Using the computer to optimize human performance in health care delivery. The pathologist as medical information specialist.

The demands for information retrieval, processing, and synthesis placed on all providers of health care have increased dramatically in the last several decades. Although systems have been developed to capture charge-related data in support of cost reimbursement, there has been a conspicuous lack of attention paid to information tools to directly enhance the delivery of patient care. The termination of cost reimbursement, together with an increasing recognition of the problems inherent in current manual record-keeping systems, is creating a significant new focus on medical information. This change in focus requires a shift in systems orientation away from financial and departmentally centered systems and toward patient-centered approaches. There is thus increasing recognition of the need for a physician-level medical information specialist to serve as an institution's chief information officer, assuming responsibility for the collection, manipulation, and availability of all patient care-related data. By virtue of training, typical experience, hospital presence, and a noncompetitive position with the hospital's medical staff, the pathologist is uniquely suited for this position. To effectively perform this role, a variety of new specialized data management tools are becoming available. Integrated information systems, patient care management by exception, decision support tools, and, in the future, "artificial intelligence" assists can all be expected to become staples of pathology practice, especially impacting those pathologists who choose to be responsive to the new practice milieu of medical information science.