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History of Romanian Medical Informatics: Learning from the Past to Reshape the Future George I

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History of Romanian Medical Informatics: Learning from the Past to Reshape the Future George I 243 © 2018 IMIA and Schattauer GmbH History of Romanian Medical Informatics: Learning from the Past to Reshape the Future George I. Mihalas1, Lacramioara Stoicu-Tivadar2 1 Academy of Medical Sciences, Timisoara Branch, Romania 2 University Politehnica Timisoara, Romania Summary 1 Introduction 2 Historical View on Medical Objectives: The paper presents a review of the history of medical Medical informatics, as an interdisciplinary Informatics in Romania informatics in Romania, starting from the pioneering works, domain, has developed in the second half relating the present, and foreseeing the future. of the last century as a natural application 2a Pioneering Period Methods: Major milestones of the development of this field have of computer science technology in various The socio-political context during the late not been simply enumerated, but described within the specific fields, including healthcare. However, the 60’s and the beginning of the 70’s in Roma- socio-political frame, grasping the entire context over the last relationship with the bio-medical domain nia was favourable to the promotion of new four decades in Romania. Two main perspectives have been had some unique features, transforming areas, especially those linked to technological traced: education and training in medical informatics and imple- medical informatics into one of the most developments. The communist party was mentations in healthcare. dynamic disciplines, unveiling new as- committed to demonstrate the capacity to cope Results: Four distinctive historical periods are identified and the pects, raising new problems, facing new with the worldwide technological advent and major events of each period are described in a critical manner. challenges, pushing the development of computer science was among the areas which The history of the Romanian Society of Medical Informatics is new technologies, and promising high- enjoyed strong official support. The emphasis presented in a separate chapter. The last section is dedicated to er care quality and new approaches to was on industrial applications; however, a the present state of the field in Romania. healthcare and adjacent fields. Moreover, couple of small research groups were created, Conclusion: The history of Romanian Medical Informatics spans besides the fast-technological advent, the approaching various topics, including medical many years and is rich in content. The Romanian Society of major socio-political changes of the last applications of computer science research, e.g. Medical Informatics is mainly the result of the efforts undertaken two decades of the 20th century, especially Dan Farcas and Vasile Baltac from Timisoara by an enthusiastic and sound professional community, trying to in Europe, left their mark over the devel- worked on the modelling of inter-neuronal continue the tradition, to achieve new goals, and to work as an opment of medical informatics in various connections [3], and Mihai Angelescu and active member of the international biomedical/health informatics countries. Therefore, a historical approach Nicolae Mihalas in Arad proposed a diag- community. to our domain should not be reduced to a nosis system for gastrointestinal diseases1. mere list of events, actions, or people, but However, the impact of such research was Keywords should rather interpret them, highlight the low and collaborations with scientists from Medical Informatics/history; technology development; education; major achievements, and trace the trends other countries were very difficult; we only health information systems; Romania throughout each period [1]. had access to some East European scientific Our paper attempts to offer the reader journals and the participation in international Yearb Med Inform 2018:243-51 such a view over the birth and development scientific events was very limited. Actually http://dx.doi.org/ 10.1055/s-0038-1641203 of medical informatics in Romania within its almost any external individual contact could specific socio-political environment, with its raise suspicions of a hidden illegal activity. ups and downs, marking the milestones, and All external contacts had to be initiated, or, at analysing the present state. For the historical least, approved by the authorities. part, we followed the staging proposed in Things started to partially change after a [2], presenting the difficulties encountered seminar on medical applications of infor- at the beginning, the efforts conducted to matics organized in 1969 in Bucharest for promote research and education, the role of the leading staff of the MoH by IBM’s Vien- industry, the relations with governmental na branch where speakers from Karolinska institutions, and international collaborations and activities. The last part presents our re- 1 The program was presented in a regional cent activities and plans for the near future. conference without printed volume. IMIA Yearbook of Medical Informatics 2018 244 Mihalas et al. University, Sweden, were invited. Soon after, The Computer Centre of the Ministry supported by Jan van Bemmel and other the Centre of Statistics of the MoH was creat- of Health was equipped in 1976 with a Fe- scientists, to organize yearly meetings in ed; later it became the Computer Centre of the lix-256 computer (the Romanian version of Prague (period 1985-1990). The location MoH and a leading institution involved in the IBM-360), used mainly for health statistics was excellent: beyond the “iron curtain”, implementation of information technology in and hosting various databases. In 1978, the inside the communist block, accessible to the Romanian healthcare system [4]. newly created Central Institute of Informatics people from Eastern Europe, but also close In the early 70’s, the political context resulting (ICI) - the official coordinator of all nation- and easily accessible from Western European from Romania’s position against the invasion al programs dedicated to the introduction countries [1]. of Czechoslovakia generated an enthusiastic of information technology in all domains By 1985, the Computer Centre of the atmosphere, which, unfortunately, lasted only (industry, transport, local administration… Ministry of Health, led by Dr. Ovidiu a couple of years. In that period, most central etc.) - initiated an ambitious project - SIROS Popescu, started a series of courses (similar institutions and territorial authorities were (Information System for Healthcare), planned to nowadays Continuous Medical Education equipped by computer centres. Education to be structured in three levels: central, ter- - CME programs) for the medical staff from and training of professionals in this new area ritorial, and healthcare units. Unfortunately, the whole country, following the course became a real need; informatics became a this project proved to be too expensive and structure we offered to medical students in mandatory discipline in almost all technical unrealistic; only a couple of components at the Timisoara, and adding some specific ap- schools yielding a new generation of well-pre- central level were completed and, eventually, plications for healthcare units and hospital pared computer scientists. The fast devel- ICI abandoned the project [4]. However, the management. These courses were developed opment of information technology imposed idea of creating a national information sys- by Dr. Dan Farcas and his team. The main frequent “update meetings”, transformed into tem for healthcare remained on the list of the merit of these courses was their contribution annual scientific conferences “Informatics future projects of the Romanian leadership. to raising the awareness about the potential for Management”, which started in 1975 By the beginning of the 80’s, the Institute use of information systems in healthcare, as in Cluj-Napoca. In 1977, the third edition of Medicine in Timisoara (today “Victor most of the attendants of these courses had of the conference introduced a new section Babes” University of Medicine and Pharma- leading positions either in hospitals or at the dedicated to medical applications, held as a cy) managed to obtain an M-18 microcom- level of local healthcare authorities. separate National Symposium in Satu-Mare, puter for research purposes, especially in In the late 80’s, some hospitals (Clinical thus marking the first official event solely preclinical disciplines (biophysics, normal Hospital “Fundeni” and Military Hospi- dedicated to medical informatics in Romania. and pathological physiology, pharmacology tal in Bucharest, Town Hospital Borsa in etc.). A library of statistical programs was Maramures county, District Hospitals in developed. This had a major impact, espe- Tirgu-Mures and Craiova…etc.) started to cially among the young staff of the university, develop components of hospital information 2b Childhood and Youth Period with several doctorate-level students also systems: patient databases, early forms of The first National Symposium of Medical expressing their desire to learn how to process electronic health records (EHRs), hospital Informatics in Satu-Mare (1977), coordinated their experimental or clinical data by them- resource management, personnel databases… by Dr. Virgil Enatescu, was a milestone in selves. This context created the conditions etc. But the most significant work was per- Romanian medical informatics. It gathered to propose a course of medical informatics formed in medical research, mainly in univer- around a hundred of participants (physicians, to medical students. After overcoming some
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