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Edward H. Shortliffe, MD, PhD
Stanford (Calif) University School of Medicine

JAMA. 1987;258(17):2375-2376.

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In Reply.—

Dr Norman is correct to point out that a primary motivation for the decision-support tools I described is their potential for a beneficial impact on the quality of patient care. In fact, the research activities in our field have always been predicated on a belief that physicians will practice better medicine, and that patients will accordingly benefit, if the physician is provided with rapid access to comprehensive clinical data, new biomedical knowledge, and diagnostic and management advice customized to the needs of the particular patient. As Dr Norman has pointed out, the adaptation of decision-support systems for quality assurance through practice monitoring is also promising. Such tools will be particularly useful if their design and integration permit them to be viewed as constructive and supportive rather than as monitors that are punitive or that insist on dogmatic adherence to inflexible guidelines.

There are several medical fields for which . . . [Full Text PDF of this Article]

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