The history of the Read Codes: the inaugural James Read Memorial Lecture 2011.

General practitioner (GP) computing has its origins in the 1970s when the benefits of clinical coding and prescribing were demonstrated. During the early 1980s Dr James Read, working with Abies Informatics Ltd, developed the eponymous Read Codes, which were broader and more comprehensive than other schemes, yet intuitive and easy to use. In 1988 a joint working party of the Royal College of General Practitioners (RCGP) and the British Medical Association (BMA) recommended that the Read Codes be adopted nationally. The Read Codes have been used by almost all GPs in the UK since the mid-1990s. Many developments in general practice, including GP fundholding (where GPs held the budgets to commission elective care for their patients), the Quality and Outcomes Framework (QOF - pay for performance for improving chronic disease management) and GP commissioning (the current NHS reform in which primary care leads commissioning of services for their patients) would have been impossible without all GPs using a common clinical coding scheme. Systematized Nomenclature For Medicine - Clinical Terms (SNOMED CT) is a merger of the Read Codes with SNOMED RT - the original SNOMED reference terminology developed by the American College of Pathologists.

The New York Brain Bank of Columbia University: practical highlights of 35 years of experience.

The New York Brain Bank processes brains and organs of clinically well-characterized patients with age-related neurodegenerative diseases, and for comparison, from individuals without neurologic or psychiatric impairments. The donors, either patients or individuals, were evaluated at healthcare facilities of the Columbia University of New York. Each source brain yields four categories of samples: fresh frozen blocks and crushed parenchyma, and formalin-fixed wet blocks and histology sections. A source brain is thoroughly evaluated to determine qualitatively and quantitatively any changes it might harbor using conventional neuropathologic techniques. The clinical and pathologic diagnoses are integrated to determine the distributive diagnosis assigned to the samples obtained from a source brain. The gradual standardization of the protocol was developed in 1981 in response to the evolving requirements of basic investigations on neurodegeneration. The methods assimilate long-standing experience from multiple centers. The resulting and current protocol includes a constant central core applied to all brains with conditional flexibility around it. The New York Brain Bank is an integral part of the department of pathology, where the expertise, teaching duties, and hardware are shared. Since details of the protocols are available online, this chapter focuses on practical issues in professionalizing brain banking.

Origins of the Arden Syntax.

The Arden Syntax originated in the 1980's, when several knowledge-based systems began to show promise, but researchers recognized the burden of recreating these systems at every institution. Derived initially from Health Evaluation through Logical Processing (HELP) and the Regenstrief Medical Record System (RMRS), the Arden Syntax defines medical logic that can be encoded as independent rules, such as reminders and alerts, with the hope of creating a public library of rules. It was first vetted at an informatics retreat held in 1989 at Columbia University's Arden Homestead. The syntax was intended to be readable by clinician experts but to provide powerful array processing, which was derived largely a programming language called APL. The syntax was improved and implemented by a number of researchers and vendors in the early 1990's and was initially adopted by the consensus standards organization, the American Society for Testing and Materials.

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

OBJECTIVES: The paper presents a review of the history of medical informatics in Romania, starting from the pioneering works, relating the present, and foreseeing the future. METHODS: Major milestones of the development of this field have not been simply enumerated, but described within the specific socio-political frame, grasping the entire context over the last four decades in Romania. Two main perspectives have been traced: education and training in medical informatics and implementations in healthcare. RESULTS: Four distinctive historical periods are identified and the major events of each period are described in a critical manner. The history of the Romanian Society of Medical Informatics is presented in a separate chapter. The last section is dedicated to the present state of the field in Romania. CONCLUSION: The history of Romanian Medical Informatics spans many years and is rich in content. The Romanian Society of Medical Informatics is mainly the result of the efforts undertaken by an enthusiastic and sound professional community, trying to continue the tradition, to achieve new goals, and to work as an active member of the international biomedical/health informatics community.

Interventions for information systems introduction in the NHS.

This article provides a historical review of five long-term interventions which were undertaken within the NHS. The objective of the exercise was to examine how information systems (IS) were introduced into operational environments. The length of the interventions ranged from 9 months to almost 3 years. The five sites were all at different stages of system development and the research was carried out using a combination of participant observation and action research. The research question asks, 'How can organizations think about and hence go about their information provision in such a way that successful IS are introduced?'

