M. Rothemund’s scientific contributions

It should be pointed out that during the interviews most of the experts had positive expectations of ESM. The developers are more generally enthusiastic than the prospective users and affected parties who, especially in respect of the diffusion of ESM into practical application, only show a limited optimism. However, the representatives of the medical profession and the health insurance industry were convinced that ESM might contribute to cost-neutral increases of quality in out-patient and in-patient medicine. But we also understood them to say that they consider other developments in medicine to be overriding, for example, a tendency of general medicine towards a more family-oriented medicine and a reduced emphasis on technology-oriented medicine. In respect of the conception shared by developers as well as potential users that over-enthusiastic expectations should rather be restrained, we consider such a balanced expectation of positive effects of ESM to be adequate to the actual knowledge of the subject.

Medizinische Experten- und Konsultationssysteme sind wissensbasierte Computerverfahren, die den Arzt bei komplexen Diagnose- und Therapieentscheidungen unterstützen sollen. In einer Studie zur Folgenabschätzung bzw. zum Technology Assessment (TA) solcher Systeme untersuchten wir: Reifegrad, Verbreitung, Diffusionschancen in den nächsten 10–15 Jahren, Aus-, Neben- und Folgewirkungen auf Versorgungsqualität, Kosten der Versorgung, Personaleinsatz, Arzt-Patienten-Verhältnis, Risiken.

Looking at the literature available you find only a few systems worth to be mentioned in regard to both aspects: Expert Systems and Primary Care. For this reason it was decided to subdivide the paper into the following chapters: Computers and Primary Care: General Problems Expert Systems and Primary Care Existing Expert Systems for Primary Care.

The workshop started with some remarks by P.L. Reichertz (see “Concluding Considerations”, this volume). In its first part the workshop focussed on questions like “Why do we need expert systems (ES) in primary care?”, “In what areas should we have ES?”, “What type of ES are recommendable”, and “What are the requirements for certification of ES?”. The following discussion surfaced a wide scope of opinions and even more questions were asked.

Das MEDIS-Institut der GSF führt eine Studie zur Abschätzung der Chancen und Risiken von Expertensystemen in der Medizin durch. Wesentlicher Bestandteil der Technologiefolgenabschätzung ist eine Bestandsaufnahme über den gegenwärtigen Entwicklungs- und Anwendungsstand sowie über die Bedingungen, Möglichkeiten und zeitlichen Perspektiven der Diffusion von Expertensystemen in die medizinische Anwendung, über die in diesem Beitrag berichtet werden soll.