v Preface to the Fourth Edition laboratory and radiologic abnormalities. Devices with embedded processors routinely monitor patients and provide warnings in critical-care settings, such as the intensive-care unit (ICU) or the operating room. Both biomedical researchers and clinicians regularly use computer programs to search the medical literature, and modern clinical research would be severely hampered without computer-based data-storage techniques and statistical analysis sys tems. Advanced decision-support tools also are emerging from research labo- ratories, are being integrated with patient-care systems, and are beginning to have a profound effect on the way medicine is practiced. Despite this extensive use of computers in healthcare settings and bio- medical research, and a resulting expansion of interest in learning more about biomedical computing, many life scientists, health-science students, and pro- fessionals have found it difficult to obtain a comprehensive and rigorous, but nontechnical, overview of the field. Both practitioners and basic scientists are recognizing that thorough preparation for their professional futures requires that they gain an understanding of the state of the art in biomedical comput- ing, of the current and future capabilities and limitations of the technology, and of the way in which such developments fit within the scientific, social, and financial context of biomedicine and our healthcare system. In turn, the future of the biomedical computing field will be largely determined by how well health professionals and biomedical scientists are prepared to guide and to capitalize upon the disciplines development. This book is intended to meet nis growing need for such well-equipped professionals. The first edition appeared in 1990(published by Addison-Wesley) and was used extensively in courses on medical informatics throughout the world. It was updated with a second edition(published by Springer) in 2000, responding to the remark able changes that occurred during the 1990s, most notably the introduction of the World Wide Web and its impact on adoption and acceptance of the Internet. The third edition(again published by Springer) appeared in 2006, reflecting rapid evolution of both technology and health-and biomedically-related applications, plus the emerging government recognition of the key role that health information technology would need to play in pro- moting quality, safety, and efficiency in patient care. With that edition the title of the book was changed from Medical Informatics to Biomedical Informatics reflecting(as is discussed in Chap. 1) both the increasing breadth of the basic discipline and the evolving new name for academic units, societies, research programs, and publications in the field. Like the first three editions, this new version provides a conceptual framework for learning about the science that underlies applications of computing and communications technology in bio- medicine and health care, for understanding the state of the art in computer pplications in clinical care and biology, for critiquing existing systems, and for anticipating future directions that the field may take In many respects, this new edition is very different from its predecessors, however. Most importantly, it reflects the remarkable changes in computing and communications that continue to occur, most notably in communications, networking, and health information technology policy, and the exploding interest in the role that information technology must play in systems integra tion and the melding of genomics with innovations in clinical practice andviii laboratory and radiologic abnormalities. Devices with embedded processors routinely monitor patients and provide warnings in critical-care settings, such as the intensive-care unit (ICU) or the operating room. Both biomedical researchers and clinicians regularly use computer programs to search the medical literature, and modern clinical research would be severely hampered without computer-based data-storage techniques and statistical analysis sys￾tems. Advanced decision-support tools also are emerging from research labo￾ratories, are being integrated with patient-care systems, and are beginning to have a profound effect on the way medicine is practiced. Despite this extensive use of computers in healthcare settings and bio￾medical research, and a resulting expansion of interest in learning more about biomedical computing, many life scientists, health-science students, and pro￾fessionals have found it diffi cult to obtain a comprehensive and rigorous, but nontechnical, overview of the fi eld. Both practitioners and basic scientists are recognizing that thorough preparation for their professional futures requires that they gain an understanding of the state of the art in biomedical comput￾ing, of the current and future capabilities and limitations of the technology, and of the way in which such developments fi t within the scientifi c, social, and fi nancial context of biomedicine and our healthcare system. In turn, the future of the biomedical computing fi eld will be largely determined by how well health professionals and biomedical scientists are prepared to guide and to capitalize upon the discipline’s development. This book is intended to meet this growing need for such well-equipped professionals. The fi rst edition appeared in 1990 (published by Addison-Wesley) and was used extensively in courses on medical informatics throughout the world. It was updated with a second edition (published by Springer) in 2000, responding to the remark￾able changes that occurred during the 1990s, most notably the introduction of the World Wide Web and its impact on adoption and acceptance of the Internet. The third edition (again published by Springer) appeared in 2006, refl ecting the ongoing rapid evolution of both technology and health- and biomedically-related applications, plus the emerging government recognition of the key role that health information technology would need to play in pro￾moting quality, safety, and effi ciency in patient care. With that edition the title of the book was changed from Medical Informatics to Biomedical Informatics , refl ecting (as is discussed in Chap. 1) both the increasing breadth of the basic discipline and the evolving new name for academic units, societies, research programs, and publications in the fi eld. Like the fi rst three editions, this new version provides a conceptual framework for learning about the science that underlies applications of computing and communications technology in bio￾medicine and health care, for understanding the state of the art in computer applications in clinical care and biology, for critiquing existing systems, and for anticipating future directions that the fi eld may take. In many respects, this new edition is very different from its predecessors, however. Most importantly, it refl ects the remarkable changes in computing and communications that continue to occur, most notably in communications, networking, and health information technology policy, and the exploding interest in the role that information technology must play in systems integra￾tion and the melding of genomics with innovations in clinical practice and Preface to the Fourth Edition