During the past twenty years, computers have evolved from relatively cumbersome machines, used primarily at work to create documents and do accounting, into sleek, intuitive, and nearly omnipresent extensions of our fingers, eyes, and brains. Ready access to the information they provide has transformed our lives. It is telling that one hears health warnings against sleeping next to a mobile phone (the most common variety of computer) because twenty years ago, no one worried about computers being taken to bed. It's not just an issue of devices' growing “sexiness.” In 1992, there wasn't much on a PC that one would desire in the middle of the night.

Healthcare also has been transformed by the expanded role of our data-purveying gizmos. Physicians and scientists have unprecedented access to the knowledge of peers around the world, enabling better decision-making. For investigators, data mining can amplify the number of subjects in a study; crowd sourcing enlists a wider perspective. Medical schools educate students more effectively with tools that offer greater realism, useful repetition, and continual assessment. Even the general public can explore medical articles online to learn more about the therapies their doctors prescribe. Also at home, devices monitor patients, report back to their caregivers, and automatically remind them to take their medicine.

There are shortcomings, of course. Physicians can feel like clerks instead of healers, and patients often resent the effect that typing has on bedside manner. Electronic health records can be spoiled when clinicians cut and paste data to save time, while haphazard standardization and interoperability limit records' utility. Crowd sourcing may generate poorly vetted noise instead of useful guidance. Hackers compromise network integrity, and insurers and industry sift through information with eyes perhaps too focused on profits. The relentless disruption of technological change creates additional stress for caregivers and administrators. And for sick patients not in the mood for a learning curve, weighing too many therapeutic options is confusing and frustrating.

Yet there is no feasible alternative to increased reliance upon our devices and their data. Wealthier countries have high expectations about maintaining the health of their rapidly aging Boomer populations, despite shrinking budgets. The developing world, with its growing middle class, wants greater investment in wellness with measurable outcomes as the result. The technological efficiency—meaning affordability—described by Moore's Law is the only way the medical community can address both demographic challenges successfully.

Back in 1992, my colleagues founded “Medicine Meets Virtual Reality” with the aim of using computers to advance clinical care and medical education. They recognized how exponential upgrades in software and hardware would make healthcare more efficient, precise, and personal. Over the years, many visionary ideas have become viable tools: it is not uncommon to read in the general media about a medical breakthrough whose basis was shared at this conference in previous years. And although “virtual reality” faded as a buzzword years ago and “NextMed” more accurately describes this conference now, the creative energy that turns information technology into better medicine remains vibrant.

Many thanks to the Organizing Committee for its steadfast support over two decades, and to all of you who are participating in this year's conference—the twentieth since 1992 and a noteworthy anniversary.

James D. Westwood

Aligned Management Associates, Inc.