Individualization, globalization and health--about sustainable information technologies and the aim of medical informatics.

This paper discusses aspects of information technologies for health care, in particular on transinstitutional health information systems (HIS) and on health-enabling technologies, with some consequences for the aim of medical informatics. It is argued that with the extended range of health information systems and the perspective of having adequate transinstitutional HIS architectures, a substantial contribution can be made to better patient-centered care, with possibilities ranging from regional, national to even global care. It is also argued that in applying health-enabling technologies, using ubiquitous, pervasive computing environments and ambient intelligence approaches, we can expect that in addition care will become more specific and tailored for the individual, and that we can achieve better personalized care. In developing health care systems towards transinstitutional HIS and health-enabling technologies, the aim of medical informatics, to contribute to the progress of the sciences and to high-quality, efficient, and affordable health care that does justice to the individual and to society, may be extended to also contributing to self-determined and self-sufficient (autonomous) life. Reference is made and examples are given from the Yearbook of Medical Informatics of the International Medical Informatics Association (IMIA) and from the work of Professor Jochen Moehr.

An Opening Chapter of the First Generation of Artificial Intelligence in Medicine: The First Rutgers AIM Workshop, June 1975.

The first generation of Artificial Intelligence (AI) in Medicine methods were developed in the early 1970's drawing on insights about problem solving in AI. They developed new ways of representing structured expert knowledge about clinical and biomedical problems using causal, taxonomic, associational, rule, and frame-based models. By 1975, several prototype systems had been developed and clinically tested, and the Rutgers Research Resource on Computers in Biomedicine hosted the first in a series of workshops on AI in Medicine that helped researchers and clinicians share their ideas, demonstrate their models, and comment on the prospects for the field. These developments and the workshops themselves benefited considerably from Stanford's SUMEX-AIM pioneering experiment in biomedical computer networking. This paper focuses on discussions about issues at the intersection of medicine and artificial intelligence that took place during the presentations and panels at the First Rutgers AIM Workshop in New Brunswick, New Jersey from June 14 to 17, 1975.

The origins of informatics.

This article summarizes the origins of informatics, which is based on the science, engineering, and technology of computer hardware, software, and communications. In just four decades, from the 1950s to the 1990s, computer technology has progressed from slow, first-generation vacuum tubes, through the invention of the transistor and its incorporation into microprocessor chips, and ultimately, to fast, fourth-generation very-large-scale-integrated silicon chips. Programming has undergone a parallel transformation, from cumbersome, first-generation, machine languages to efficient, fourth-generation application-oriented languages. Communication has evolved from simple copper wires to complex fiberoptic cables in computer-linked networks. The digital computer has profound implications for the development and practice of clinical medicine.

Human computers: the first pioneers of the information age.

Before computers were machines, they were people. They were men and women, young and old, well educated and common. They were the workers who convinced scientists that large-scale calculation had value. Long before Presper Eckert and John Mauchly built the ENIAC at the Moore School of Electronics, Philadelphia, or Maurice Wilkes designed the EDSAC for Manchester University, human computers had created the discipline of computation. They developed numerical methodologies and proved them on practical problems. These human computers were not savants or calculating geniuses. Some knew little more than basic arithmetic. A few were near equals of the scientists they served and, in a different time or place, might have become practicing scientists had they not been barred from a scientific career by their class, education, gender or ethnicity.

[Internationalism and science. Social and scientific bases of the European information science movement]. / Internacionalismo y ciencia. Las bases sociocientíficas del movimiento documental europeo.

As part of a continuing line of research on scientific documentation we propose in this article a novel approach to the study of the European information science movement at the end of the nineteenth and beginning of the twentieth centuries. We suggest that this movement took place within the context of increasing internationalism of scientific endeavours, a process which was paralleled by the standardization of units, weight and measures for the different sciences. We investigate problems arising from scientific communication in connection with other aspects apparently unrelated to Information Science. Specifically, we refer to conflicts between nationalism and colonialism; concordance and discord between science policy and the corporate interests of nonscientific associations; higher educational policy; the professionalization of sciences; and the economic interests at stake as a consequence of the use of different information models.

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record.

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software--over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done.