Preface to the Fourth Edition studies by seeing real systems in use---ideally by using them yourself. Your understanding of system limitations and of what you would do to improve a biomedical-computing system will be greatly enhanced if you have had per sonal experience with representative applications. Be aggressive in seeking opportunities to observe and use working systems In a field that is changing as rapidly as biomedical informatics is, it is diffi ult ever to feel that you have knowledge that is completely current. However, the conceptual basis for study changes much more slowly than do the detailed technological issues. Thus, the lessons you learn from this volume will provide you with a foundation on which you can continue to build in the years ahead The need for a course in biomedical Informatics A suggestion that new courses are needed in the curricula for students of the health professions is generally not met with enthusiasm. If anything, educators d students have been clamoring for reduced lecture time, for more emphasis on small group sessions, and for more free time for problem solving and refle tion. A 1984 national survey by the Association of American Medical Colleges found that both medical students and their educators severely criticized the traditional emphasis on lectures and memorization. Yet the analysis of a panel on the General Professional Education of the Physician( GPEP)(Association of American Medical Colleges 1984)and several subs equent st udies and reports have specifically identified biomedical informatics, including computer appli- cations, as an area in which new educational opportunities need to be developed so that physicians and other health professionals will be better prepared for clinical practice. The AAMC recommended the formation of new academic units in biomedical informatics in our medical schools, and subsequent studies nd reports have continued to stress the importance of the field and the need for its inclusion in the educational environments of health professionals The reason for this strong recommendation is clear: The practice of medi- cine is inextricably entwined with the management of information. In the past, practitioners handled medical information through resources such as the near- est hospital or medical-school library; personal collections of books, journals, and reprints; files of patient records; consultation with colleagues: manual office bookkeeping; and(all-too-often flawed) memorization. Although these techniques continue to be variably valuable, information technology is offerin new methods for finding, filing, and sorting information: online bibliographi retrieval systems, including full-text publications: personal computers, laptops tablets, and smart phones, with database software to maintain personal infor mation and commonly used references: office-practice and clinical information systems to capture, communicate, and preserve key elements of the health record; information retrieval and consultation systems to provide assistance when an answer to a question is needed rapidly; practice-management systems to integrate billing and receivable functions with other aspects of office or clinic organization; and other online information resources that help to reduce thexii studies by seeing real systems in use—ideally by using them yourself. Your understanding of system limitations and of what you would do to improve a biomedical-computing system will be greatly enhanced if you have had per￾sonal experience with representative applications. Be aggressive in seeking opportunities to observe and use working systems. In a fi eld that is changing as rapidly as biomedical informatics is, it is diffi - cult ever to feel that you have knowledge that is completely current. However, the conceptual basis for study changes much more slowly than do the detailed technological issues. Thus, the lessons you learn from this volume will provide you with a foundation on which you can continue to build in the years ahead. The Need for a Course in Biomedical Informatics A suggestion that new courses are needed in the curricula for students of the health professions is generally not met with enthusiasm. If anything, educators and students have been clamoring for reduced lecture time, for more emphasis on small group sessions, and for more free time for problem solving and refl ec￾tion. A 1984 national survey by the Association of American Medical Colleges found that both medical students and their educators severely criticized the traditional emphasis on lectures and memorization. Yet the analysis of a panel on the General Professional Education of the Physician (GPEP) (Association of American Medical Colleges 1984 ) and several subsequent studies and reports have specifi cally identifi ed biomedical informatics, including computer appli￾cations, as an area in which new educational opportunities need to be developed so that physicians and other health professionals will be better prepared for clinical practice. The AAMC recommended the formation of new academic units in biomedical informatics in our medical schools, and subsequent studies and reports have continued to stress the importance of the fi eld and the need for its inclusion in the educational environments of health professionals. The reason for this strong recommendation is clear: The practice of medi￾cine is inextricably entwined with the management of information . In the past, practitioners handled medical information through resources such as the near￾est hospital or medical-school library; personal collections of books, journals, and reprints; fi les of patient records; consultation with colleagues; manual offi ce bookkeeping; and (all-too-often fl awed) memorization. Although these techniques continue to be variably valuable, information technology is offering new methods for fi nding, fi ling, and sorting information: online bibliographic￾retrieval systems, including full-text publications; personal computers, laptops, tablets, and smart phones, with database software to maintain personal infor￾mation and commonly used references; offi ce- practice and clinical information systems to capture, communicate, and preserve key elements of the health record; information retrieval and consultation systems to provide assistance when an answer to a question is needed rapidly; practice-management systems to integrate billing and receivable functions with other aspects of offi ce or clinic organization; and other online information resources that help to reduce the Preface to the Fourth Edition