Developing decision support systems: a change in emphasis.

Against a backdrop of many demonstrably proficient expert systems that are not routinely used, and a user community that is skeptical of the benefits of using such technology in healthcare, the AIM funded Dilemma project is attempting to introduce decision support technology into shared care environments within scenarios from the specialties of oncology and cardiology. This paper outlines the experiences of one work-package of the Dilemma project which is concerned with the development of applications with a decision support component for use in shared care of coronary artery disease patients. We suggest reasons why expert systems have failed to gain acceptance in the past, and conclude that a shift in emphasis from building expert systems to building clinically useful applications that have an expert system component may improve the chances of acceptance of this technology in the future.