amusingly, the computerworld summary doesn't include the paper's summary: "Finally, we believe that the computer’s potential to improve efficiency is unrealized

amusingly, the computerworld summary doesn't include the paper's summary: "Finally, we believe that the computer’s potential to improve efficiency is unrealized because the commercial marketplace does not favor optimal products. Coding and other reimbursement-driven documentation might take precedence over efficiency and the encouragement of clinical parsimony. The largest computer success story has occurred at Veterans Administration hospitals where global budgets obviate the need for most billing and internal cost accounting, and minimize commercial pressures." It seems like hospitals hyper-optimize single actions at the expense of efficiency of pipelined actions. sort of like... An addition takes a single clock, a multiplication takes a single clock, but a multiplication followed by an addition takes 100 clocks. Except tongue depressors and temperature taking instead of arithmetic; money instead of time. I doubt you could build a more cost effective system to have a doctor walk in, take your temperature and leave.