Reference: Shortliffe, E. H. Testing Reality: The Introduction of Decision- Support Technologies for Physicians. 1989.
Abstract: Studies of knowledge-based systems methods have long been predicated on the assumption that decision making in medicine is difficult, that medical education has for too long emphasized memorization of factual knowledge as the principal determinant of excellence, and that the techniques of medical informatics and computer science offer solutions to the significant challenges facing clinical decision makers. To those working in the field, such presumptions seem clearly valid. Yet anyone who has introduced a consultation system for clinical testing can attest to the problems faced in attracting and maintaining the interest of the clinicians for whom the system was idealistically intended. Formal studies of physicians' attitudes have appeared in several publications, and as recently as 1981 our laboratory performed a survey to address such questions. Much has changed in the past decade, however, and many people have observed that the interest in computing issues among physicians has increased dramatically with the introduction of personal computing and, more recently, with the development of well-engineered graphical interfaces. Rather than undertake another formal study, we recently collaborated in a "market research" project with a pharmaceutical company that was interested in the current (late 1987) attitudes of private practitioners toward information management and computer-based solutions to record keeping and decision-making challenges. The results of such a study are necessarily anecdotal and informal, but the insights we gained have been valuable.