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DOCUSENT RES2ME ED 050 755 LI 002 815 TITLE Proceedings ofa Conference on Medical Intormation Systems. INSTITUTION Health Services and Mental Health Administration (DREW), Bethesda, Md. SPONS AGENCY Kaiser Foundation Hospitals, Oakland, Calif. PUB DATE Jan 70 NDTE 196p. EDRS PRICE EARS Price MF-$0.65 HC-$6.58 DESCRIPTORS *Automation, Computers, Computer Storage Devices, Conferences, Hospitals, *Information Networks, Information Processing, *Information Systems, *Medical Libraries, Prediction, Programing Languages, Records (Forms) IDENTIFIERS *Medical. Information Systems ABSTRACT The purposes of this conference are: to define the current state of technology; to identify the problems, needs and emerging technology; and to consider alternative computer _replications to multiple-facility medical information systems for the delivery of medical care and for health services research. The papers presented include:(1) General Requirements for a Medical Information System (MIS) ; (2) Evaluation Techniques for Medical Intormation Systems; (3) Evaluation of a Medical Data System;(4) Quality of Data in the Medical Record; (5) Terminology and Content of the Medical Record; (6) Targe vs Small, Single vs Multiple Computers; (7) A Statewide Medical Infor:dation System; (8) The Kaiser-Permanente Medical Information System; (9) High Level Programming Languages; (10) Acquisition and Analysis of Narrative Medical Record Data; (11) Visual Display Terminals in a Hospital Information System (HIS) ; (12) Computers and Doctors; Use and Consequences;(13) Moss Random Storage Devices and Their Application to a Medical Information System (MIS); (14) Prototype for Future Computer Medical Record.6 and(15) The Medical Information System (MIS) for 1975. (MM) MEDICAL INFORMATION SYSTEMS DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION LCN U.S. DEPARTMENT OF HEALTH. EDUCATION & WELFARE LC\ OFFICE OF EDUCATION THIS DOCUMENT HAT BEEN REPRODUCED EXACTLY AS RECEIVED FROM THE PERSON OR ORGANIZATION MG! VATING ITPOINTS OF C:0 VIEW OR OPINIONS STATED DO NOT NECES SARILY REPRESENT OFFICIAL OFFICE OF EDU L.C.N CATION POSITION OR POLICY Proceedings ofa Conferenceon MEDICAL INFORMATION SYSTEMS Morris F. M.D., Chairman Sponsored by THE HEALTH SERVICES RESEARCH CENTER OF THE KAISER-PERMANENTE MEDICAL CARE PROGRAM (NORTHERN CALIFORNIA REGION) and NATIONAL CENTER FOR HEALTH SERVICES RESEARCH AND DEVELOPMENT JANUARY 28-30, 1970 GC) SAN FRANCISCO, CALIFORNIA C\/ DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION 2 The National Center for Health Services Research and Development (NCHSRD) supports, by research grants, a number of multidisciplinary Health Services Research Centers. Each Center concentrates on one major national and international resource. Several research centers have held invitational conferences to define the leading edges of research in their selected area of interest. The proceedings of theseconferencesreflectcurrent and forefront thinking of established investigators. The following proceedings have been published or are in press. Outcomes Conference 1.11. Methodology of Identifying, Measuring, and Evaluating Outcomes of Health Service Programs, Systems, and Subsystems. California Centerfor HealthServicesResearch, University of California, Los Angeles. Dr. Lester Breslow, Director Conceptual Issues in the Analysis of Medical Care Utilization Behavior.HealthServicesResearch Center,Kaiser Foundation Hospitals, Portland, Oregon, Dr. Merwyn Green lick,Director Conference on Medical Information Systems. Health Services Research Center, Kaiser Foundation Hospitals, Oakland, California. Dr. Morris Col len, Director Conference on University Medical Care Programs. Health Services Research Center, Harvard Medical School, Boston, Massachusetts. Dr. P. M. Densen, Director Copies of these proceedings may be ordered from the individual Health Services ResearchCentersortheOfficeof Scientificand Technical Information, NCHSRD, 5600 Fishers Lane, Rockville, Maryland 20852 Liorary of Congress Catalog Card No.73-608078 3 PROGRAM of a Conference on MEDICAL INFORMATION SYSTEMS I. REQUIREMENTS, OBJECTIVES, kND EVALUATION OF A MEDICAL INFORMATION SYSTEM (MIS) Chairman:Morris F. Co lien, B.E.E., M.D. Director, Department of Medical MethodsResearch. The Permanente Medical Group and Kaiser Foundation Research Institute Requirements and Objectives Morris F Co Ilen, B.E.E., M.D. Methods of Evaluation Charles D. Flag le, D. Eng. Professor of Operations Research, The Johns Hopkins Ur.iversity Baseline Evaluation of MIS Robert H. Richart, Ph. D. Senior Health Services Analyst, Department of Medical Methods Research, The Permanente Medical Group and Kaiser Foundation Research Institute 11. THE CONTENT OF