A Father's Reflections

The whole field of health I.T. might look quite different without Morris Collen, the "father of medical informatics," who turned 100 on November 12. Back in 1961, Collen, one of the eight original physicians of Kaiser Permanente, represented the organization at a meeting in New York about using computers in medicine. "My brain got all fired up," he says. He soon established Kaiser Permanente's Medical Methods Research, which became the internationally renowned Division of Research. He started tracking the health status of thousands of Kaiser Permanente patients with an IBM mainframe and stacks of punch cards. "I decided to use the computer to develop a system for preventive care and evaluation of new members," he says. "I was concerned about using the computer for sick patients, because we didn't have experience in that, so using it for healthy patients seemed to be the way to start." The system had early clinical decision support rules to let patients know if they should be further screened for diabetes, heart disease or cancer. Collen also wrote A History of Medical Informatics in the United States, 1950-1990, which he's now updating. He has consulted with the Division of Research since his formal retirement in 1983, and still goes in occasionally. HDM talked with him about the evolution of health care informatics, and work still to be done.

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