Medical informatics' promised land: Are we there yet?

A decade age, a "promised land" was envisioned in which the true potential of medical informatics would be realized. A decade later, it is time to ass ess academic medicine's progress in its journey into this medial informatic s promised land. To that end, the author considers how out academic medical centers have been affected by changes in social, financial, and technical forces originating either "inside" or "outside" these institutions. He desc ribes how the Internet and the World Wide Web have brought about an explosi on in the availability of biomedical information, eased communication acros s the globe, made more information available at a lower cost, and changed t he pace of everyday work. Although he argues that academic medical centers have not always kept pace with these changes, information systems are impro ving as the leaders in academic medicine come to appreciate the value of bo th information technology and the people who understand it. To reach the "p romised land" envisioned a decade ago, academic medical centers must treat medical informatics as a central component of their academic mission.