addressed in building systems for such uses. Examples also help to reveal the remaining barriers to successfu implementations. Some of the application systems described in the book are well established, even in the commercial marketplace. Others are just begin- ning to be used broadly in biomedical settings. Several are still largely con- fined to the research laboratory Because we wish to emphasize the concepts underlying this field, we gen erally limit the discussion of technical implementation details. The computer- science issues can be learned from other courses and other textbooks one exception, however, is our emphasis on the details of decision science as they relate to biomedical problem solving( Chaps. 3 and 22). These topics gener- lly are not presented in computer-science courses, yet they play a central role in the intelligent use of biomedical data and knowledge. Sections o medical decision making and computer-assisted decision support accordingly include more technical detail than you will find in other chapters All chapters include an annotated list of Suggested Readings to which you can turn if you have a particular interest in a topic, and there is a comprehen sive Bibliography, drawn from the individual chapters, at the end of the book. We use boldface print to indicate the key terms of each chapter; the defini- tions of these terms are included in the Glossary at the end of the book. Because many of the issues in biomedical informatics are conceptual, we have included Questions for Discussion at the end of each chapter. You will quickly discover that most of these questions do not have"right"answers They are intended to illuminate key issues in the field and to motivate you to examine additional readings and new areas of research It is inherently limiting to learn about computer applications solely by reading about them. We accordingly encourage you to complement yourxi informatics concepts, computers, and advanced communication devices one day may pervade every aspect of biomedical research and clinical practice. The Study of Computer Applications in Biomedicine The actual and potential uses of computers in health care and biomedicine form a remarkably broad and complex topic. However, just as you do not need to understand how a telephone or an ATM machine works to make good use of it and to tell when it is functioning poorly, we believe that technical biomedical-computing skills are not needed by health workers and life scien￾tists who wish simply to become effective users of evolving information tech￾nologies. On the other hand, such technical skills are of course necessary for individuals with career commitment to developing information systems for biomedical and health environments. Thus, this book will neither teach you to be a programmer, nor show you how to fi x a broken computer (although it might motivate you to learn how to do both). It also will not tell you about every important biomedical-computing system or application; we shall use an extensive bibliography to direct you to a wealth of literature where review articles and individual project reports can be found. We describe specifi c sys￾tems only as examples that can provide you with an understanding of the conceptual and organizational issues to be addressed in building systems for such uses. Examples also help to reveal the remaining barriers to successful implementations. Some of the application systems described in the book are well established, even in the commercial marketplace. Others are just begin￾ning to be used broadly in biomedical settings. Several are still largely con- fi ned to the research laboratory. Because we wish to emphasize the concepts underlying this fi eld, we gen￾erally limit the discussion of technical implementation details. The computer￾science issues can be learned from other courses and other textbooks. One exception, however, is our emphasis on the details of decision science as they relate to biomedical problem solving (Chaps. 3 and 22). These topics gener￾ally are not presented in computer-science courses, yet they play a central role in the intelligent use of biomedical data and knowledge. Sections on medical decision making and computer-assisted decision support accordingly include more technical detail than you will fi nd in other chapters. All chapters include an annotated list of Suggested Readings to which you can turn if you have a particular interest in a topic, and there is a comprehen￾sive Bibliography, drawn from the individual chapters, at the end of the book. We use boldface print to indicate the key terms of each chapter; the defi ni￾tions of these terms are included in the Glossary at the end of the book. Because many of the issues in biomedical informatics are conceptual, we have included Questions for Discussion at the end of each chapter. You will quickly discover that most of these questions do not have “right” answers. They are intended to illuminate key issues in the fi eld and to motivate you to examine additional readings and new areas of research. It is inherently limiting to learn about computer applications solely by reading about them. We accordingly encourage you to complement your Preface to the Fourth Edition