Posts Tagged ‘San Francisco’

The Tokyo Accords, Kaiser Permanente and the Genesis of the American Medical Informatics Association

posted on June 28, 2010

by Bryan Culp

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.”

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Harry Bridges and Sidney Garfield: Synergistic Collaboration

posted on March 31, 2010

Harry Bridges at ILWU meeting 1960

By Ginny McPartland
During the Cold War, the average American scorned any ideas that even hinted at socialism. Going against mainstream politics in the 1950s was fraught with danger.

Henry J. Kaiser and Sidney Garfield, MD, took their licks from the conservative medical establishment for their nontraditional ideas of health care. They were called “socialist” even though both were adamantly opposed to “socialized medicine.”  

Their contemporary– and sometimes collaborator — militant labor leader Harry Bridges was accused of being a communist, which he was not, as he fought hard and dangerously for bargaining power for dock workers.  

Marking the 20th anniversary of Bridges’s death this month brings to mind the groundbreaking 20th century achievements of these working class heroes. Despite the opposition, they didn’t back down.  

For Harry Bridges, elevating the worker to the bargaining table was a lifetime passion. His heart was with the “working stiff” who was considered almost like property of the employer before unions. “The basic thing about this lousy capitalist system,” Bridges declared, “is that the workers create the wealth, but those who own it, the rich, keep getting richer and the poor get poorer.” 

Born in Australia in 1900, Bridges was inspired by Jack London’s books to go to sea. He jumped ship on his first job because he disagreed with the skipper on the treatment of the seaman. He landed in San Francisco and soon began to organize the waterfront workers.  

His work culminated in 1934 in the San Francisco dock workers strike that resulted in the death of two men, casualties of police bullets. Union members refused to work until they could negotiate higher wages and a method of getting work on the docks without having to pay a kickback. The strikers won and Harry Bridges was set for 40 years as the president of the International Longshoremen and Warehousemen’s Union (ILWU) starting in 1937.  

“A Working Class Hero Is Something to Be” — John Lennon

By 1950, the ILWU had become a strong advocate for its members, and its leadership worked to spread unionism to other industries. The ILWU pioneered health and welfare benefits for its members. 

Enter Sidney Garfield: 
After the War when the Richmond shipyards closed, Kaiser and the Permanente doctors were ready, willing and able to take care of people. Both men had track records of providing affordable care to the working man. The health plan had been opened up to the public in 1945 but the enrollment was small. 

Enter Harry Bridges: 
It was a marriage with great potential. Bridges needed a health plan for his members and Henry Kaiser needed health plan members. Instant symbiosis.
  

In many ways, the goals of the two organizations converged. Bridges wanted all of his workers to have a health assessment and screenings to prevent disease. Kaiser Permanente’s Garfield saw how to accomplish the “multiphasic” examinations for all twenty thousand workers and later set up a way of collecting the results, at first on paper, and then in KP’s pioneering computerization of medical records. In effect, the ILWU members were guinea pigs for what has grown and expanded into KP’s electronic medical records prowess.  

Young Harry Bridges aboard ship about 1920.

Along the way, Bridges helped Kaiser Permanente by writing editorials in the ILWU newsletter supporting the health plan physicians. In 1953 Bridges assailed the San Pedro Community Hospital in Los Angeles for refusing privileges to KP doctors. In 1954, he criticized the American Medical Association for trying to block group medicine. “Group medicine is here to stay,” he wrote. 

In turn, Permanente physicians at times provided medical care on credit for striking ILWU members. Henry Kaiser was in favor of unions. In 1954, Kaiser said problems can be averted “simply by genuine recognition that the right of collective bargaining . . . is sound, essential human relations. I agreed a long time ago that unions are here to stay.” 

In 1965, Kaiser received the AFL-CIO’s highest honor for his achievements in voluntary medical care, housing and labor relations. Previous winners included former President Harry Truman and former First Lady Eleanor Roosevelt.  

To view Arlo Guthrie’s tribute to Harry Bridges on Youtube: http://tinyurl.com/y87jt34
 

Top photograph by Otto Hagel, from Men and Machines, 1963; reproduced by permission of the Center for Creative Photography; © 1998 The University of Arizona Foundation
Ship photo courtesy of ILWU Archives, Anne Rand Research Library, International Longshore and Warehouse Union, San Francisco

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