By Tom Debley
Director, Heritage Resources
“Matching the superb technology of present-day medicine with an effective delivery system can raise U.S. medical care to a level unparalleled in the world.”
Someone might have said that last week talking about electronic medical records, a potentially superb technology which have barely begun to penetrate U.S. hospitals
But actually, the vision quoted above came 40 years ago this month from Dr. Sidney R. Garfield, founding physician of Kaiser Permanente. He wrote about it in a groundbreaking April 1970 article published in Scientific American—the most important paper of his career. Since 1970, it has been cited in other scientific and medical papers more than 200 times and reprinted three times.
"Computer Center" was at center of Dr. Sidney Garfield's vision 40 years ago.
“Health testing combines a detailed computerized medical history with a comprehensive panel of physiological tests administered by paramedical personnel,” Garfield wrote. “Tests record the function of the heart, thyroid, neuromuscular system, respiratory system, vision and hearing. Other tests record height and weight, blood pressure, a urine analysis and a series of 20 blood chemistry measurements plus hematology.
“…By the time the entire process is completed the computerized results generate ‘advice’ rules that recommend further tests when needed or, depending on the urgency of any significant abnormalities, an immediate or routine appointment with a physician.
The entire record is stored by the computer as a health profile for future reference.
“Most important of all, it falls into place as the heart of a new and rational medical care delivery system.”
That last sentence helps to explain why last year 12 of the very first 13 American hospitals to be rewarded by HIMSS, the leading health IT association, for having the highest level of e-connectivity were Kaiser Permanente hospitals. This year, 24 Kaiser Permanente hospitals have achieved that status, with more on the way.
Early Computing Center at Kaiser Permanente
Great achievements start with a grand vision, followed by persistence and hard work. Garfield’s vision was indeed grand. But it did not start with the Scientific American article. It was actually 50 years ago in May that he first proposed that Kaiser Permanente embrace the computer, with the Scientific American article coming after the first 10 years of research and testing. More on that next month.
Meanwhile, if you want to read the Scientific American article, you can find the reprint in this link to The Permanente Journal. Or, if you have a copy of my book, “The Story of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care” (The Permanente Press, 2009), you will find it as Appendix 5.
