When conversation is better than computation

While largely ignored in informatics thinking, the clinical communication s pace accounts for the major part of the information flow in health care. Gr owing evidence indicates that errors in communication give rise to substant ial clinical morbidity and mortality. This paper explores the implications of acknowledging the primacy of the communication space in informatics and explores some solutions to communication difficulties. It also examines whe ther understanding the dynamics of communication between human beings can a lso improve the way we design information systems in health care. Using the concept of common ground in conversation, proposals are suggested for mode ling the common ground between a system and human users. Such models provid e insights into when communication or computational systems are better suit ed to solving information problems.