You may have heard the news this spring that every Kaiser Permanente medical facility is now equipped with KP HealthConnect®.  KP has the largest private sector, integrated, electronic health record implementation in the world. 

What may come as a surprise is that KP has been for decades a leader in medical informatics – the theory, practice and “dynamo” behind today’s health e-connectivity.

Thirty years ago medical informaticians gathered in Tokyo, Japan, for the world congress “MEDINFO 80.”  Medical informatics was a young discipline then, and Tokyo was the site of the third congress, the two previous congresses having convened in Stockholm (1974) and Toronto (1977).  KP physicians and informaticians participated in all three. Among them was KP’s founding physician, Dr. Sidney Garfield, who delivered a paper at the first congress in Stockholm.

What made the Tokyo congress different?  It was the first of the congresses to be organized by the new International Medical Informatics Association (IHEA), the formation of this mostly-European-in-membership society from a parent organization of wider scope (the International Federation for Information Processing) was itself a sign that the field of medical informatics was maturing.

Morris F. Collen, MD

Second, Tokyo was the first of the world congresses to have significant U.S. involvement.  Kaiser Permanente’s Morris F. Collen, MD, a pioneer in the field of medical informatics, was the program chair and Donald A. B. Lindberg, MD, then at the University of Missouri at Columbia (currently the Director of the National Library of Medicine) was the editor of the conference proceedings.  Participants from the United States delivered a total of 51 papers in Tokyo on subjects ranging from medical information systems and computer-based medical records to computer-aided diagnosis and clinical decision support.

By way of background, in 1980 there were two medical informatics associations in the United States with less than 500 members each: the Society of Computer Medicine (SCM) and the Society for Advanced Medical Systems (SAMS).  Each convened separate annual meetings and each held board members in common.  And because there was some duplication of effort within them, there grew within each the conviction that the profession in the United States would be served if the two societies merged. 

At Tokyo, Dr. Marion Ball (then Director of Computer Systems at Temple University’s Health Sciences Center) and president-elect of SCM, and Dr. Ben Williams, the president of SAMS, formed an ad hoc meeting of members of their boards to discuss “common interests and possible common future activities.”  Dubbed the “Tokyo Accords” by Williams, in these discussions lay the genesis of the American Medical Informatics Association.

The enthusiasm generated in Tokyo resulted in the First Congress of the American Medical Informatics Association (AMIA Congress 82) held in May 1982 in San Francisco.  The congress was organized by Dr. Collen and was sponsored by the Kaiser Foundation Hospitals, with SAMS, SCM, and IHEA and other organizations acting as co-sponsors.  Concurrently in the months preceding and following the congress, the American Medical Informatics Association grew with the expressed purpose “to advance the field of medical informatics in the United States.”

So when the Kaiser Permanente Thrive ad “Connected” airs on your local station, remember the medical informatics congresses that convened in Tokyo and San Francisco over thirty years ago, and the foresight of the KP leadership to nurture the emerging field of medical informatics.

Click on the arrow to watch “Connected.”

Let me share the back story.

Recently, my colleague, Bryan Culp, and I got to spend an afternoon with Dr. Lester Breslow. He is the great public health leader in California who invented the “multiphasic exam” after World War II. The idea was to develop and use mass screening techniques to improve public health. He later became director of the California State Department of Public Health and served as dean of the School of Public Health at UCLA.

Dr. Breslow shared his memories of how an illustrious Permanente physician and classmate from the University of Minnesota Medical School, Dr. Morris F. Collen, adapted the “multiphasic exam” for use with thousands of longshoremen who joined Kaiser Permanente in 1951. Within a year, the exams were being expanded to other patients.

But the big news came in 1963-64 when, with partial support of a grant from the U.S. Public Health Service, Dr. Collen replaced paper records with a computerized “automated multiphasic screening program” that provided a total of a half million examinations in its first decade. Those were among the first computerized medical records in history and have been providing important long term medical information for researchers for more than four decades.

So, how does that relate to the new study? Well, the research findings came from tracking the medical data of members of Kaiser Permanente’s Northern California Region from 1967 to 2007 by using those very multiphasic testing records pioneered by Dr. Collen, who is widely regarded worldwide as pioneer of the field of medical informatics.

–Tom Debley