The development and implementation of competent and cost-effective computerized medical records that profoundly improve physician productivity and knowledge management will require the development of a new paradigm for the representation and analysis of medical knowledge and logic. Medical knowledge is acquired inductively by observing, measuring, and eliciting information from patients in a process that is investigational rather than transactional. Most, if not all, current approaches to health information technology (HIT) rely on a logic and data structure that imposes significant limitations on the ability of physicians to thoroughly and efficiently document and access empiric patient data because the information is almost invariably organized in a way which presumes, rather than makes explicit, the relationships of concepts and their meaning.
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