THE NEXT-GENERATION EMERGENCY DEPARTMENT

The greatest advances in medicine over the next two decades will resul t from application of the tools and principles of informatics to the p roblems of clinical medicine. New developments in medical informatics will drive advances in clinical care, administration, research, and ed ucation. Information flow in the emergency department a decade hence w ill be characterized by a transformation from a ''hunter-gatherer'' in formation model to a ''publisher-subscriber'' model in which the right information will always be available at the right time. In large part , information will be gathered automatically rather than manually. Com puters will be ubiquitous and almost invisible. Invasive and attached monitoring and testing will yield to new remote and noninvasive techno logies. Information will be shared and modified as needed, rather than recreated and reentered by each caregiver. Eventually, the use of inf ormation technologies in the emergency medicine workplace will enhance our traditional role as hands-on providers of direct patient care.