Guidelines and protocols for clinical practice (sometimes also termed practice policies) are receiving increasing attention from clinicians and health services as means for applying best current knowledge to maximise the quality and efficiency of delivered healthcare within the given economic constraints. This volume contains the proceedings of a Conference organized in April 1994 by the Health Telematics programme (1991-1994), the AIM programme, which forms part of the Third Framework Programme for Research and Technological Development of the Commission of the European Communities.

Earlier discussions among projects participating in this programme had confirmed the growing and widespread importance of this trend within medicine, and the widely recognised potential for healthcare telematics to facilitate the creation, use and constant improvement of clinical guidelines so as to deliver fullest benefits to patients. This observation was strongly reinforced by the results of the EPISTOL study, an accompanying action of the Health Telematics programme set up to clarify the potential impact of knowledge-based systems (KBS) for the health sector. As the chapter in this volume by Pedro Barahona reports, applications of KBS to the use of clinical guidelines were highlighted by this study as a feasible and worthwhile objective for research and development in health telematics during the next few years.

A significant number of projects within the current Health Telematics programme were found to have an active interest in this subject. Accordingly, a Conference was convened to explore the scope and needs for further work in this area. This was accomplished by means of talks by domain experts, presentations by members of all interested Health Telematics projects, and discussion of future needs and measures, including inputs to planning of the CEC 4th Framework Programme and its Health Telmatics workplan.

Twenty-two speakers contributed to the meeting, including representatives of 13 Health Telematics projects and invited experts from outside organizations (Peter C Gøtzsche, The Nordic Cochrane Centre, Denmark; Jean-Louis Renaud-Salis, French Federation of Cancer Centres; Dr Ian Purves, The Sowerby Unit for Primary Care Informatics, Newcastle). Three parallel working sessions addressed issues relating to Primary and Community Care, Secondary and Shared Care, and Guidelines and Knowledge Engineering/Methodology. Specific clinical areas of guideline use presented by speakers included: general medical practice (prevention; prescribing; chronic disease management), cancer, cardiology, neurology, gastro-enterology, rehabilitation, shared care and intensive care.

Some of the conclusions and practical recommendations which emerged from the Conference are reported in Colin Gordon's chapter below. We believe that these Proceedings form an important addition to the literature of health telematics, reflecting the range and depth of innovative talent mobilised in the current European Health Telematics programme. We hope they provide some pointers towards practical ways in which telematics can help meet the health objectives of European citizens, governments, and healthcare professionals.

Colin Gordon and Jens Pihlkjaer Christensen (Editors)