Medical Informatics: Past and Future

Part of the Health Informatics book series (HI)


Led in its earliest decades by a few pioneers and supported by a small number of professional organizations and universities, medical informatics was funded primarily by federal grants and contracts until 1980, when industry began to enter the marketplace. Despite technology advances, diffusion across health care was slow, and computers were used predominately for business functions. In the 1980s specialized subsystems were developed for the clinical laboratory, radiology, and pharmacy, but by 1989 only a few medical information systems were operational, most of them in academic health centers that had received federal funding. In the 1990s, distributed information systems allowed physicians to enter orders and retrieve test results using clinical workstations; and hospital networks integrated data from all the distributed clinical specialty databases in an electronic patient record. By the end of 1990s, systems were up and running in the Department of Defense and Veterans Administration. In the 2000s, more clinicians in the United States were using electronic health records, due in part to steps taken to adjust the computer to its professional users. Diffusion was further advanced in 2010, when direct federal funding was extended to health care providers using systems that met “Meaningful Use” requirements in caring for Medicare and Medicaid patients. Advances expected in the next decade include precision medicine and patient genotyping; telehealth care; cloud computing; support for elder care with multiple chronic diseases and polypharmacy; advanced clinical decision support; patient data security; big data analytics, improved population health, public health, and disaster management; and interoperability and integration of care across venues.


Medical informatics Clinical support systems Electronic health record Technology diffusion Physician adoption Historical development Technological innovations Federal role 


  1. 1.
    Ball MJ, Jacobs SE. Hospital information systems as we enter the decade of the 80’s. Proc Annu Symp Comput Appl Med Care. 1980;1:646.PubMedCentralGoogle Scholar
  2. 2.
    Ball MJ, Hammon GL. Maybe a network of mini-computers can fill your data systems needs. Hosp Financ Manag. 1975;29:48.Google Scholar
  3. 3.
    Ball MJ. Computers-prescription for hospital ills. Datamation. 1975;21:50–1.Google Scholar
  4. 4.
    Barret V. Best small companies. Forbes. 2011;188:82–92.Google Scholar
  5. 5.
    Blum BI, Lenhard Jr RE, McColligan EE. An integrated data model for patient care. IEEE Trans Biomed Eng. 1985;32:277–88.CrossRefPubMedGoogle Scholar
  6. 6.
    Bronzino JD. In: Bronzino JD, editor. Computers and patient care. Saint Louis: C.V. Mosby; 1977. p. 57–102.Google Scholar
  7. 7.
    Burnett KK, Battle H, Cant GD. Uniform Health-Care Information Act. Chicago: National Conference of Commissioners on Uniform State Laws; 1985.Google Scholar
  8. 8.
    Cardiff Publishing. Fifth annual market directory of computers in healthcare. Englewood: Cardiff Pub. Co; 1988.Google Scholar
  9. 9.
    Collen MF. A history of medical informatics in the United States, 1950 to 1990. Indianapolis: American Medical Informatics Association; 1995.Google Scholar
  10. 10.
    Dorenfest SI. The decade of the 1980’s: large expenditures produce limited progress in hospital automation. US Healthc. 1989;6:20–2.PubMedGoogle Scholar
  11. 11.
    Effros M, Goldsmith A, Medard M. Wireless networks. Sci Am. 2010;302:73–7.CrossRefGoogle Scholar
  12. 12.
    Friedman C, Hripcsak G, Johnson SB, Cimino JJ, Clayton PD. A generalized relational schema for an integrated clinical patient database. Proc SCAMC. 1990; 335–339.Google Scholar
  13. 13.
    Greenes RA, Pappalardo AN, Marble CW, Barnett GO. Design and implementation of a clinical data management system. Comput Biomed Res. 1969;2:469–85.CrossRefPubMedGoogle Scholar
  14. 14.
    Greenes RA, Shortliffe EH. Medical informatics. An emerging academic discipline and institutional priority. JAMA. 1990;263:1114–20.CrossRefPubMedGoogle Scholar
  15. 15.
    Herner & Co. The use of computers in hospitals: Report III-Survey analysis; Report IV-Descriptions of computer applications. Bethesda: National Center for Health Services Research; 1968.Google Scholar
  16. 16.
    Hoffman T. The 6th annual medical hardware and software buyers guide. MD Comput. 1989;6:334–77.PubMedGoogle Scholar
  17. 17.
    King LS. The automobile makes an impact. JAMA. 1984;251:2352–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Lacey R. Ford, the men and the machine. Boston: Little, Brown; 1986.Google Scholar
  19. 19.
    Ledley RS. A personal view of sowing the seeds. In: Blum BI, Duncan KA, editors. History of medical informatics. New York: ACM Press; 1990. p. 84–110.Google Scholar
  20. 20.
    Lev-Ram M. Intel’s sunny vision for the cloud. Fortune. 2011;164:95–100.Google Scholar
  21. 21.
    Lindberg D. Special aspects of medical computer records with respect to data privacy. In: Williams B, editor. Proc 2nd Illinois Conf Med Inform Syst, University of Illinois Urbana. Pittsburgh: Instrument Society of America; 1975. pp. 35–38.Google Scholar
  22. 22.
    Maturi VF, DuBois RM. Recent trends in computerized medical information systems for hospital departments. Proc SCAMC. 1980;3:1541–9.Google Scholar
  23. 23.
    McDonald CJ, Tierney WM. Computer-stored medical records: their future role in medical practice. JAMA. 1988;259:3433–40.CrossRefPubMedGoogle Scholar
  24. 24.
    Miller RF. Computers and privacy: what price analytic power? Proc Annu Conf ACM. New York: ACM. 1971; 706–716.Google Scholar
  25. 25.
    Newald J. Hospitals look to computerization of physician office linkage. Hospitals. 1987;61:92–4.Google Scholar
  26. 26.
    Open CDS. Open clinical decision support tools and resources., 10 Jan 2015.
  27. 27.
    Polacsek RA. The fourth annual medical software buyer’s guide. MD Comput. 1987;4:23.PubMedGoogle Scholar
  28. 28.
    Reiser SJ, Anbar M. The machine at the bedside: strategies for using technology in patient care. New York: Cambridge University Press; 1984.Google Scholar
  29. 29.
    Schiff GD, Rucker TD. Computerized prescribing: building the electronic infrastructure for better medication usage. JAMA. 1998;279:1024–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Spencer WA. An opinion survey of computer applications in 149 hospitals in the USA, Europe and Japan. Inform Health Soc Care. 1976;1:215–34.CrossRefGoogle Scholar
  31. 31.
    Starr P. The social transformation of American medicine. New York: Basic Books; 1982.Google Scholar
  32. 32.
    Stroud C, Altevogt BM, Lori Nadig L, Hougan M. Forum on medical and public health preparedness for catastrophic events; Institute of Medicine. Washington, DC: National Academies Press; 2010.Google Scholar
  33. 33.
    The Economist. Tanks in the cloud. De Economist. 2011;402:49–50.Google Scholar
  34. 34.
    Young EM, Brian EW, Hardy DR, Kaplan A, Childerston JK. Evaluation of automated hospital data management systems (AHDMS). Proc SCAMC. 1980;1:651–7.Google Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Arizona State UniversityTempeUSA
  2. 2.Department of Biomedical InformaticsMayo ClinicRochesterUSA

Personalised recommendations