As its name implies, this book deals with clinical information systems. The clinical information system (or CIS) is an automated system with a long term database containing clinical information used for patient care. This definition excludes business systems (no clinical data), physiological monitoring systems (no long term database), and many research systems (not used in patient care). The theses of this book are (a) that CIS technology is mature, (b) that the CIS will have a major impact upon patient care and the health delivery system, and (c) that the number of commercial systems which now offer these potential benefits is very small. The objective of this book is to establish the above theses and thereby (a) inform both users and developers, (b) increase the demand for more sophisticated products, and finally, (c) provide marketplace incentives to advance the state of the art. The CIS is an application of computer technology for a specific class of problems. Its development requires a knowledge of the technology with an understanding of the application area. As with any tool-based application, the scope of the product will be limited by the capability of the tool. In the case of the CIS, reliable computers with comprehensive database facilities became com mercially available in the early 1970s. By the mid 1970s there was a maturation of the literature, and evaluations of 5-years' use began to appear. As will be shown, there have been surprisingly few new ideas introduced since the 1970s."

This series in Computers and Medicine had its origins when I met Jerry Stone of Springer-Verlag at a SCAMC meeting in 1982. We determined that there was a need for good collections of papers that would help disseminate the results of research and application in this field. I had already decided to do what is now Information Systems for Patient Care, and Jerry contributed the idea of making it part of a series. In 1984 the first book was published, and-thanks to Jerry's efforts - Computers and Medicine was underway. Since that time, there have been many changes. Sadly, Jerry died at a very early age and cannot share in the success of the series that he helped found. On the bright side, however, many of the early goals of the series have been met. As the result of equipment improvements and the consequent lowering of costs, com puters are being used in a growing number of medical applications, and the health care community is very computer literate. Thus, the focus of concern has turned from learning about the technology to understanding how that technology can be exploited in a medical environment."

A Clinical Information System for Oncology describes a medical information system designed and implemented in a cancer center but with broad applicability to medical practice beyond the cancer center environment in both inpatient and outpatient settings. Regarded as forward looking in 1978, the system has the distinction of still being in production. Indeed, its functionality has continued to grow and its technical implementation to evolve with the changing technology over the last decade. The authors detail the functions supported by this unique system, illustrate how it assists in the care process, review its development history, and evaluate its impact on the delivery of care in terms of cost, user satisfaction, and efficacy. Unlike much information technology, the system is an active participant in medical decision making: it includes comprehensive tools for managing and displaying clinical data; automatically produces care plans from protocols; and features unique tools which support the effective use of blood products. Professionals in medical informatics, hospital administrators, and physicians will find this book a valuable addition to their professional library.

This book provides a unique examination of the software development process, arguing that discipline, still dominated by methods conceived in the framework of older technologies, must undergo a fundamental reexamination of its guiding principles in order for significant progress to take place. To gain fresh insights into how we ought to direct future research, the author begins with a search for first principles. The book begins with an exploration of the scientific foundations of computer technology, then examines design from the perspective of practitioners. The book also offers a critique of the methods employed in software development and an evaluation of an alternate paradigm that has been used successfully for 14 years. The concepts reviewed here comprise a set of core readings for understanding the research and development challenges that will confront computer technology in the 21st century and will be of great interest to computer science researchers and educators, graduate students, and software engineers.