June 28, 2010

The Tokyo Accords and the genesis of the American Medical Informatics Association

Morris F. Collen, MD

You may have heard the news this spring that every Kaiser Permanente medical facility is now equipped with KP HealthConnect®. KP has the largest private sector  electronic health record implementation in the world.

What may come as a surprise is that KP has been for half-century a leader in medical informatics — the theory, practice and “dynamo” behind today’s health e-connectivity.

Thirty years ago leading informaticians gathered in Tokyo, Japan, for the congress "MEDINFO 80."  Medical informatics was a young discipline, and Tokyo was the site of the third congress. The two previous congresses convened in Stockholm (1974) and Toronto (1977).  KP physicians participated in all three.  Our founding physician, Dr. Sidney Garfield, delivered a paper at the first congress in Stockholm.

What made the Tokyo congress different?  It was the first of the congresses to be organized by the new International Medical Informatics Association (IHEA), the formation of this mostly-European-in-membership society from a parent organization (the International Federation for Information Processing) was a sign that the field of medical informatics was maturing.

Second, Tokyo was the first of the world congresses to have significant U.S. involvement.  Kaiser Permanente’s pioneer in medical informatics, Morris F. Collen, MD, was the program chair and Donald A. B. Lindberg, MD, then at the University of Missouri at Columbia was the editor of the proceedings.  Participants from the United States delivered 51 papers in Tokyo on subjects ranging from computer-based medical records to computer-aided decision support.

By way of background, in 1980 there were two medical informatics associations in the United States with less than 500 members each: the Society of Computer Medicine (SCM) and the Society for Advanced Medical Systems (SAMS).  Each convened separate annual meetings and each held board members in common.  And because there was some duplication of effort within them, there grew within each the conviction that the field in the U.S. would be served if the two societies merged.

At Tokyo, Dr. Marion Ball a director of Computer Systems at Temple University and president-elect of SCM, and Dr. Ben Williams, the president of SAMS, formed an ad hoc meeting of members and boards to discuss “common interests and possible common future activities.”  Dubbed the “Tokyo Accords” by Williams, in these meetings lay the genesis of the American Medical Informatics Association.

The enthusiasm generated in Tokyo resulted in the First Congress of the American Medical Informatics Association (AMIA Congress 82) held in San Francisco in 1982.  The congress was organized by Dr. Collen and was sponsored by the Kaiser Foundation Hospitals, with SAMS, SCM, and IHEA and other co-sponsors.  Concurrently in the months preceding and following the congress, the American Medical Informatics Association grew up with the expressed purpose “to advance the field of medical informatics in the United States.”

So when the Kaiser Permanente Thrive ad “Connected” airs on your local station, remember the medical informatics congresses that convened in Tokyo and San Francisco over thirty years ago, and the foresight of the KP leadership to nurture the emerging field of medical informatics.