Möhr J R
School of Health Information Science, University of Victoria, PO Box 3050, Victoria, BC, Canada V8W 3P5.
Int J Med Inform. 2002 Nov 20;66(1-3):95-106. doi: 10.1016/s1386-5056(02)00041-2.
This paper examines the paper of Haux et al. in this issue of this journal. It gives some background on specifics of the German health care system, which underlie the theses and prognoses proposed by Haux et al. In analogy to a forecast of the future of health informatics, which is now 10 years old, I then suggest that these attempts meet two types of challenges:that of overestimating the positive effects of recent advances, which later are found not to scale up; and that of blind spots with respect to unforeseen significant advances. The attempt to find indications of such in the projections of Haux et al. leads, among other, to the conclusion that the projections of direct linkages between patients and care providers may be overoptimistic. As to whether the deviating opinions matter in the end, it is concluded that the technology advances may require less attention that the restructuring of the health care system required to take advantage of the advances of technology.
本文审视了豪克斯等人在本期期刊上发表的论文。文中介绍了德国医疗保健系统的一些具体背景情况，这些情况是豪克斯等人提出的论点和预测的基础。类似于对已有十年历史的健康信息学未来的预测，我随后指出，这些尝试面临两类挑战：一是高估近期进展的积极影响，而这些影响后来被发现无法扩大规模；二是对未预见的重大进展存在盲点。在豪克斯等人的预测中寻找此类迹象的尝试，除其他外，得出的结论是，患者与护理提供者之间直接联系的预测可能过于乐观。至于这些不同意见最终是否重要，结论是技术进步可能不如利用技术进步所需的医疗保健系统重组那样需要关注。
