Posts Tagged ‘Morris Collen’

Rosie park in Richmond not just for Rosies

posted on May 19, 2010

By Ginny McPartland   

World War II changed everything. Women dared to strike out for the first time into a man’s world of work. America’s harbors sprouted hyperactive shipyards, and a burgeoning U.S. heavy industry turned out the steady stream of weapons and vehicles needed to outlast our enemies. “We won the war because we out-produced everyone else,” observed Lucille “Penny” Price, a Richmond, California, shipyard electrician during the war. 

Diverse shipyard workers in class

A grateful American society has been thanking the stereotypical “Rosie the Riveter” for her role in war production ever since the war ended 65 years ago. About 25 percent of the hundreds of thousands of West Coast shipyard workers were women, but the park is really dedicated to all home front workers – welders, electricians, pipe fitters, cleaners, helpers – everyone. 

Telling the “Rosie” stories, as well as chronicling the dramatic societal changes the war spawned, is the mission of the Rosie the Riveter/World War II National Historical Park in Richmond. The park sits on the Richmond waterfront where the wartime Kaiser shipyards were situated. 

Celebrating World War II’s home front legacy 

As the nation marks the 65th anniversary of the war’s end this year, the Rosie park celebrates its 10 years as an institution dedicated to keeping the lessons of World War II from being forgotten. Kaiser Permanente, whose medical care program started in the Kaiser West Coast shipyards in 1945, also celebrates its decade-long association with the park to keep the war’s legacy alive. 

The health plan’s contributions to the park’s mission will be formally recognized on Monday, May 24, when the city of Richmond and the National Park Service present Kaiser Permanente Heritage Resources Director Tom Debley with the 2010 Home Front Award. Debley is being honored for “initiatives to create and support the Rosie the Riveter/World War II Home Front National Historical Park.” 

Ambulances at the ready in Richmond

The powerful synergy of the national park-Kaiser Permanente partnership was highlighted at a recent party to raise funds for the Rosie the Riveter National Park Trust. Debley was guest speaker and gave his talk about the history of health care reform. 

About 150 people attended the annual event in the old cafeteria on the former site of Kaiser Shipyard No.3, raising $38,000 for various trust community projects. These projects include Rosie’s Girls, a summer camp for adolescent girls; restoration of Atchison Village wartime housing, which is on the National Register of Historic Places thanks to work by the Rosie trust. You can find out more about trust projects at http://www.rosietheriveter.org 

The cafeteria, an ugly duckling the day before, was transformed into a lovely swan by Saturday night. NPS Ranger Elizabeth Tucker, along with Rosie Trust dinner co-chairperson Jane Bartke and others, dressed up the place with a couple hundred posters, photos and other war era artifacts. Rosemary Blaylock, a friend of Bartke, collected products and household items that recalled a simpler time before the war. She made up see-through packets that contained wartime candies M&Ms, malt balls, and bite-size York’s Peppermint patties. 

Among the guests at dinner was a sunny Kaiser Permanente President and CEO George Halvorson and his photographer wife Lorie Halvorson; pioneering Permanente physicians Morris Collen and Ed Schoen, who treated shipyard workers; Diane Hedler, director of Quality for the Permanente Federation and Rosie trust board member; Alide Chase, senior vice president of Quality and Safety; Robert Erickson, retired chief counsel for Kaiser Foundation Health Plan and Hospitals; Glen Hentges, chief financial officer for the Permanente Federation; Clair Lisker, retired hospital nursing administrator and educator, her family including her son Wes Lisker a physician at Hayward Medical Center; John August, executive director of the Coalition of Kaiser Permanente Unions; Dianne Dunlap, August’s deputy and member of the Rosie trust board; Holly Potter, vice president, public relations and stakeholder management, Brand Strategy, Communications and Public Relations; Bill Graber, Kaiser Foundation Health Plan and Hospitals Board of Directors member; Richard Reed, senior project manager, Health Plan Process Administration; and Mark Aquino, Patient Care Services. 

