I never cease to marvel at how fear of computers is debated in American medicine after 50 years.
Indeed, sometimes contemporary news and commentaries remind me of why I decided to write a new biography of Sidney R. Garfield, MD, who was a revolutionary figure on a number of fronts in 20th century medical history. His legacy, of course, is Kaiser Permanente, where 8 million people now have electronic medical records because of the work he started in 1960.
As one medical historian has observed, Garfield created “a medical program that changed the face of U.S. health care.” What brought all this to mind as a way to launch our new history blog was an exchange of opinions a few months back in the New York Times. Said a medical school professor: “The computer depersonalizes medicine,” adding that “before we embrace the inevitable, there should be more discussion and study of electronic records.” Commented another professor, from another medical school, “I must agree wholeheartedly … the presence of a computer in the exam room is more of a detriment than an advantage.”
Wow! I almost spilled my morning coffee! Dr. Garfield rejected such ideas starting in 1960 — a half century ago. An electronic medical record, he said, can “give the physician a much sounder base for better doctor-patient relations than he has today.”
The view was cemented as a Kaiser Permanente philosophy by 1968, when its Annual Report focused on its work to take full advantage of new technologies and stated, “The computer cannot replace the physician, but it can keep essential data moving smoothly from laboratory to nurse’s station, from X-ray department to the patient’s chart, and from all areas of the medical center to the physician himself.”
Thus, Kaiser Permanente joined a handful of others in launching the first medical computing experiments in history, which is why today it can maintain the largest system of civilian electronic health records, serving doctors and their patients in the world. And why, in the 1990s, we did the earliest research establishing that the computer in the exam room does not interfere with the doctor-patient relationship.
Dr. Garfield truly was a visionary. If you are interested in knowing more about him, my new biography is called “The Story of Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care” (The Permanente Press, 2009). It can be ordered directly from the publisher or through other retailers.