Medical informatics: the substantive discipline behind health care computer systems.

The computer is rapidly becoming an interactive workstation for medical research and for clinical decision-making and it has become a preferred instrument for communication and documentation throughout health care. However, when the attempt is made to use the rigid conventions of information processing to impose order on the characteristically volatile and unpredictable phenomena encountered in the clinical setting, deep seated logical issues are uncovered. This challenge has generated the new field of Medical Informatics, one major goal of which is to formulate computer logics that can properly relate the idealized descriptions of disease, the rules for medical practice and the general guidelines for health care to the intricate diversities encountered in the care of individual patients. The Integrated Academic Information Management System (IAIMS) program of the National Library of Medicine provides the most ambitious environment for research in this new endeavor.