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Information Technology in the Community

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As health care moves into the community, nurses and physicians are not the only ones with new jobs—patients have new and increasing responsibilities for self-care and disease management. Information technologies can provide the necessary tools to ensure that patients are well equipped to meet these challenges.

Under the umbrella of the theme “Information Technology in Community Health,” the participants at the 1997 AMIA Spring Congress learned of new and emerging technologies with the potential to enhance patients’ abilities to engage in self-help, promote self-care, and implement disease-management strategies. This issue of JAMIA includes four papers addressing developments in information technologies designed to better equip patients and consumers to meet these challenges.

Mary Gardiner Jones opened the congress with a plenary address exhorting the Health Informatics community to participate in shaping the national information infrastructure. From her perspective as a consumer advocate, Ms. Jones cautioned that the current trajectory of progress for the NII is more responsive to the communications and education sectors of society than to the needs of the health care system.

She advocated that we who work at the nexus of technology and health care must in turn serve as advocates for our patients and clients whose chance to benefit from the NII depends on our ability to garner its resources for health care delivery.

Rosenthal reported a prototype voice-enabled system for generating structured reports. Voice technology remains elusive as a reliable mechanism for providing input into computer systems. Consumers and patients may best be served by information systems that support voice data entry. Efficient and effective use of voice technologies removes the barriers to consumer access to health information once posed by typing skill and access to computers.

Other papers addressed clinical, rather than technology, issues. Choice of appropriate therapy relies heavily on understanding patients’ preferences for health outcomes and clinical treatments. Elicitation of these highly individualistic values is complex and time consuming, far exceeding the resources available in the contemporary health care encounter. Lenert and colleagues describe a WWW-accessible system to assess a patient’s quality of life.

Such tools also could be used to aid patients in value clarification. Use of such programs affords patients the time and privacy to conduct personal introspection and helps prepare them to better participate in clinical decision making.

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