This article traces past trends and current developments in medical computing in the
United States. It suggests a link between shifts in emphases in medical computing and
in federal government policy toward health care delivery. The development of medical
computing was not driven solely by the internal imperatives of science and technology,
but by dreams and visions of how computers could revolutionize medicine. Such dreams
and visions constitute a mythical charter similar to ideologies and rhetoric used to
mobilize support by other computerization movements. This mythical charter influenced
development of medical computing by tying computing in medicine to policy goals. This
charter also affected historical accounts in medical computing, which are characterized
by technological determinism and evidence of cognitive dissonance due to failure to
achieve policy goals.
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