Intensive Care Units (ICU) are information and personnel intensive high technology clinical departments. In the U.S.A. they represent 10 % of hospital beds but 25 % of costs. Together with laboratories and radiology departments, ICUs are the medico - technical pre-requisite for high quality hospital medical / surgical practices.

ICSIC has concentrated on action coordination in ICUs. A lot of operational problems in ICUs result from human interactions in fairly large teams (25-100 people) where responsibilities are shared and actions are distributed.

The structure of actions in ICUs was modelled in terms of scenarios - such as therapy scenarios, laboratory test scenarios... ie recurrent organization of work in which personnel and resources are engaged. Workflows are the building blocs of scenarios : they describe the transfer of tasks and responsibilities from requestor to actor in 4 steps (requesting, setting rules and conditions of satisfaction, ie expected results and planning, performing the planned technical tasks and reporting, evaluating the results). Workflow management is the basis of nursing, care, and support of medical activities. This is not specific for ICUs and has broader application.

User acceptance and system transferability are a must for any successful industrial product. Standards are required also about how people work together, about how they assess changing situations, about how they interact with a computer at the bedside and not only about data communications. In this respect a complex data base structure was designed and an innovative Human Computer Interaction scheme was conceived and implemented ; it is currently being tested in the field. It has application beyond the ICU world.

To support these activities, an innovative technological platform is being tested (UNIX V, PC network, Ethernet,TCP/IP & NFS protocols, X-windows, SQL database). Short term exploitation of the results was achieved through a fast development of spin off systems, as early as begin 1991.