Of course, the national park service was well represented by Ranger Betty Soskin Reid, our most celebrated local Rosie who worked in the shipyards and is the oldest ranger in the park system; park Superintendent Martha Lee; Ric Borjes, Chief of Cultural Resources for four Bay area park sites; and Elizabeth Tucker, park ranger and all-around get-things-done person. Other special guests of the night were Bernice Grimes, of Walnut Creek, who was a scaler at the Kaiser shipyards,  Mary Gillum, of Portland, Ore., who was a machinist in an Oregon Kaiser shipyard, and Marian Sousa, a draftswoman in Shipyard #3. 

Rosie Marian Wynn, a wartime pipe welder, Marjorie Hill, a Red Oak Victory volunteer, Amanita Cornejo, a Contra Costa College volunteer, and Marian Sousa helped with set-up and clean-up for the dinner. 

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50 Years Ago: The Birth of Computers in KP Medicine

posted on May 13, 2010

By Tom Debley

Dr. Sidney Garfield is seen in 1970 in an experimental health education center when he and his colleagues worked on his idea of "a building for health" built around the idea of central compuyting and health education.

Kaiser Permanente today is arguably the most advanced non-governmental health care organization in the country, and perhaps in the world, in the use of computers in medicine. A key historic reason for that leadership is its pioneering role. So this week we recognize the moment this work all began exactly 50 years ago.

The big lesson is that innovation did not occur through magic. It took vision, openness to new ideas, and dedicated work by thousands of people over the ensuing decades.

The result is that, at a time when electronic medical record systems have barely scratched the surface of American medicine, they are pervasive throughout Kaiser Permanente. All 8.6 million members have their own electronic medical records, which are also available throughout the organization’s 36 hospitals.

What’s more, the system’s Web-based member portal enables members to view most portions of their own medical record on line, send secure messages to their doctors, order prescriptions, make appointments, view lab results, and much more.

The critical moment when the futuristic vision of computer-enabled medical care came together with an organizational willingness to embrace new ideas came in May 1960. At a four-day leadership meeting, Sidney R. Garfield, our founding physician, was giving a report about hospital designs. Then, he shifted gears and announced, “I would like to use my remaining minutes on a more important, new concept. I want to throw this idea on the table for your consideration. Please accept it in the spirit it is given. It is a controversial idea, but please keep an open mind.”

It was a whopper.

“Let us conceive a building for health—designed, streamlined and geared to serve our healthy members. This health institute could conceivably function in this fashion. Each new health plan member would automatically and periodically be called in for service. On his first visit, a history would be taken and fed in a computer.

“A duplicate of this history would be sent to his service area. On each periodic visit or service visit, further data would be taken . . . and fed into this record. This would not only develop records never before available, but might do so at a great savings in time of physicians.”

The late Dr. John G. Smillie, who was at the meeting, commented on the discussion at the time that physicians who were there felt Garfield’s proposal “had exciting merit,” adding they said “it should be studied from many angles, and designed and redesigned… (and) should be made flexible to meet new developments…”

Dr. Morris F. Collen is seen in a photo shot for the cover of Modern Medicine magazine in 1968.

Over the next decade, the 1960s, research and testing headed by Garfield’s colleague, Morris F. Collen, MD, propelled Kaiser Permanente into a leadership role in the emerging field of medical informatics.

Within that decade, more than one million patients had early versions of electronic medical records and became more involved in their own care because of the new levels of knowledge available to them and their doctors.

“It was the first transformational aspect of looking at how the system of caring for patients could change,” recalls Dr. Marion J. Ball, author of “Consumer Informatics: Applications and Strategies in Cyber Health Care” and adjunct professor at The Johns Hopkins University School of Nursing.

Dr. Collen recognized in the early years of his work that the computer would be an incredibly important tool in modern medicine, declaring in 1966: “The computer will probably have the greatest impact on medical science since the invention of the microscope.”

Dr. Cecil C. Cutting, the first executive director of The Permanente Medical Group, challenged all physicians in 1965 to embrace the future in a talk to the American Association for the Advancement of Science.

“. . . The great challenge,” he said, “will be the willingness of traditional medicine to accept these new concepts and reorganize to provide these services. The future . . . in medicine may well rest on the open-mindedness of the doc¬tors of the country to anticipate inevitable trends and lead the way. We earnestly hope they will.”