THE PATIENT RECORD TO BE INCLUDED IN A MEDICAL INFORMATION SYSTEM Chairman: David D. Rutstein, M.D. Ridley Watts Professor of Preventive Medicine, Harvard Medical School Quality of Data in the Record Alvan R. Feinstein, M.D. Professor of Medicine and Epidemiology, Yale University School of Medicine; Chief, Clinical Biostatistics and Eastern Research Support Center, West Haven Veterans Administration I, )spital Terminology and Content of the Record Burgess L. Gordon, M.D. Director, Office of Current Medical Terminology, Division or Scientific Activities, American Medical Association High Density Data for MIS Records Homer R. Warner, M.D., Ph. D. Professor and Cbdirman, Department of Biophysics and Bioengineering. University of Utah III.EQUIPMENT DESIGN AND IMPLEMENTATION FOR MIS FOB, MULTIPLE FACILITIES Chairman: Carlos Vallbona, M.D. Professor and Chairman, Department of Community Medicine, Baylor College of Medicine U Large vs Small, Single vs Multiple Compplers Cesar A. Caceres, M.D. fi.ofessor and Chairman, Department of Clinical Engineering, George Washington University Medical Center AStatewideMIS Donald A. B. Lindberg, M.D. Professor and Chairman, Department of Information Science, University of Missouri-Columbia The Kaiser-Permanente MIS Edmund E. Van Brunt, M.D. Project Chief, Medical Data System, Department of Medical Methods Research, The Permanente Medical Group and Kaiser Foundation Research Institute IV. PROGRAMMING FOR DATA STORAGE AND RETRIEVAL FOR A LARGE MEDICAL DATA BASE Chairman:Baldwin G. Lamson, M.D. Director, UCLA Hospitals and Clinics; Professor of Pathology, University of California at Los Angeles Structured vs Unstructured Information James W. Sweeney, Ph. D. Director, Computing Centers, and Professor of Epidemiology, University of Oklahoma iii High Level Programming Languages G. Octo Barnett, M.D. Director, Labori.ory of Computer Science, Massachusetts General Hospital; Assistant Professor of Medicine, Harvard Medical School Natural Language Data Management ArriAd W. Pratt, M.D. Director, Division of Computer Research and Technology, National Institutes of Health V. PHYSICIAN-COMPUTER INTERACTION, CONCEPTS AND METHODS Chairman:Jay Goldman, D.Sc. Professor and Chairman, Department of Industrial Engineering, University of Missouri-Columbia Dictation /Transcription /Magnetic Tape Robert E. Robinson, III, M.D. Director, Data Processing Development Group, Bowman Gray School of Medicine of Wake Forest University Cathode Ray Tube/Light Pen Samuel J. Singer, B. Chem. E., M.D. Senior Computing Scientist, Department of Medical Methods Research, The Permanente Medical Group and Kaiser Foundation Research Institute iv ''7 Television Tube/Keyboard Warner V. Slack, M.D. Associate Professor of Medicine and Computer SCi211CCS, University of Wisconsin Medical Center VI.PROJECTED HIGH PRIORITY NEEDS FOR MEDICAL INFORMATION SYSTEMS Chairman:William J. Horvath, Ph.D. Research Physicist, Mental Health Research Institute. University of Michigan Mass Random Storage Devices Joseph F. Terdiman, M.D., Ph. D. Senior Bio-Information Engineer, Department of Medical Methods Research, The Permanente MedicGroup and Kaiser Foundation Research Institute Prototype for Future Computer Medical Records Lou S. Davis, M.A. Manager, Computer Center, Department of Medical Methods Research, The Permanente Medical Group and Kaiser Foundation Research Institute The Medical Information System (MIS) of 1975 Bruce D. Waxman, Ph. D. Director, Health Care Technology Program, National Center for Health Services Research and De' elopment FOREWORD In December, 1968, the National Center for Health Services Research and Development granted an award to the Kaiser Foundation Research Institute to establish a Health Services Research Center. The objective of this Centeristoconduct heal thservicesresearchwithinthe Kaiser-Permanente medical care program, utilizing a medical information system which will ultimately provide a base of medical data for one million people. With the encouragement and support of the National Center for Health Services Research and Development, thisconference on Medical Information Systems was planned and conducted. The purposes of this conference were: to define the current state of technology; to identify the problems, needs and emerging technology; and to consider alternative computer applications to multiple-facility medical information systems for the delivery of medical care and for health services research. These proceedings of the conference do not contain the papers of Drs. Pratt, Sweeney, and Warner bocause their final manuscripts were not yet available at press time. Dr. Hayes substituted for Dr. Waxman as the final speaker. The National Center for Health
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