That modern healthcare requires information technology to be efficient and fully effective is evident if one spends any time observing the delivery of institutional health care. Consider the observation of a practitioner of the discipline, David M. Eddy, MD, PhD, voiced in Clinical Decision Making, JAMA 263:1265-75, 1990, ". . .All confirm what would be expected from common sense: The complexity of modern medicine exceeds the inherent limitations of the unaided human mind." The goal of this thesis is to identify the technological factors that are required to enable a fully sufficient application of information technology (IT) to the modern institutional practice of medicine. Perhaps the epitome of healthcare IT is the fully integrated, fully electronic patient medical record. Although, in 1991 the Institute of Medicine called for such a record to be standard technology by 2001, it has still not materialized. The author will argue that some of the technology and standards that are pre-requisite for this achievement have now arrived, while others are still evolving to fully sufficient levels. The paper will concentrate primarily on the health care system in the United States, although much of what is contained is applicable to a large degree, around the world. The paper will illustrate certain of these pre-requisite IT factors by discussing the actual installation of a major health care computer system at the University of Rochester Medical Center (URMC) in Rochester, New York. This system is a Picture Archiving and Communications System (PACS). As the name implies, PACS is a system of capturing health care images in digital format, storing them and communicating them to users throughout the enterprise.

Library of Congress Subject Headings

Health services administration--Information technology; Medical care--Information technology

Publication Date


Document Type


Student Type


Degree Name

Information Sciences and Technologies (MS)

Department, Program, or Center

Information Sciences and Technologies (GCCIS)


Rayno Niemi

Advisor/Committee Member

Anne Haake

Advisor/Committee Member

David Krusch


Physical copy available from RIT's Wallace Library at RA971.23 .S35 2004


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