As medicine becomes more complex and the knowledge base expands, the integration of computer systems into clinical practice would appear to be an inescapable necessity rather than an option. The issues of security and reliability have largely been solved by industrial and business applications of computer technology. The larger challenge lies in designing convenient, efficient and acceptable interfaces between the clinician and computer for data input and presentation. In the future, decision making algorithms are likely to assist the clinician in diagnosis and management to a degree that should significantly improve clinical effectiveness.