A History of MEDICAL INFORMATICS in the United States - 1950 to 1990 by Morris Frank Collen, MD, American Medical Informatics Association, BooksCraft, Inc, Indianapolis, IN © 1995, 489 pp, No price given.

Review by Del Meyer, MD

Doctor Collen, an internist at Kaiser Permanente in Oakland, became the hospital’s Chief of Medicine in 1942, the Medical Director in 1952, and the Director of the Division of Research in 1961. In the latter capacity, for 18 years he concentrated his efforts on developing computer applications to medicine. He continues as Director Emeritus of the Division of Research at the Kaiser Permanente Medical Care Program. In 1993, the American College of Medical Informatics named an Award of Excellence after him.

Dr. Collen defines informatics as the science, engineering and technology of computer hardware, software, and communications. During the past four decades, he witnessed the transition from the end of the Industrial Age to the beginning of the Information Age, which included the amazing decrease in size and increase in speed of computer systems.

He outlines some information history: In 1946, network television broadcasting began and the first US electronic digital computer was built at the University of Pennsylvania; the first biomedical researchers began using exploring computers in the 1950s; medical science began using mainframe computers in the 1960s and minicomputers in the 1970s. The English term medical informatics first appeared in 1974. In the 1980s, with the introduction of microcomputers and networks, medical informatics became pervasive.

During the late 1900s, about 95% of medical care was provided outside of the hospital. Office information systems (OIS) were generally simpler than hospital records. The first COmputer STored Ambulatory Record (COSTAR) system was initiated in 1971 at Mass General.

The International Federation for Information Processing (IFIP) was formed in 1960. One of its committees was active in medical computing and started the first MEDINFO Congress in 1974. The third MEDINFO Congress was held in 1980 in Tokyo. It was the first to be sponsored by the International Medical Informatics Association and was chaired by the author and edited by Donald A B Lindbergh, subsequently of the National Library of Medicine. The US had its first significant involvement during the 1980 Congress.

Although medical care, medical research and medical education are related, the rate of diffusion of medical informatics was different in each of these fields. Dr Collen was primarily involved in computer applications to direct patient care which is the emphasis of this volume. He feels we are only beginning to realize the profound changes that technology will have on the biomedical community.

As Donald Lindbergh, MD, Director of the National Library of Medicine states in the foreword - ..."just as Moliere’s would-be gentleman was astonished and delighted to discover that he’d been speaking prose all his life, the medical profession at large is going to discover that they have all along been using the fruits of Medical Informatics." Additional volumes of this treatise are promised.