THE LEARNING-PROCESS IN THE EPISTEMOLOGY OF MEDICAL INFORMATION

Progress in the past few decades in representing medical knowledge, al ong with the availability of low-cost, powerful workstation computers, has increased interest in encoding all medical records in electronic form, But despite the advantages of legibility, access, and automated performance reviews, computerization may also restrict what can be rec orded and rigidify health care interactions with patients. Balancing t he beneficial and negative effects requires an understanding of medica l practice, especially the difference between human knowledge and toda y's computer programs. Human perceptual and conceptual capabilities br ing an aspect of improvisation and reinterpretation to every human act ion, which in general computers today cannot replicate. Designers of m edical record systems must consider the creative process by which desc riptions are generated by people, as well as the collaborative process by which descriptions of past work are reinterpreted for guiding futu re decisions. This paper provides a framework for understanding these issues, illustrated by design opportunities.