William F. Bria II and Richard L. Rydell. 96 pages. Chicago: American Hospital Publishing; 1992. $29.95 for members of the American Hospital Association; $37.50 for nonmembers.

Implementation of a hospital information system is a complex task involving many constituents. The physician has frequently been an outsider in the design and implementation of these systems. However, physicians themselves are increasingly seeking to influence this process. Various aspects of the relation between physicians and the use of a hospital information system have been addressed in several hundred articles, at least five textbooks, and several forums on Bitnet and the Internet.

This text does not use these sources. It is a case study of the authors' experience with implementing hospital information systems. This book is intended for health care providers who do not have sophisticated knowledge of the role physicians may play in information systems.

The eight chapters in this text can be classified by issues of physician involvement and acceptance (one chapter); organizational culture and readiness for implementation of a health information system (two chapters); system selection, design, implementation, and evaluation (two chapters); hardware, software, and data security issues (one chapter); and identification of immediate and long-range benefits of such a system (one chapter). Drawing on extensive personal experience, the authors arrange these chapters to form a blueprint for implementing an information system.

Although the authors are successful at keeping their ideas uncomplicated, this blueprint unfortunately suffers from lack of depth. A stated goal is to generate full commitment of physicians in the implementation of an information system, which should realize clinical, financial, and operational benefits. Yet little of the book is focused specifically on these aspects. Rather, the focus seems to shift from the physician's perspective to that of management or even the information system staff. None of these perspectives is explored with sufficient detail. The text does not provide a supplemental bibliography or list of suggested reading to aid the physician seeking additional knowledge or perspectives.

Overall, this book is most valuable as a general overview of the complex nature of implementing a health information system, including the political and organizational factors affecting its acceptance. Physicians engaged in the selection, implementation, or evaluation of a health information system could use this book to influence the acceptance of these systems by other health care professionals.