August 1980 Memo HPP-80-16 Department of Computer Science Report No. STAr-CS-80-816

This memo contains two papers that deal with medical computing. The first, written for a book on cybernetics and society, examines the range of medical computing systems, plus some of the logistical and human engineering challenges limiting their utility or acceptance. It addresses five recurring themes that characterize the introduction of medical computing systems: 1) the need for the proposed application, 2) the system users, 3) the logistics of system introduction, 4) the required computational techniques, and 5) the required technological resources. In the context of these topics, suggestions are offered for long-range research and resource policies that are appropriate for assuring the development of practical clinical computing. The second paper, presented at a meeting on artificial intelligence in May 1980, takes a more detailed look at the reasons that medical computing systems have had a limited impact on clinical medicine. When one examines the most common reasons for poor acceptance of such systems, the potential relevance of artificial intelligence techniques becomes evident. The paper proposes design criteria for clinical computing systems and demonstrates their relationship to current research in knowledge engineering. The MYCIN System is used to illustrate the ways in which one research group has responded to the design criteria cited.