AIM: a personal view of where I have been and where we might be going

My own career in medical informatics and AI in medicine has oscillated between concerns with medical records and concerns with knowledge representation with decision support as a pivotal integrating issue. It has focused on using AI to organise information and reduce 'muddle' and improve the user interfaces to produce 'useful and usable systems' to help doctors with a 'humanly impossible task'. Increasingly knowledge representation and ontologies have become the fulcrum for orchestrating re-use of information and integration of systems. Encouragingly, the dilemma between computational tractability and expressiveness is lessening, and ontologies and description logics are joining the mainstream both in AI in Medicine and in Intelligent Information Management generally. It has been shown possible to scale up ontologies to meet medical needs, and increasingly ontologies are playing a key role in meeting the requirements to scale up the complexity of clinical systems to meet the ever increasing demands brought about by new emphasis on reduction of errors, clinical accountability, and the explosion of knowledge on the Web.