Present Status of Computer Support in Ambulatory Care

The Working Group 5 of the International Medical Informatics Associ ation (IMIA) dedicates its work to information systems in primary and ambulatory care. The first conference of this Working Group in Hanno ver in 1980 produced a review of the state of the art of that time and gave perspectives for future development (Rienhoff, O. and Abrams, M.E. (eds.): The Computer in the Doctor's Office, Horth Holland, Amsterdam: 1980). In the meantime, a rapid development has taken place. Therefore it seemed appropriate to hold another working conference which was con ducted in Munich, December 2-6, 1985. The goal of this working conference was to review the developments in this field and to critically evaluate the progress achieved so far. The conference addressed general principles in system development and prerequisists for their successful introduction into routine use. Furthermore, the topics of expert systems and new technologies were discussed in the context of their usefulness and usability in ambula tory care systems. As before, it became very clear that actual computer systems to sup port ambulatory and/or primary care have to meet the conditions of the health care delivery systems, into which they are to be placed.

ELIAS: Support of the Dutch General Practitioner.- Computer in the Doctor's Office in the Federal Republic of Germany - Legal, Economic and Functional Aspects of Computer Support in Ambulatory Care.- Primary Provider Groups; An Alternative Prepaid Health Care Delivery and Financing System.- Experiences with a Comprehensive Computer Based Information System for Primary Care in Finland.- Videotex and General Practice.- The Characterization Frame: A Tool to Describe General Practice Office Information Systems.- An Approach to Evaluation of Number, Duration and Cost of the Disability Pensions Granted for Rheumatic Diseases.- The Use of Computers in Outpatient Medical Care in the GDR.- Computer Systems and Services in South Africa.- Problems of Co-ordinating and Standardizing Information for the Monitoring of Primary Medical Care. The Case of Bavaria.- Expert Systems in Primary Care.- Obstacles in Computer-Aided Diagnosis.- New Ways and Possibilities of Primary Preventive Health Care by Computer-Supported Psychophysiological System-Analysis.- The Use and Relevance of the International Classification of Primary Care (ICPC) in Structuring Patient Information.- The Impact of Computers on Ambulatory Health Care.- Integrating Expert Systems with Primary Care Information Systems.- A System for the Generation of a Production Rules Network for Medical Expert Systems.- Presentation of a Multi-User System for Office Based Patient Drug Interaction.- Medical Treatment Assistance with an Interactive Drug Information System.- Development and Implementation of a Longterm Medical Documentation for Primary Care.- A Data Management System in Assistance to Hypertension Treatment in Primary Health Care.- The Continuous Morbidity Registration Nijmegen; A Database for LongitudinalEpidemiology in Primary Care.- Workshop on New Technologies in Primary Health Care and in Education for Doctors and Patients - Report.- Workshop on Networking and Standardization in Communication - Report.- Workshop on Expert Systems and User Needs resp. Patient Records - Report.- Concluding Considerations.- Author Index.- Authors Addresses.