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To the Editor.—The obstacles to sophisticated use of information technology (IT) in medication prescribing described by Drs Schiff and Rucker¹ are applicable to all areas of health care IT.

I recently attended the Hospital Information Management Systems Society (HIMSS) conference, the largest vendor trade show for health care IT. The attendance of around 20,000 people broke all previous records. Unfortunately, the number of clinicians in attendance was quite low. Health care IT is led almost exclusively by commercial vendors and health care corporate management information services (MIS) departments. There is a poverty of clinician leadership.

Even medical informaticists, clinicians ideally qualified to provide such leadership, often find themselves poorly accepted in vendor and MIS shops. This may be due to territorial issues, cultural differences, and methodological differences. One such methodological difference is the clinician's favoring of a participatory approach to application development, which represents a significant departure from traditional . . . [Full Text of this Article]

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RELATED ARTICLE

Computerized Prescribing: Building the Electronic Infrastructure for Better Medication Usage
Gordon D. Schiff and T. Donald Rucker
JAMA. 1998;279(13):1024-1029.
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