That Kaiser Permanente was changing from a pioneer to a continuing leader in health information technology (IT) was well established by 1968, when its annual report stated: “The computer cannot replace the physician, but it can keep essential data moving smoothly from laboratory to nurses’ station, from X-ray department to the patient’s chart, and from all areas of the medical center to the physician himself.”

This early embrace of health IT – and persistent work in the half century since – explains why, as I’ve mentioned in earlier blogs, 12 of the first 13 American hospitals to be rewarded by HIMSS, the leading health IT association, for having the highest level of e-connectivity were Kaiser Permanente hospitals. This year, 24 Kaiser Permanente hospitals have achieved that status, with more on the way. Meanwhile, less than 1 percent of America’s hospitals are at this stage.

What was said of Dr. Garfield two decades ago is just as true today: “Sidney Garfield…had a way of always operating on the cutting edge of the future.”

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On the Road to KP HealthConnect®

posted on December 7, 2009

by Bryan Culp

Today Kaiser Permanente is a national leader in implementation of an integrated electronic health record.  For evidence of this see the recognition given KP at the 2009 Annual HIMSS Awards.  KP physicians and specialists, nurses, pharmacists, lab technologists – all of the allied clinical professionals – can enter and retrieve data using a computer-based patient record cradled in security at any point of service from the medical office to hospital settings. Through KP HealthConnect the member’s primary care physician and the clinicians involved in the total health care of the member can connect to information on therapies, interventions and preventive care to improve health and the quality of life.

The road that led to KP HealthConnect goes back more than forty years when a secure, electronic health record in an integrated system was an aspiration of the team at KP’s Medical Methods Research (MMR). In 1968 Morris F. Collen, MD and his team built a medical information system that peers described in the era as the most advanced of its kind. It was an aspiration of medical informaticians throughout the country, and KP was uniquely qualified to deliver on the promise.

First some background. In 1963 the MMR team used an IBM 1440 computer to store patient clinical data collected in a discrete unit involved in the early detection of disease. The fledgling information system designed for the multiphasic screening exam stored patient identification data, physician examination and patient history data, lab results, and EKG and X-ray interpretations. Programmed rules and algorithms alerted physicians to diagnostic results that fell outside of normal limits. Patient histories were accessible to physicians for comparison study throughout the life of the patient. The system also advanced epidemiological research and evidence-based protocols.

Morris Collen conferring with informatician James Sweeney of Tulane University, 1969

Morris Collen conferring with informatician James Sweeney of Tulane University, 1969

With this as a starting point, MMR aspired to design a comprehensive information system with the patient record at its core and with ancillary subsystems for the storage of pharmacy and lab pathology data; administrative information (patient identification / account services); and hospital information (admissions, bed utilization, inventories). With computing ability to store and retrieve pertinent data amassed over years, the design called for real-time reporting and 24/7 communication of essential medical data at all points of service, with robust security protocols to protect member confidentiality.

By 1969 system design had matured and the National Center for Health Services Research and Development Agency funded a five-year pilot implementation at the San Francisco Kaiser Foundation hospital and medical offices.

Within four years the San Francisco Kaiser Foundation hospital and physician offices were recording and storing patient registration data and physician diagnoses from 13 outpatient clinics for 2000 visits daily in its medical, surgical, pediatric and obstetrical clinics. Pharmacists in the outpatient pharmacies entered 1,200 prescriptions daily into the appropriate electronic patient records. A clinical laboratory subsystem handled data for 3,000 daily lab tests. Electrocardiogram, pathology and radiology reports were recorded via IBM magnetic tape-selectric typewriters. All systems data was fed via phone data line from a Honeywell mini-computer on-site in San Francisco to the central IBM computer in Oakland.

Central Computer Center, Oakland, ca. 1969

Central Computer Center in Oakland, ca. 1969

Though the project terminated in 1973 when the granting agency went out of existence informaticians viewed the KP San Francisco integrated system as a milestone achievement in medical information systems. A. F. Westin, Professor of Public Law & Government at Columbia University drew note to its distinction when he said that “few other medical institutions have moved as far in the development of a computerized medical record system.” Donald Lindberg, MD, the current Director of the National Library of Medicine, remarked: “…by far the most advanced of all American general MISs was that at Kaiser Permanente.”

See Kaiser Permanente: 50 Years of Health IT Leadership

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